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Psychosocial resources related to survival among non-robust community-dwelling older people: an 18-year follow-up study
Psychosocial resources have been considered to be associated with survival among frail older adults but the evidence is scarce. The aim was to investigate whether psychosocial resources are related to survival among ...
Chronic conditions and multimorbidity associated with institutionalization among Finnish community-dwelling older people: an 18-year population-based follow-up study
<p>Key summary points</p><p>Aim The aim of the study is to assess the association of chronic conditions and multimorbidity with institutionalization in older people.</p><p>Findings Having dementia, mood or neurological ...
Frailty, walking ability and self-rated health in predicting institutionalization: an 18-year follow-up study among Finnish community-dwelling older people
<p>Background <br></p><p>In clinical practice, there is a need for an instrument to screen older people at risk of institutionalization. Aims To analyze the association of frailty, walking-ability and self-rated health (SRH) with institutionalization in Finnish community-dwelling older people. <br></p><p>Methods <br></p><p>In this prospective study with 10- and 18-year follow-ups, frailty was assessed using FRAIL Scale (FS) (n = 1087), Frailty Index (FI) (n = 1061) and PRISMA-7 (n = 1055). Walking ability was assessed as self-reported ability to walk 400 m (n = 1101). SRH was assessed by a question of general SRH (n = 1105). Cox regression model was used to analyze the association of the explanatory variables with institutionalization. <br></p><p>Results <br></p><p>The mean age of the participants was 73.0 (range 64.0-97.0) years. Prevalence of institutionalization was 40.8%. In unadjusted models, frailty was associated with a higher risk of institutionalization by FS in 10-year follow-up, and FI in both follow-ups. Associations by FI persisted after age- and gender-adjustments in both follow-ups. By PRISMA-7, frailty predicted a higher risk of institutionalization in both follow-ups. In unadjusted models, inability to walk 400 m predicted a higher risk of institutionalization in both follow-ups and after adjustments in 10-year follow-up. Poor SRH predicted a higher risk of institutionalization in unadjusted models in both follow-ups and after adjustments in 10-year follow-up. <br></p><p>Discussion <br></p><p>Simple self-reported items of walking ability and SRH seemed to be comparable with frailty indexes in predicting institutionalization among community-dwelling older people in 10-year follow-up. Conclusions In clinical practice, self-reported walking ability and SRH could be used to screen those at risk.</p>...
Dysphagia, hypothyroidism, and osteoradionecrosis after radiation therapy for head and neck cancer
<h3>Objectives</h3><p>To analyze the long-term side effects of radiation therapy (RT) for head and neck cancer (HNC).</p><h3>Methods</h3><p>Retrospective chart analysis of all 688 HNC patients treated during 2010–2015 at Turku University Hospital, Finland. All patients who survived for more than a year after RT/chemoRT were included (n = 233). Intensity modulated RT (IMRT) with standard fractionation was applied in each case.</p><h3>Results</h3><p>One hundred and six patients (45%) reported persisting dysphagia, for which neck RT increased risk. Definitive neck RT to high-risk volume did not increase late toxicity risks compared to elective neck RT. Radiation-induced hypothyroidism (29%, n = 67) was more common among younger patients and females. Osteoradionecrosis (12%, n = 29) was more common in the oral cavity cancer group (20.7%, n = 92) compared to all other subsites.</p><h3>Conclusions</h3><p>Late toxicities of RT for HNC are common. Age, gender, tumor subsite, and neck RT affect susceptibility to long-term side effects.</p><h3>Level of evidence</h3><p>4.</p>...