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Biomedical subjects

M Schroll

Publications and source records attributed to M Schroll.

At least 91 records · Page 5Linked to original sources
PubMed1996

Symptoms of depression, acute myocardial infarction, and total mortality in a community sample.

BACKGROUND: Depression has been shown to adversely affect the prognosis of patients with established coronary artery disease, but there is comparatively little evidence to document the role of depression in the initial development of coronary disease. METHODS AND RESULTS: Study participants were 409 men and 321 women who were residents of Glostrup, Denmark, born in 1914. Physical and psychological examinations in 1964 and 1974 established their baseline risk factor and disease status and their level of depressive symptomatology. Initial myocardial infarction (MI) was observed in 122 participants, and there were 290 deaths during follow-up, which ended in 1991. A 2-SD difference in depression score was associated with relative risks of 1.71 (P = .005) for MI and 1.59 (P < .001) for deaths from all causes. These findings were unchanged after we controlled for risk factors and signs of disease at baseline. There were no sex differences in effect sizes. CONCLUSIONS: High levels of depressive symptomatology are associated with increased risks of MI and mortality. The graded relationships between depression scores and risk, long-lasting nature of the effect, and stability of the depression measured across time suggest that this risk factor is best viewed as a continuous variable that represents a chronic psychological characteristic rather than a discrete and episodic psychiatric condition.

Aged↗
PubMed1996

Postural balance and its sensory-motor correlates in 75-year-old men and women: a cross-national comparative study.

BACKGROUND: There are no earlier cross-national comparative studies analyzing the functions of the posture control mechanisms and its sensory-motor correlates in elderly subjects. We investigated whether there are differences in balance between elderly subjects living in different geographical areas, and analyzed the sensory-motor associates of balance in men and women separately. METHOD: Using a force platform method, the functioning of the posture control system under three standardized conditions (normal standing, eyes open; normal standing, eyes closed; and tandem standing, eyes open) was studied among samples of 75-year-old residents in three Nordic localities, namely Glostrup in Denmark, Göteborg in Sweden, and Jyväskylä in Finland. The associations of the variables describing performance in each test with other sensory and motor functions were studied using correlation analyses and multivariate regression models. RESULTS: Differences between the populations were observed in both tests with visual control, favoring the participants from Glostrup and Jyväskylä compared with those from Göteborg. However, only minor differences between the subjects from different localities were observed in the test performed with the eyes closed. In all localities there was a primary sex difference in favor of the women which, however, mainly disappeared when body height was taken into the analyses as a covariate. A good performance in the balance tests (body height-adjusted values) was associated with good visual acuity, low vibrotactile thresholds, and high psychomotor speed. Also, isometric muscle strength, especially hand grip and body extension, was positively associated with good performance in the balance tests. Among the women, a poorer balance was observed in women with a smaller body mass. The results of the multivariate analyses showed that among the men, the most important predictors of good performance in the balance tests were low vibrotactile threshold on the foot, high isometric hand grip strength, and low body stature. Among the women, the most important predictors were low body stature, high body mass, high isometric body extension strength, and high psychomotor speed. However, only a small proportion of the variance in balance (about 13% in the men and 11% in the women) could be explained by the help of these factors. CONCLUSIONS: As the same procedure was applied to the analysis of postural balance, some differences between the populations living in different localities could be detected in some of the tests. The better performance of the women in the balance tests may partly be explained by anthropometric factors, especially differences in body height. There may also be differences in sensory-motor associates of balance in elderly men and women. On the basis of the associations observed, it is difficult to explain the differences in balance between the sexes or subjects living in different localities. Within the sexes, only a small proportion (10-13%) of the variation in balance during normal standing with eyes open could be explained by the factors included in the study.

Aged↗
PubMed1996

Health and physical performance of elderly Europeans. SENECA Investigators.

