This project has several advantages. It is expected to generate a rich data base relevant for future research on aging and care and to have a direct impact on the future Swedish system of care and services for the elderly.

Keywords:collaborative work practices and IT, health information on the Web, healthcare service innovation and IT, IT design and development methodologies, healthcare professional training Abstract:Older-adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and healthcare solutions. Older-adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older-adults ranging from 59-100 years old. Internet use was investigated with: age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults these factors as well as living with someone and http://mc.manuscriptcentral.com/HIJ Health Informatics Journal F o r P e e r R e v i e w having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older-adults by a society that is today being shaped by the Internet.

This study investigated the relationship between light and strenuous exercise and depression, as well as gender differences in this relationship, in a representative sample of 860 elderly Swedish suburb-dwelling men and women in age cohorts from 60 to 96 years, drawn from among participants in the Swedish National Aging and Care study. The relationship between depression and self-reported changes in exercise status over time was also examined. Exercise activities were measured with four survey questions, and depression, with the Montgomery Asberg Depression Rating Scale. The inactive elderly had higher depression scores than more active individuals, both in terms of light and strenuous exercise. The continuously active group had lower depression scores than both continuously inactive individuals and individuals reporting a shift from activity to inactivity during the preceding year. Light exercise had a somewhat stronger effect on depression for women.

People aged 60 or more are the most frequent users of healthcare services. In this age range, however, both frequent and infrequent users can be found. Frequent users have high rates of illnesses. Previous research has found that the frequency may be influenced also by psychological and social factors. The aim of this study was to investigate to what degree such factors add to the explanation of differences in number of visits to a physician. A cross-sectional study was conducted with a random sample consisting of 1017 individuals, aged 60 to 78 years, from the Blekinge part of the Swedish National Study on Aging and Care database. The data were collected during 2001 to 2003. Hierarchical logistic regression analyses were used with frequent (three visits or more during a year) and infrequent use as a dichotomous dependent variable. The final statistical analyses included 643 individuals (63% of the sample). Independent variables were sense of coherence (SOC), internal locus of control, education level and social anchorage. Control variables were age, gender, functional ability and comorbidity. The results showed that comorbidity was most strongly related to frequent use [adjusted odds ratio (OR) = 8.17, 95% confidence interval (CI) 5.54–12.04]. In addition, SOC and internal locus of control had small, but significant effects on the odds of being a frequent user (adjusted OR = 1.03, 95% CI 1.00–1.06 and adjusted OR = 1.14, 95% CI 1.02–1.27, respectively). The lower the SOC and the internal locus of control were, the higher were the odds of frequent use. Education level and social anchorage were unrelated to frequency of use. The results indicate that frequent healthcare services users are more ill than infrequent users. Psychological factors influence the use only marginally, and social factors as well as age and gender are not by themselves reason for frequent healthcare services use.

This study investigated the relation between personality factors, as measured by the Swedish version of the NEO-FFI questionnaire, and the realism in older adults' (aged 60-93 years, = 1,384) probability confidence judgements of their answers to general knowledge questions. The results showed very small effect sizes for the contribution of the personality variables to the fit between the proportion correct answers and the level of one's confidence judgements. Although personality differed somewhat within the age span studied and between the genders no differences were found in the relation between the dimensions of the NEO-FFI and the degree of realism in the confidence judgements as a function of age or gender. In total, the results show a significant but very small effect of personality on the realism in older adults' confidence judgements of their semantic knowledge.

The purpose of this study was to investigate the relationship of light and strenuous exercise, and self-reported change in exercise status, with different components of cognitive function, and gender differences in this relation, in a large, representative sample included in the Swedish National study on Aging and Care (SNAC). Eight-hundred-and-thirteen participants in age-cohorts from 60-96 years completed a wide range of cognitive function tests, the Mini Mental State Exam (MMSE) and survey questions concerning exercise behaviour and exercise change with light or strenuous intensity. ANCOVA, controlling for age, education, depression, functional status and co-morbidity, demonstrated a main effect for light exercise, but not for strenuous exercise, on five of the six cognitive tests and the MMSE, for men but nor for women. A negative change in exercise status was associated with lower MMSE scores for men but not for women. Individuals exercising with light intensity several times a week had the highest cognitive test and MMSE scores and the inactive group had the lowest scores. The results of the study may contribute to increased knowledge in the exercise-mental health relationship for elderly and spawn new research specifically on gender differences in this relation.

The results indicate that physical activity has a salutogenic effect by enhancing the quality of life, and it can be assumed to be connected to quality of life by generating pleasure and relaxation.

The increased reliance on Internet use in social functions has presumably left out a part of the population: the oldest-older adults. These are people who have not kept themselves up to date with the technological developments for various reasons. There are, however, exceptions from whom we have something to learn. This study investigates the older people in Sweden who started to use the Internet over a period of 6 years. Cognition, extraversion, openness, functional disability, household economy, sex, age and education were investigated in relation to starting to use the Internet. A chi-square test, Spearman correlation and a logistic regression analysis were conducted. It was found that higher cognition, being male and being between the ages of 60 and 80 years were determining factors in starting to use the Internet for the Swedish older adult. Our results indicate that the oldest-older adults are slow to adapt to using the Internet and more attention should be paid on how to support this group.