This paper contributes to the positioning and definition of concepts describing person-environment relationships. The definitions suggested challenge current terminology, but can support in developing more efficient research and practice strategies. In order to develop theory for application to societal planning issues, the definition of concepts is a necessary step.

By emphasising the involvement of elderly people in a project applying a mixed-method approach, the overriding objective of this study was to identify and prioritise concrete measures aimed at increasing accessibility and safety in the outdoor pedestrian environment within a residential area of a Swedish town. Measures generally given priority were: the separation of pedestrians/cyclists, lower speed limits, better maintenance and specific measures in pedestrian walkways such as wider sidewalks, curb levels and form and more even surfaces on pavements. Definition of these priorities offered knowledge to the highway department concerning the importance of small details in relation to the larger infrastructure. The elderly people in the study district found new ways to communicate with and influence those within the community who are responsible for these matters

Rollators are valuable for the users and a relevant societal intervention. However, a better match between person and technology, enhanced user training and follow-up can improve the outcome of the intervention. Furthermore, better rollator design is called for, and buses and the outdoor environment need to be made more accessible.

BackgroundRestrictions in social and leisure activity can have negative consequences for the health and well-being of stroke survivors. To support the growing number of people who are ageing with stroke, knowledge is needed about factors that influence such activity in a long-term perspective.AimTo identify long-term predictors of the frequency of social and leisure activities 10 years after stroke.Method145 stroke survivors in Sweden were followed-up at16 months and 10 years after a first-ever stroke. Data representing body functions, activities & participation, environmental factors and personal factors at 16 months after stroke, were used in multiple linear regression analyses to identify predictors of the activity frequency after 10 years, as assessed by the ‘Community, social and civic life’ sub-domain of the Frenchay Activities Index (FAI-CSC).ResultsAt the 10-year follow-up the frequency of social and leisure activities varied considerably among the participants, with FAI-CSC scores spanning the entire score range 0–9 (mean/median 4.9/5.0). Several factors at 16 months post stroke were independently related to the long-term activity frequency. The final regression model included four significant explanatory variables. Driving a car (B = 0.999), ability to walk a few hundred meters (B = 1.698) and extent of social network (B = 1.235) had a positive effect on activity frequency, whereas an age ≥ 75 years had a negative effect (B = -1.657). This model explained 36.9% of the variance in the FAI-CSC (p<0.001).ConclusionStroke survivors who drive a car, have the ability to walk a few hundred meters and have a wide social network at 16 months after a first-ever stroke are more likely to have a high frequency of social and leisure activities after 10 years, indicating that supporting outdoor mobility and social anchorage of stroke survivors during rehabilitation is important to counteract long-term inactivity.

This paper focuses on older peoples' needs as pedestrians by examining their perceptions of the outdoor environment in both bare-ground and snow/ice conditions. Qualitative and quantitative methods are used, including focus group interviews, participant observations, and questionnaires. The results show that older people consider accessibility/usability issues as very important and that the importance depends on such individual background variables as age, sex, occurrence of functional limitations, use of mobility devices, and dependence on walking as transport mode. In bare-ground conditions, physical barriers are more important for the oldest old (80+) and for older people with functional limitations or mobility devices. However, orderliness-related issues (e.g. cyclists in pedestrian areas, lighting, and litter/graffiti) are equally important regardless of the background variables. In snow/ice conditions, ice prevention is considered more important than snow removal. Snow removal on a detailed level (e.g. removal of heaps of snow on pavements and zebra crossings) is emphasised. In conclusion, it is important to study subgroups, not older people as one group, in the analysis of accessibility/usability of outdoor environments. Further, even though those accessibility issues emphasised in current Swedish governmental directives on accessibility are considered as important by older people themselves, especially among the oldest old and among those with functional limitations and mobility devices, the needs will not totally be fulfilled by current directives. For example, winter maintenance, problems with cyclists in pedestrian areas, and the need for benches are neglected.

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Background and Purpose— Long-term studies of outcome after stroke are scarce. Our aim was to study functional status and patient-reported outcome 10 years after a first-ever stroke. Methods— Ten-year follow-up was conducted among the survivors from a population-based group of 416 patients included in the Lund Stroke Register, Sweden, between March 1, 2001, and February 28, 2002. The Barthel index was used to assess the functional status and the modified Rankin Scale to assess the degree of disability. The EQ-5D scale was used for survivors’ self-reports about health outcome and the specific Short-Form 36 (SF-36) question for rating their overall health. The patients also reported their frequency of physical activity. Results— Among 145 survivors 10 years after stroke (median age, 78 years), 59% were men, 90% lived in their ordinary housing, 73% were assessed as independent, and 71% had no or slight disability. The need of assistance with mobility and self-care was reported by 14% and with usual activities by 22%. Moderate pain was reported by 39%, and 4% had a high degree of pain. Moderate anxiety/depression was reported by 28% and high degree only by 1%. Overall health status was reported in positive terms by more than two thirds of the survivors. Almost half the cohort reported the same frequency of physical activity (≥4× weekly) as before stroke onset. Conclusions— This study indicates that 10-year stroke survivors in Sweden are mostly independent in daily activities and report good overall health and frequent physical activity, although half of them are ≥78 years.