OBJECTIVE: To assess four-year changes in different measures of health, functional limitations and activities of daily living occurring in elderly Europeans who participated in the SENECA surveys of 1988/89 and 1993. METHODS: Similar questions on self-perceived health, chronic diseases, drug intake and activities of daily living (ADL) were asked in a standardized way in 1988/89 and in 1993. In 1993 an objective test of physical performance (PPT) was added. SETTING: Nineteen towns in 12 European countries were surveyed in 1988/89; 1282 men and 1304 women born between 1913 and 1918 participated in SENECA's baseline study. Nine of the towns participated in the follow-up study in 1993 and four new localities joined. SUBJECTS: Data on health and physical performance are presented for 571 men and 603 women from nine towns in Europe who took part in both SENECA studies and, additionally for 105 men and 156 women from the four localities examined in 1993 only. RESULTS: Of the 571 men and 603 women examined at both baseline and follow-up, 54% of the men and 37% of the women could do all mobility and selfcare items of daily living in 1988/89 without difficulty or help. In 1993, only 40% of the men and 22% of the women could do so, i.e. on balance 63 fewer men and 72 fewer women than in 1988. There was much less variation between towns in simple function tests than in the basic ADL actions. The PPT (sum score) was on average 20.8 in men and 20.3 in women, ranging from 14.8 to 22.8 across towns. Over the four-year period, the proportion perceiving their health to be excellent or good decreased, but the changes differed considerably from one town to another. At follow-up, 68% of the men and 78% of the women had at least one chronic disease; the average number of diseases for each participant in the total SENECA population being 1.1. The range in prevalence of chronic diseases varied from 40% in Spanish men to 100% in Portuguese women. Although there was no significant increase in the number of participants reporting chronic disease, the number of chronic diseases per participant increased from 0.9 to 1.0 in men and from 1.1 to 1.3 in women. CONCLUSIONS: During the period from 1988/89 to 1993 the proportion of ADL-independent men and women decreased by 25% and the number of people perceiving their health to be poor increased by 21%, but there was no change in the prevalence of chronic diseases.

Activities of Daily Living↗
PubMed1996

Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment.

A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help for the clinician concerned with hospital based geriatric medicine. It may also be useful for quality control and teaching. Not least, it may be useful for health professionals other than geriatricians. To some extent, the position of geriatric medicine in the Nordic countries varies between the countries. However, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have shown favourable outcomes. Results from controlled Nordic trials are compiled and summaries of meta-analyses are presented. The concept of Nordic geriatric work-up is based on a model defining health and disease in old age as dimensions of pathology, impairments, functional limitations, and disability, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors and barriers, stating important differences between multidisciplinary and interdisciplinary processes. Checklists and assessment scales may be very useful when performing a geriatric work-up, but they should be used with caution. Specific scales covering different functional areas of the geriatric patient are recommended for clinical practice. Such scales must be valid, reliable, acceptable to the patient, responsive to change, and should be in an appropriate format, as well as easy to administer. Prior to the use among geriatric teams in the Nordic countries the scales should be translated into all the Nordic languages, and the translated versions should ideally have been subjected to validity and reliability testing. However, so far no scale meets these demands regarding all the five Nordic languages.

Aged↗
PubMed1995

Minnesota Multiphasic Personality Inventory profiles in persons with or without low back pain. A 20-year follow-up study.

STUDY DESIGN: A general health survey including a cross-sectional study of 404 men and women aged 50 years who underwent follow-up evaluation at ages 60 and 70 years. OBJECTIVES: The participants completed the Minnesota Multiphasic Personality Inventory at age 50 and 60 years and were interviewed at age 60 and 70 years regarding low back pain experienced in the preceding 10 years. SUMMARY OF BACKGROUND DATA: Minnesota Multiphasic Personality Inventory data in low back pain patients are derived mainly from selected materials. This study presents data from a general population and sheds light on the controversy: "What comes first--Minnesota Multiphasic Personality Inventory changes or low back pain?". METHODS. Within the frame of a general health survey where the primary aim was to study cardiovascular risk factors, the participants completed a shortened Danish version of the Minnesota Multiphasic Personality Inventory at age 50 and 60 years; low back pain data were collected at interviews at age 60 and 70 years, and this study focused on the Hypochondriasis-Depression-Hysteria scales of the Minnesota Multiphasic Personality Inventory. RESULTS: Presence of low back pain from ages 50 to 60 and from ages 60 to 70 years was associated with elevated Hypochondriasis-Depression-Hysteria scales at age 50 and 60 years. Profiles showing the "conversion-V" configuration were present with a history of low back pain, at the 50-year and 60-year Minnesota Multiphasic Personality Inventory test. Minnesota Multiphasic Personality Inventory scores collected at age 50 years were not different between those who did report and those who did not report low back pain during the decade from 60 to 70 years, provided that they had not experienced low back pain during the period from age 50 to 60 years. CONCLUSIONS: Elevations of Minnesota Multiphasic Personality Inventory Hypochondriasis-Depression-Hysteria scales were shown in persons with a history of low pack pain. The results indicated that low back pain is preceded by elevated Minnesota Multiphasic Personality Inventory scales was not supported.

