1,720,986 research outputs found
Health care utilization among elderly according to body mass index and risk of malnutrition
Get PDFBackground: Malnutrition is prevalent among elderly, and this trend is projected to continue due increased life expectancy and more so, malnutrition has been attributed to morbidity and mortality. Further, investigations reveal that malnutrition is associated with prolonged hospital stay, use of emergency services and long term care services. The association between health care utilization and malnutrition will be explored in this study. Method: The study material was collected from the Tromsø 6 cross-sectional study. The study population is comprised of 4017 elderly women (53.5%) and men (46.5 %) aged ≥65 years. The assessment of malnutrition was effectuated by using the body mass index (BMI) and the Malnutrition Universal Screening Tool (MUST). The BMI was classified in to six categories, while the MUST derived three MUST score categories 0, 1, and 2+. The score 1 and 2+ indicated medium and high risk respectively. While taking into consideration some socio-economic and demographic variables, the exploration of the association between health care utilization (visit to GP or medical specialist last year or surgery the last three years) and nutritional assessment variables was accomplished using cross tabulation, analysis of variance (ANOVA) and logistic regression.
Results: The respondents in the higher BMI categories were most likely to visit the GP, but no relationships were found between BMI and use of medical specialist or surgery during the last three years. Inconsistent associations were seen regarding risk of malnutrition and GP consultations, but there were indications that increased risk of malnutrition was associated with higher odds of surgery during the last three years and visit to the medical specialist last year. Discussion: The results suggest that BMI and MUST score is related to selected indicators of health care utilization, but in different directions. The cross-sectional design of the study limits the possibility for conclusions regarding causality. The results may also suggest that elderly subjects at high risk for malnutrition do not get sufficient attention in the primary health care. Search words: elderly, malnutrition, health care utilization, BMI, MUS
A longitudinal study of the changes in BMI, waist circumference, waist-to-height-ratio and desired BMI of the participants in the 4th, 5th and 6th survey of the Tromsø Study.
Get PDFBackground: prevalence of obesity and overweight continues to increase in Norway, and more in young than old. This thesis has sought to describe the changes in BMI, with supplementary analyses of WC and WHtR, over a 13-year period. Furthermore, desired BMI (DBMI) has been analysed to assess whether the discrepancy between weight and desired weight is dependent on BMI categories of normal weight, overweight or obese. Methods and materials: The thesis has used data from the Tromsø Study, specifically surveys 4 (T4), 5 (T5) and 6 (T6). The material has been analysed both cross-sectionally and longitudinally, and so the population available for analyses depends upon participation in the different surveys. Results: The results show that BMI increased over the 13-year study period in both genders and all age groups but those aged 70-74 in T4. Increase was significantly associated with age at baseline, with a negative trend of BMI-increase with increasing age. A similar pattern applies for WC and WHtR. DBMI increased in all age groups of both genders, but the increase of DBMI was less than that of BMI during the period.
Conclusion: Between T4 and T6, BMI increased in all age groups of both genders, an increase which is also evident in WC and WHtR. The analyses of BMI from the longitudinal cohort of T4, T5 and T6 indicate that the best part of the increase occurred between T4 and T5. The difference between BMI and DBMI is different between BMI categories, with normal weight people expressing low discrepancy between BMI and DBMI. The results confirm and extend previous knowledge on development of BMI in the Norwegian population
Age at menarche. The reproducibility of self-reported menarcheal age and the association between age at menarche and total- and cardiovascular mortality - The Tromsø Study
Get PDFBackground: The possible relationships between age at menarche and total as well as cardiovascular mortality has been investigated, but has not been established.
Aim: The first aim was to investigate the reproducibility of self-reported menarcheal age from 1986-1987 (Tromsø 3) to 1994-1995 (Tromsø 4). The second aim was to examine the association between age at menarche and cardiovascular- or all-cause mortality.
Methods: This is a prospective cohort based on data from the Tromsø study. Follow-up for reproducibility purpose was 7 years. Pearson’s correlation analysis and Bland Altman plot was used in the reproducibility study. In the investigation of all-cause and cardiovascular disease mortality follow-up was from date of attending Tromsø 4 until 30.06.2015 (mean follow up on 18.7 years) and until 31.12.2012 (mean follow-up on 16.7 years), respectively. Cox survival analysis was used to investigate the association between menarcheal age and mortality.
Results: Reported menarcheal age in Tromsø 4 was significantly related to that reported in Tromsø 3 (r = 0.84, p <0.001). Mean difference in reported menarcheal age was negligible, 0.01 years. A total of 2203 women died during the follow up in the investigation of all-cause mortality. During the follow up of cardiovascular mortality, 654 women died from cardiovascular disease (184 from stroke, 250 from ischemic heart disease and 220 from other cardiovascular related causes). There was no association between age at menarche and total mortality after adjusting for confounding factors. For total cardiovascular mortality there was an indication of a weak positive linear relationship after adjustments. One year increase in age at menarche was associated with 7 % increased cardiovascular mortality (HR: 1.07, 96% CI: 1.01 – 1.14, p =0.03).
