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The impact of ADL-status, dementia and body mass index on normal body temperature in elderly nursing home residents
Linköping University, Department of Medicine and Health Sciences, Clinical Physiology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
2002 (English)In: Archives of gerontology and geriatrics, ISSN 0167-4943, Vol. 35, no 2, 161-169 p.Article in journal (Refereed) Published
Abstract [en]

A subset of seniors might demonstrate a lower body temperature compared with younger subjects. However, data on normal body temperature in seniors are sparse. The aim of the study was to study normal body temperature with a view of predicting factors of low body temperature in non-febrile seniors. Elderly women (n=159) and 78 men, aged ≥65 years, living in community resident homes were included in the study. Data on chronic diseases and medication were collected from medical records. Tympanic and rectal temperature was measured twice daily; once at 7–9 AM and then at 6–8 PM. In addition, body mass index (BMI), activities of daily living (ADL) status, as well as details regarding dementia and malnutrition were recorded. The variation in tympanic and rectal temperatures ranged from 33.8 to 38.4 °C and 35.6 to 38.0 °C, respectively. ADL status, dementia and BMI were significantly related to lower and analgesic to higher tympanic temperature. Dementia was significantly related to lower rectal temperature. Therefore, dementia, BMI, ADL status and analgesic shall not be overlooked when assessing temperature in seniors. More research is needed to further clarify the influence of these predictive factors, as well as the impact of BMI and malnutrition.

Place, publisher, year, edition, pages
2002. Vol. 35, no 2, 161-169 p.
Keyword [en]
Dementia, Activities of daily living status, Body mass index, Normal body temperature in elderly
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13663DOI: 10.1016/S0167-4943(02)00019-5OAI: diva2:21128
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2009-06-04
In thesis
1. Measurement and evaluation of body temperature: Implications for clinical practice
Open this publication in new window or tab >>Measurement and evaluation of body temperature: Implications for clinical practice
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim was to explore factors influencing the normal variation and measurement of body temperature. Additional aims were to study morbidity, mortality and the clinical presentation of pneumonia and predictors for survival in elderly nursing-home residents. Two hundred and thirty seven non-febrile nursing home residents (aged 66-99 years) and 87 healthy adults (aged 19-59 years) were included. In elderly individuals, the morning ear and rectal body temperature was measured at baseline and pneumonia and survival was observed at one- two and three-year. In healthy adults the rectal, ear, oral and axillary temperature were measured simultaneously on one morning and repeated measurements were performed in three subjects.

Overall, the range of normal body temperature was wider then traditionally stated. In elderly nursinghome residents, functional and cognitive impairment and BMI < 20 were related to a lower body temperature and medication with analgesics to a higher. Compared to adults < 60 years elderly persons had a higher average ear and a lower rectal temperature. Men and postmenopausal women < 60 years had lower body temperature than premenopausal women. The repeated measurements showed a wide individual variability irrespective of the site of measurement, and that replicated measurements do not improve accuracy. When comparing the rectal temperature with oral, ear and axillary readings the average difference was > 0.5°C with a wide individual variation.

The yearly incidence of nursing-home acquired pneumonia varied between 6.9% and 13.7%. Functional impairment, chronic obstructive pulmonary disease (COPD) and male sex were related to a higher risk of acquiring pneumonia and presenting non-specific symptoms were common. Age and functional impairment predicted mortality, irrespective of gender, while cerebral vascular insult, a lower body mass index and malnutrition in women and heart disease, COPD, medication with sedatives and mortality rate index in men were gender specific predictors. Surviving women had a higher baseline body temperature than non-surviving, while no such difference was found in men.

When assessing body temperature, it is important to consider the site of measurement, technical design, operator technique, age and gender and, in elderly nursing-home residents, physical and cognitive impairment, body constitution and medication with analgesics. The best approach is to use an unadjusted mode, without adjusting to another site. To prevent a delayed diagnosis of pneumonia, one should be aware of a low baseline body temperature and lack of specific clinical symptoms in elderly nursing-home residents. Preserving and/or improving functional, cognitive, nutritional status and preventing agitation and confusion would improve survival in nursing-home residents.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. 54 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 872
Assessment, body temperature measurement, elderly, evaluation, infection, nursing home, pneumonia, survival
National Category
Medical and Health Sciences
urn:nbn:se:liu:diva-5200 (URN)91-7373-848-4 (ISBN)
Public defence
2004-12-02, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Available from: 2004-12-19 Created: 2004-12-19 Last updated: 2012-01-25Bibliographically approved

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Sund-Levander, MärthaWahren, Lis Karin
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