Age Distribution↗
PubMed1995

Hostility, incidence of acute myocardial infarction, and mortality in a sample of older Danish men and women.

An abbreviated version of the Cook-Medley Hostility Scale (ACM) was a predictor of documented acute myocardial infarction and total mortality. The sample consisted of 409 men and 321 women, residents of Glostrup, Denmark, who were 50 years old at the initiation of the study in 1964. Follow-up continued through 1991. Although not significant (relative risk (RR) = 1.22) in a model that contained only age and sex as covariates, the hostility scale scores were associated with increased risk of myocardial infarction in models controlling for traditional risk factors. A two standard deviation difference was associated with a RR of 1.53 (95% confidence interval (CI) 1.04-2.25), an effect that remained after eliminating the data of those with signs of ischemia at baseline. Hostility was also predictive of total mortality with controls for age and sex (RR = 1.35, CI 1.07-1.71), with controls for traditional risk factors (RR = 1.44, CI 1.13-1.83), and with additional controls for baseline ischemia and pulmonary function (RR = 1.36, CI 1.06-1.75). There were no sex differences in effect sizes. In cross-sectional analyses, high hostility was associated with higher body mass index, more physical activity at work, and poorer pulmonary function. These results constitute a rigorous test of the relation between hostility and health and increase the known generality of the phenomenon across sexes, age groups, and cultures.

Age Distribution↗
PubMed1995

Psychomotor speed and physical activity in 75-year-old residents in three Nordic localities.

Psychomotor speed was studied in samples of 75-year-old men and women in three Nordic localities, namely Glostrup (Denmark), Gothenburg (Sweden), and Jyväskylä (Finland). Both simple and multi-choice reaction and movement time tests were applied using visual and auditory stimuli. The aim of the present report was to analyze the role of habitual physical activity and physical fitness as associates of psychomotor speed. The results indicated a higher psychomotor speed in the physically more active and, in most cases, fitter subjects in both the simple and more complex tasks, a higher speed of performance in men compared to women, and, to some extent, more favorable values in Gothenburg and Jyväskylä than in Glostrup. The overall findings suggest that habitual physical activity may enhance psychomotor speed in elderly subjects. Basic differences in activity did not, however, explain the differences in psychomotor speed observed between the localities or between the sexes.

Acoustic Stimulation↗
PubMed1995

Stroke incidence, case fatality, and mortality in the WHO MONICA project. World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease.

BACKGROUND AND PURPOSE: This report compares stroke incidence, case fatality, and mortality rates during the first years of the WHO MONICA Project in 16 European and 2 Asian populations. METHODS: In the stroke component of the WHO MONICA Project, stroke registers were established with uniform and standardized rules for case ascertainment and validation of events. RESULTS: A total of 13,597 stroke events were registered from 1985 through 1987 in a total background population of 2.9 million people aged 35 to 64 years. Age-standardized stroke incidence rates per 100,000 varied from 101 to 285 in men and from 47 to 198 in women. The combined stroke attack rates for first and recurrent events were approximately 20% higher than incidence rates in most populations and varied to the same extent. Stroke incidence rates were very high among the population of Finnish men tested. The incidence of stroke was, in general, higher among populations in eastern than in western Europe. It was also relatively high in the Chinese population studied, particularly among women. The case-fatality rates at 28 days varied from 15% to 49% among men and from 18% to 57% among women. In half of the populations studied, there were only minor differences between official stroke mortality rates and rates measured on the basis of fatal events registered and validated for the WHO MONICA stroke study. CONCLUSIONS: The WHO MONICA Project provides a unique opportunity to perform cross-sectional and longitudinal comparisons of stroke epidemiology in many populations. The present data show how large differences in stroke incidence and case-fatality rates contribute to the more than threefold differences in stroke mortality rates among populations.

Adult↗
PubMed1995

Influence of dietary factors on weight change assessed by multivariate graphical models.