Conclusion: Self-reported age at menarche in Tromsø 4 was strongly correlated with that reported in Tromsø 3, both when combined and in stratified age-groups. A positive linear trend was observed between menarcheal age and cardiovascular disease mortality after adjusting for confounding factors
Gir utdanning lavere diabetes-prevalens og lavere nivå av glykosylert hemoglobin (HbA1C)? En tverrsnittsstudie fra Tromsøundersøkelse IV 1994/ 95.
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Bakgrunn: De fleste som har diabetes i Norge har diabetes type 2. Antall personer med denne sykdommen forventes å øke. Overvekt, fysisk inaktivitet og usunne vaner øker risikoen for diabetes. Diabetes og dens relevante risikofaktorer følger en sosial gradient hvor de med lavest utdanning har høyest risiko.
Materiale og metode: Data i oppgaven er hentet fra Tromsøundersøkelse IV, og baserer seg på spørreskjema og en liten klinisk undersøkelse. Vi har inkludert 20084 personer med data om utdanningslengde og selv-oppgitt diabetes i analysen. Vi har ekskludert personer under 35 år og de som oppgir å ha fått diabetes før 35-års alder fra analysen. Det er i hovedsak diabetes type 2 vi studerer. I analysene av relasjoner mellom utdanningslengde og HbA1c er også personer som oppgir å ha diabetes blitt eksludert.
Resultat: Det er en signifikant sammenheng mellom diabetesprevalens og utdanningslengde for begge kjønn, med sterkest sammenheng for kvinner. For kvinner er det en signifikant sammenheng med HbA1c-nivå og utdanningslengde justert for noen faktorer. I en mer omfattende analyse var det ingen signifikant sammenheng. For menn er det ingen signifikant sammenheng med HbA1c-nivå i noen analyser. Det er signifikant sammenheng mellom relevante risikofaktorer og utdanningslengde for begge kjønn.
Konklusjon: Diabetesprevalens og risiko for diabetes reflektert i økt HbA1c-nivå varierer med utdanningslengde. Resultatene våre viser signifikante sammenhenger som består etter justering for livsstil. Dette tyder på at et ønske om å redusere sosiale ulikheter i helse i tillegg til å fokusere på den enkeltes levevaner, må inkludere tiltak på samfunnsnivå som bidrar til utjevning av ugunstige levekår.
Nøkkelord: Diabetes, HbA1c, risikofaktorer, sosioøkonomisk status, utdanningslengde
Klimaendringer og vektorbåren sykdom. En litteraturstudie om mulig effekt av klimaendringer på malaria, denguefeber og flåttbåren sykdom.
Get PDFFNs klimapanel er klare i sin konklusjon. Klimaendringer er faktiske, og man må forberede seg på endrede leveforhold, i hele verden. Blant utfordringene med å spå fremtiden, finner man vektorbåren sykdom. På grunn av kompleks økologi som inkluderer mikrobe, vektor og vert, kan det være verdifullt å undersøke i hvilken grad de påvirkes av endret klima. I denne oppgaven har man sett nærmere på hvorvidt sykdommene denguefeber, malaria, Lyme borreliose og skogsflåttencefalitt påvirkes av endrede klimatiske forhold. Relevant litteratur er innhentet og analysert. Alle fire sykdommer er på fremmarsj enkelte steder i verden, selv om malaria globalt sett har en minkende insidens. Dette skyldes ikke ene og alene klimaendringer, men spesielt økt temperatur er med å bidra til gunstige forhold for sykdommene. I tiden fremover kan man forvente økt forekomst, spesielt i randsonene av i dag endemiske områder. Migrasjon, krig og konflikter sekundært til klimaendringer kan også bidra til økning. Dette legger nok en stein til den byrden klimaendringer gir. Man bør globalt gjennomføre tiltak i henhold til FNs klimapanels rapporter
Fett eller muskler - ett fett for beinmassen? : sammenhenger mellom fett- og muskelmasse og beintetthet (BMD), en tverrsnittsstudie basert på befolkningsundersøkelsen Tromsø V
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This thesis evaluates how fat body mass (FBM) and lean body mass (LBM) influence bone mineral density (BMD) in total body, weight bearing and non-weight bearing parts of the skeleton. It is a cross-sectional study based on absorptiometry data from a large population based study (Tromsø V). The project involved an initial quality control of the data, and includes data from 1354 men and women aged 32-87 in 2001.
The result shows that both FBM and LBM are independent predictors of BMD. One kilogram increase in LMB gives larger increase in BMD than one kilogram increase in FBM. Both have a positive influence on BMD in weight bearing parts (whole body and hips), whereas for non-weight bearing parts (forearm), only LBM is significant. This may indicate that the mechanical force generated by action of muscles have an additional effect on BMD other than the gravitational force from the body mass itself.
