Who pays for my care?

Today working, tomorrow old and retired!

We have to learn a lot of things about how we should live today if our ambition is to became healthy old persons later. The Finns as European people are getting older. Who will take care of us then later? Continue reading

Geriatric Medicine in the land of mountains and fjords

Marit Apeland Alfsvåg is leader of the Geriatric Department at Stavanger University Hospital and Prof Annette Hylen Ranhoff is Professor of Geriatric Medicine at the University of Bergen.

Norway has a long coast, fjords and huge mountain areas. The population is small with only 5 million people, and 4 million live in cities.

Norway has become part of the wave of ageing. The percentage of people who are 65 years or older is about 14% and is estimated to reach 23% in 2030. The care of the older people has been declared to be a national priority. Continue reading

My Week in Meetings

by Timo Strandberg

These winter weeks are usually very busy for Finnish geriatricians and often quite cold weather (possibly down to minus 30 degrees Celsius) does hinder us. Actually, this winter we have enjoyed quite nice weather with some snow and reasonable temperatures. In January-February we have some regional doctor’s meetings and the 2-day “Geriatricians’ Days” are traditionally during  the last week of January. The Board of Finnish Geriatricians (SG) organizes these days, and the board members rotate every 3 years from one University city (with medical faculty, 5 in Finland)  to another. In 2014, geriatricians from the Turku region had their third time and they had made the congress especially glamorous. Continue reading

One Week Last October

Anthony Fiorini, Consultant Geriatrician and Senior Lecturer, Clinical Chairperson of the Department of Geriatrics, Malta tells us about his week.


I am an early riser by nature, not because of advancing age! Household chores are finalised, then a quick swim in a nearby indoor pool. By 7.30 am I am on the road, crawling to work.

The 8 km car journey takes half an hour. Malta is the EU’s most densely populated country and it feels like everybody is driving to work at this time!

Continue reading

There’s an order to things: Item response theory as a way to make sense of functional decline in dementia

Sarah McGrory is a PhD Student at the Alzheimer Scotland Dementia Research Centre at the University of Edinburgh. Reblogged from the British Geriatrics Society blog.functional decline

Are some activities harder than others for people with dementia? In our research, recently reported in Age and Ageing, we looked at how people with dementia differed in their day to day activities. 202 people with mostly mild to moderate dementia in Scotland were asked about their activities

Activities (using the telephone, shopping, food preparation, housekeeping, laundry, travelling, taking medications, handling finances) can be measured using a questionnaire called the Lawton Instrumental Activities of Daily Living (IADL) scale. Usually scores on the individual tasks are added together to give a total score ranging from 0 to 8. This number can hide a lot of information about a patient’s functional ability. It assumes every functional activity is equally difficult, which is rarely the case. For example, being able to manage your finances is likely to be harder for most people than being able to eat.

Our research used a statistical technique called item response theory (IRT) to get more information from a questionnaire about function. IRT allows the different activities to be ranked according to their difficulty. This can be especially useful for assessing progression of cognitive impairment. Knowing the expected order of decline can help to monitor progression, so any changes from the usual course, or changes in rates of decline, can be identified and studied. IRT can help to identify key tasks in a scale, and can also show in what order tasks might become more difficult as dementia progresses.  To do this, though, clinicians and researchers have to record answers to every task on a scale, not just to the total number.

We found that the tasks included in the scale could be ordered by increasing difficulty from being able to use the telephone (easiest) to the ability to shop (most difficult). This means a person may be having problems shopping independently may showing the first sign of functional difficulties related to cognitive impairment. Problems with this task should alert doctors as a possible early symptom of cognitive decline. Recognising these early stages is very important and can help people live independently for as long as possible with the help of medications, family education and counselling.  Looking at the individual tasks within a scale instead of relying on the total score can help us to understand more about dementia progression and help us to identify care requirements for patients.