OBJECTIVE: To analyse the influence of dietary factors on weight changes in a multifactorial context by use of graphical models. DESIGN: Two age-stratified cohorts of Danish men and women were examined twice with five years interval. SETTING: The Glostrup Population Studies in the Copenhagen County, Denmark. SUBJECTS: A random population sample of 2009 men and women, aged 30, 40, 50, and 60 years. METHODS: At baseline all underwent a general health examination including measurement of height and weight, and they completed questionnaires regarding familial predisposition, cohabitation, school education, vocational training, social class, smoking habits, physical activity during work and leisure time, and parity. Dietary intake was evaluated by 7-day food records, allowing estimation of total energy intake and intake of fat and alcohol. At the follow-up examination height and weight were measured again and at each examination BMI was calculated. The statistical analysis was performed by graphical models based on multidimensional contingency tables defined by independence graphs, these may include several categorial or ordinal scale variables and include the assumed temporal relationship between the variables. RESULTS: BMI at entry depended on familial predisposition to obesity, and for women on cohabitation as well. At follow-up 5 years later, BMI in the male group was only related to former BMI, whereas in the female group it was influenced by parity as well. There were several significant associations between the dietary factors, other life style habits and social factors. However, no significant associations were found between total energy intake, percentage of energy from fat or from alcohol and weight changes. For neither gender was there any significant influence of other putative determining factors. CONCLUSION: No influence of dietary factors on weight changes were found when assessed in the context of many other putative determinants of weight change.

Adult↗
PubMed1994

[Right of self-determination and the duty to treat--the conflict between the patients's right to self-determination and the physician's duty to treat in relation to living wills].

The principle of autonomy requires competency. A competent patient is a patient who is capable of exercising his or her right to self-determination. However, in practical clinical work there is a continuum between competency and incompetency, and it is the doctor who has to decide whether the right to autonomy can be meaningfully upheld. When a patient rejects curative treatment, a conflict arises between the patient's right to autonomy and the doctor's duty to treat. While emphasizing the principle of autonomy is a guideline, the presence or absence of a living will is almost misguided. One may fear that the question of whether cure or relief is possible may altogether be neglected when a living will is in existence. The interpretation of when a living will should be used is dependent on the health staff's evaluation. There are widely divergent opinions of when a person is unavoidably dying or permanently incapable of taking care of themselves physically and mentally. If a treatment does not have a view to a cure, an improvement or a relief of symptoms it should in all circumstances be discontinued, independently of whether or not a living will is in existence.

Clinical Competence↗
PubMed1994

[Follow-up home visits to elderly patients after hospitalization. A randomized controlled study].

The aim of this randomized, controlled study was to evaluate a model for follow-up of patients aged 75 or more after discharge from hospital. One hundred and sixty-three patients from the intervention group were visited in their homes by a district nurse on the day after discharge from hospital and two weeks later by their general practitioner. For 181 control patients, discharge took place according to the usual procedures. One year after discharge 25 patients from the control group had been admitted to nursing homes compared to ten from the intervention group (p < 0.05). At the same time the control patients stayed 2700 days in the institutions, the intervention patients 1950 days. It is proposed to introduce this simple and practicable follow-up routine when elderly people are discharged from hospital.

Aftercare↗
PubMed1994

[The importance of nutrition for the prevention of osteoporosis].

The prevalence of osteoporosis is increasing, and is a significant burden on society. Dietary composition is an important determinant of the bone mineral density in the growth period, and of the magnitude of the age related bone mineral loss, in particular among postmenopausal women. Therefore, an improvement of the diet has an important role in the prevention of osteoporosis. A sufficient intake of calcium and vitamin D can reduce the risk of fractures in postmenopausal women, and it is likely that a low calcium intake may affect peak bone mass negatively. Calcium in the Danish diet comes mainly from dairy products. Half a litre of milk and 25 g of cheese will cover most people's calcium requirement. Part of the calcium requirement may also be covered by consuming other foods such as cabbage, broccoli and beans. Children, adolescents and elderly individuals who avoid dairy products are recommended to take a calcium supplement. The status of vitamin D among the elderly can be improved by a daily outdoor stay and by a frequent intake of fatty fish such as herrings. Elderly persons who stay indoors are recommended to take a vitamin D supplement.

Adolescent↗
PubMed1994

Casual blood pressure in a general Danish population. Relation to age, sex, weight, height, diabetes, serum lipids and consumption of coffee, tobacco and alcohol.