The hip fracture incidence in the Norwegian population is among the highest in the world, and the proportion of elderly people in the population is increasing. Risk of fracture increases with age and it is a clear correlation between BMD and this risk. Improved knowledge of patterns and processes relevant for reducing the incidence rate is therefore important in order to improve public health.
Keywords:
Bone Mineral Density (BMD), distal forearm, total hip, total body, body mass, fat body mass (FBM, lean body mass (LBM), body composition, Dual-energy X-ray absorptiometry (DEXA), population stud
Insidens av atrieflimmer i Tromsøundersøkelsen 1986-2011
Get PDFAtrieflimmer (AF) er den vanligste arytmien i hjertet. Den har sitt utspring i atriene, og er derfor klassifisert som en supraventrikulær arytmi. Tidligere studier har vist at AF har en klar sammenheng med økende alder, og at menn har hyppigere insidens enn kvinner. I denne oppgaven ønsket vi å studere hvordan insidensen av AF i Tromsøundersøkelsen forandret seg fra 1986 til 2011. Vi ønsket også å se hvordan utviklingen var fordelt på kjønn. Noen studier som har beskrevet utviklingen av AF insidens over den samme tidsperioden som vi studerte har vist en liten økning i aldersjustert insidens for begge kjønn, mens noen andre studier har ikke vist noen økning i aldersjustert insidens i den samme perioden. Studiepopulasjonen vår var hentet fra Tromsøundersøkelsen. Vi delte studieperioden inn i tre bolker, 1986-95, 1996-05 og 2006-11. Vi brukte en metode der vi delte opp en persons deltakelse i linjer på ett år, som muliggjør skifte av aldersgruppe ettersom personen blir eldre. Indirekte aldersjustert insidens per 1000 personår for menn i de tre periodene var 2,51, 3,89 og 3,89. For kvinner var de tilsvarende ratene 1,07, 2,39, og 2,36. Vi bekreftet dermed at menn hadde hyppigere insidens enn kvinner. Det var også en klar økning i insidens med økende alder. Vi har også vist at det var en økning i insidens for begge kjønn fra den første perioden til den andre, men at denne økningen flatet ut for begge kjønn fra andre til tredje periode. Økningen mellom de to første periodene kan være en reell økning i AF tilfeller i denne perioden. Men det kan også være at det kommer av at flere personer kommer inn på sykehus og får diagnostisert sin AF. Det kan også være at flere pasienter får tatt EKG, og at man dermed får flere ”tilfeldige” funn av AF
The use of self-administered questionaires about food habits.
No full textPapers in this thesis: I: Jacobsen BK, Thelle DS.: ‘The Tromsø Heart Study: responders and non-responders to a health questionnaire, do they differ?’, manuscript, later published in: Scand J Soc Med. 1988;16(2):101-4 II: Bjarne K. Jacobsen, Synnøve F. Knutsen, and Raymond Kriutsen: ‘The Tromsø Heart Study: Comparison of Information from a Short Food Frequency Questionnaire with a Dietary History Survey’, Scand J Public Health, March 1987 15: 41-47
III: Jacobsen BK, Thelle DS: ‘THE TROMSØ HEART STUDY: FOOD HABITS, SERUM TOTAL CHOLESTEROL, HDL CHOLESTEROL, AND TRIGLYCERIDES’. Am. J. Epidemiol. (1987) 125 (4): 622-630 IV: Bjarne K. Jacobsen, Dag S. Thelle: ‘The Tromsø heart study: The relationship between food habits and the body mass index’. Journal of Chronic Diseases, Volume 40, Issue 8, 1987, Pages 795–800 (http://dx.doi.org/10.1016/0021-9681(87)90131-7) V: Bjarne Koster Jacobsen and Dag Steinar Thelle: ‘The Tromsø Heart Study: Is Coffee Drinking an Indicator of a Life Style with High Risk for Ischemic Heart Disease?’. Acta Medica Scandinavica, 1987, Volume 222, Issue 3, pages 215–221 (http://dx.doi.org/10.1111/j.0954-6820.1987.tb10662.x) VI: Bjarne K. Jacobsen and Dag S. Thelle: ‘RISK FACTORS FOR CORONARY HEART DISEASE AND LEVEL OF EDUCATION: THE TROMSØ HEART STUDY’. Published in Am. J. Epidemiol. (1988) 127 (5): 923-932.VII: Bjarne K. Jacobsen, Erik Bjelke, Gunnar Kvåle, and Ivar Heuch: ‘Coffee Drinking, Mortality, and Cancer Incidence: Results From a Norwegian Prospective Study’. Published in JNCI J Natl Cancer Inst (1986) 76 (5): 823-831
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