[Medical rehabilitation in nursing home--effects on functional outcome and use of the services]. / Medisinsk rehabilitering i sykehjem--effekt på funksjon og forbruk av tjenester.

BACKGROUND: Improved functioning is a primary objective in nursing homes. MATERIAL AND METHODS: A total of 146 patients participated in the study, 116 for rehabilitation and 30 for respite care. 122 were admitted from home, 23 from hospital and one from a full-time care facility. The mean age was 78. The multi-disciplinary team consisted of a geriatrician, registered nurses and auxiliary nurses, an occupational therapist, a physical therapist and a speech therapist. Assessments were made before admission and about two months after discharge. The mean number of days in the nursing home was 35 (28-42 days). RESULTS: A total of 141 were able to resume living at home, whereas five were discharged to permanent care in a nursing home. At the follow-up, gait was improved for 23, was unchanged for 121, and had deteriorated in two (p < 0.001). Of the 21 patients who had been confined to wheelchairs or were bedridden, eight were now able to walk. Regarding change in ADL functions, only personal hygiene reached statistical significance (p < 0.05). Perceived global coping was improved for rehabilitation patients (p = 0.05). No significant changes in mental functioning or in the use of nursing services were found. The average number of hours of home help was reduced from 3.3 to 2.7 a week (p = 0.01). INTERPRETATIONS: The most notable effects were improved mobility and decreased dependence on home-help services.

[Project geriatric outpatient clinic. A study on geriatric outpatient clinics and patient basis]. / Prosjekt geriatrisk poliklinikk. En studie om geriatrisk poliklinikk og pasientgrunnlaget.

In 1996 PROJECT: geriatric outpatient clinic was initiated by the Ministry of Health and Social Affairs. The purpose was to collect more extensive information about geriatric outpatient clinics in Norway with regard to organization of the clinics, the types of activities and the clinics and the patients attending them. Information on the activities in 1995 was collected, and a summary prepared. Detailed records were made of the activities at 15 geriatric outpatient clinics during March 1996: 288 initial contacts and 239 repeat contacts were recorded. Assessment for mental impairment and multimorbidity constituted 41% of the referrals. The average number og patients per opening hour was rather low: 0.7 (range 0.08-2.5). The pay-back for the hospital was low and there was little incentive to operate the clinics.

Lp(a) lipoprotein level and longevity.

Lp(a) lipoprotein forms a distinct class of serum lipoproteins. Its unique immunochemical properties are caused by the Lp(a) polypeptide chain which is attached to apolipoprotein B (apoB) by a disulfide bridge. The level of Lp(a) lipoprotein is under strict genetic control. It is well established that a high level of Lp(a) lipoprotein is a genetic risk factor for atherosclerotic disease, particularly coronary heart disease (CHD). Since cardiovascular disease is one of the major causes of death there should be a shortage of people with genetic determinants of cardiovascular disease in people who are very old and still have adequate physical and mental capacities. The authors have studied Lp(a) lipoprotein levels in 102 persons who were 83 years or older when blood samples were drawn. This study group was a subpopulation of a series comprising 456 persons who had been 80 years or older at intake in an intervention study of old people living at home. Only those without physical or mental incapacities were included in the present study. There was a striking shortage of persons with an Lp(a) lipoprotein level higher than the 75th percentile of the general population in this series of people who had achieved successful ageing. The highest value observed among the old people corresponds to the 88th percentile of the general population. It is highly unlikely that the present observations reflect chance events or fall in Lp(a) lipoprotein levels in people who had higher levels at a younger age. The most likely explanation of our finding is that a sizeable fraction of people with high Lp(a) lipoprotein levels die before reaching a very high age.(ABSTRACT TRUNCATED AT 250 WORDS)

[Normal aging--causes, consequences]. / Den normale aldring--årsaker, virkninger.

Genetic mechanisms influence the aging process. The DNA-repair influences the longevity of a species, and the DNA molecule may be altered by free radicals. Cellular degeneration because of aging occurs in subpopulations of cells, and leads to age changes in the tissues, organs and the whole organism. There is a hierarchy in the way functional capacity declines in old age. Normal and pathological changes are difficult to distinguish in old age. Multi organ failure may lead to vague disease manifestations. In old individuals there is often degenerative age changes in many vital organs, but no definite cause of death found by autopsy. In order to improve the functional ability, individual training is one strategy, the other is to adjust the environments to improve the coping ability despite of disease and old age.

Intervention studies among elderly people.

There are not many reports of Nordic intervention studies on the health and medical care of the elderly. Nevertheless much knowledge about old age is available and should be applied in practice under controlled conditions. In this overview article the authors present some experience from four of the Nordic countries to encourage further intervention studies, and focus some important aspects to be taken into consideration.