A population survey was conducted on 3608 randomly selected Danes aged 30, 40, 50 and 60 years respectively. Of these, 3400 were not in medical treatment for arterial hypertension. The following parameters were investigated: sex, age, serum lipid levels (total cholesterol, HDL cholesterol, triglycerides), presence of diabetes mellitus, height, body mass index (BMI), and average daily consumption of coffee, tobacco and alcohol. Analysis with multiple linear regression showed that all variables with the exception of triglycerides, HDL cholesterol and height were significantly associated with systolic blood pressure. Likewise all factors except diabetes, triglycerides and height were significantly associated with diastolic blood pressure. Further analysis in which the effect of each parameter was corrected for by the effects of the remaining variables, demonstrated that apart from age and sex only BMI and high alcohol consumption were positively associated with differences in blood pressure greater than a few mmHg. However, the variation in both systolic and diastolic blood pressures was only partly accounted for by the parameters studied--in the covariates analysis R2 for systolic blood pressure was 0.28 and R2 for diastolic blood pressure was 0.30. In conclusion, this investigation demonstrated that blood pressure is relatively independent of other factors important in the development of cardiovascular disease. Of the above-mentioned factors with some influence on blood pressure only age, BMI and high alcohol consumption have potential clinical importance.

Adult↗
PubMed1993

[Smoking habits and risk of coronary heart disease, especially risk associated with low daily tobacco consumption].

The purpose of this study was to estimate the risk of acute myocardial infarction related to smoking habits, especially the risk among smokers with a daily tobacco consumption of five grams or less. The study is based on data from the 1914 population examined by the Glostrup Population Studies at the age of 50 and 60 in 1964 and 1974. Information concerning deaths and cases of hospitalisation has been obtained from national registers up to 1985. Blood pressure, lipids, body mass index and physical activity were used as confounders. It was not possible to make a definite conclusion for the group smoking five grams or less daily as a class, since both the size of the group and the number of myocardial infarctions within it were small. When tobacco consumption was used as a quantitative variable the risk of myocardial infarction was found to increase with increasing amount but the relation was found not to be non-linear. The best description of the tobacco-related risk of myocardial infarction was a logarithmically relation to daily tobacco consumption.

Denmark↗
PubMed1993

[Incidence of myocardial infarction in Denmark. Results from Dan-Monica 1982-1984].

The mortality from ischemic heart disease in Denmark has changed from a steady increase towards a decrease also in younger males during the 1980s. During this period, the Glostrup Population Studies have registered the incidence of myocardial infarction, risk factor changes and changes in medical care in Copenhagen county (320,000 inhabitants) as part of WHO MONICA, which compares 39 centres in 26 countries. The incidence of myocardial infarction during the first three years, 1982-1984, of the Heart Register, DAN-MONICA at Glostrup Hospital, is reported. The register is complete and valid. If the age specific incidence of myocardial infarction in Denmark was as in this survey, the results indicate an age standardized incidence for the Danish population including all age groups over the age of 25 of 5.58 per 1000 per year (7.48 per 1000 adult males and 3.99 per 1000 adult females).

Adult↗
PubMed1993

NORA--Nordic research on ageing. Functional capacity of 75-year-old men and women in three Nordic localities.

The aim of this cross-national study was to describe and compare differences in functional capacity of 75-year old people in three Nordic urban localities. As the life-expectancy at the age of 75 differs between the Nordic countries, there is reason to look for similar differences in functional capacity, taking differences in socio-demography, lifestyle, living conditions and health into consideration. In 1989-1991, 400 75-year-old men and women were selected to represent 75-year-olds in a Danish, Finnish and Swedish city. They participated in examinations which focused on functional capacity and health, where identical questionnaires, tests, and equipment were employed. The methods employed were developed from the experience gathered during previous studies of epidemiology of ageing in Glostrup, Gothenburg, and Jyväskylä. Functional capacity is the dependent variable multifactorially related to age, health, living conditions, and life style. The data collection was performed with participation rates in the interviews of 85% in Glostrup, 83% in Gothenburg, and 92% in Jyväskylä. The participation rates in the laboratory examinations were 76%, 67% and 77%, respectively. Examples of differences in socio-demographic background, lifestyle and measures of health and performance in the three localities are given. The Nordic study on physical, psychological and social capacity of 75-year-olds was performed with sufficiently standardised methods to allow a comparison of the results. Similar comprehensive cross-sectional comparative studies of the elderly people have not been performed earlier. Local and cross-national results will be published in each field separately and in combination.

Aged↗