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Sökning: LAR1:gu > Skoog Ingmar 1954 > Östling Svante 1953 > Tidskriftsartikel

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21.
  • Hansson, Oskar, et al. (författare)
  • Evaluation of Plasma A beta as Predictor of Alzheimer's Disease in Older Individuals Without Dementia: A Population-Based Study
  • 2012
  • Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 28:1, s. 231-238
  • Tidskriftsartikel (refereegranskat)abstract
    • Amyloid-beta (A beta) pathology is a major component in the mechanisms behind Alzheimer's disease (AD). Measurement of A beta(42) in cerebrospinal fluid predicts cognitive decline in patients with mild cognitive impairment and identifies AD in patients with dementia. However, studies on A beta in plasma are contradictory. In this prospective population-based study, plasma A beta(42) and A beta(40) were measured at baseline in 730 adults aged 70 years or older and without dementia. After five years, plasma levels were analyzed again and participants were assessed for development of dementia. During follow-up, 53 individuals (7%) developed dementia of which 37 (5%) were classified as AD. No difference in baseline plasma A beta(42), A beta(40), or A beta(42)/A beta(40) ratio levels were observed between converters to dementia or AD compared to the cognitively stable individuals. However, individuals with plasma A beta(40) levels above the median level for the group at baseline had an increased risk of developing dementia and AD during the follow-up, even after adjustment for age, gender, APOE genotype, and educational level (odds ratio = 2.2, 95% confidence interval = 1.0-4.7, p < 0.05). Neither plasma A beta(42) nor the A beta(42)/A beta(40) ratio influenced the risk of developing dementia or AD. Moreover, A beta(42) and A beta(40) levels increased over the 5 years, whereas the A beta(42)/A beta(40) ratio decreased (p < 0.001). In conclusion, this study suggests that measurement of plasma A beta should not be used clinically to predict dementia or AD. However, plasma A beta(40) may possibly be regarded as a moderate risk marker comparable to other risk markers for AD such as first-degree family history of dementia.
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22.
  • Hörder, Helena M, et al. (författare)
  • Midlife cardiovascular fitness and dementia A 44-year longitudinal population study in women
  • 2018
  • Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 90:15, s. E1298-E1305
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years. A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders. Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03-0.54) among those with high fitness and 1.41 (95% CI 0.72-2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness. Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.
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23.
  • Jaraj, Daniel, et al. (författare)
  • Mortality and risk of dementia in normal-pressure hydrocephalus: A population study.
  • 2017
  • Ingår i: Alzheimer's & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 13:8, s. 850-857
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction We examined mortality, dementia, and progression of hydrocephalic symptoms among untreated individuals with idiopathic normal-pressure hydrocephalus (iNPH) in a population-based sample. Methods A total of 1235 persons were examined between 1986 and 2012. Shunted individuals were excluded. We examined 53 persons with hydrocephalic ventricular enlargement (probable iNPH: n = 24, asymptomatic or possible iNPH: n = 29). Comparisons were made with individuals without hydrocephalic ventricular enlargement. Results The 5-year mortality was 87.5% among those with probable iNPH. The hazard ratio (HR) for death was 3.8 (95% confidence interval [CI]: 2.5–6.0) for probable iNPH. Those with possible iNPH and asymptomatic hydrocephalic ventricular enlargement had increased risk of developing dementia, HR 2.8 (95% CI: 1.5–5.2). Only two individuals with hydrocephalic ventricular enlargement remained asymptomatic. Discussion In the present sample, persons with clinical and imaging signs of iNPH had excess mortality and an increased risk of dementia. The data also suggest that radiological signs of iNPH might be more important than previously supposed.
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24.
  • Joas, Erik, 1983, et al. (författare)
  • Blood Pressure Trajectories From Midlife to Late Life in Relation to Dementia in Women Followed for 37 Years
  • 2012
  • Ingår i: Hypertension. - 0194-911X .- 1524-4563. ; 59:4, s. 796-801
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract. Higher midlife blood pressure increases risk for dementia. To further understand the relation between blood pressure and dementia, it is necessary to examine evolution of blood pressure from midlife to late life. We examined blood pressure trajectories using linear mixed models in a representative sample of middle aged women (N1462) who were followed from 1968–1969 until 2005–2006 with comprehensive medical and neuropsychiatric examinations. Dementia was diagnosed according to established criteria. Among those not treated with antihypertensives, higher systolic blood pressure at baseline but not blood pressure trajectories from 1968 to 1992 was associated with dementia and Alzheimer disease. Those with history of antihypertensive treatment had higher baseline systolic blood pressure than those who were never treated. In this group, those who developed dementia and Alzheimer disease had lower baseline systolic blood pressure and steeper increase in systolic blood pressure from 1968 to 1992 than those who did not. A steeper decline in systolic blood pressure during the later part of the study was observed in those who developed dementia regardless of antihypertensive treatment. The latter association was attenuated or disappeared when adjusting for body mass index. The association between blood pressure and dementia is complex and influenced by antihypertensive treatment. The findings emphasize the importance of detecting increased blood pressure in midlife and controlling blood pressure in those treated. Whether the trajectory of blood pressure is a risk factor or part of the clinical course of dementia needs to be elucidated.
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25.
  • Joas, Erik, 1983, et al. (författare)
  • Sex differences in time trends of blood pressure among Swedish septuagenarians examined three decades apart: a longitudinal population study
  • 2017
  • Ingår i: Journal of Hypertension. - 0263-6352 .- 1473-5598. ; 35:7, s. 1424-1431
  • Tidskriftsartikel (refereegranskat)abstract
    • Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.OBJECTIVE:: The aim of this study was to analyze the influence of birth cohort, sex and age on the trajectories of SBP and DBP in two birth cohorts of 70-year-olds, examined 3 decades apart and followed up at ages 75 and 79–80 years. METHODS:: Two population samples of 70-year-olds from Gothenburg, Sweden, were examined. The first, born in 1901–1902, was examined in 1971–1972 (n?=?973). The second, born in 1930, was examined in 2000 (n?=?509). Both samples were re-examined at ages 75 and 79–80 years. RESULTS:: We found that SBP and DBP were considerably lower in septuagenarian men and women born 1930 compared with those born 1901–1902, also when adjusting for antihypertensive treatment in different ways. The decline was especially pronounced in women. Blood pressure was higher in women than in men in the 1970s, whereas there were no sex differences in the 2000s. The age-related decline in SBP started earlier and was more accentuated in those born in 1930 than in those born in 1901–1902. CONCLUSION:: Blood pressure decreased, and the age-related decline in SBP started earlier in septuagenarians examined in the 2000s compared with those examined in the 1970s. The decrease was especially pronounced in women and diminished the sex differences. Antihypertensive treatment only partly explained our findings, suggesting that other mostly unknown factors played an important role.
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26.
  • Johansson, Lena, 1972, et al. (författare)
  • Common psychosocial stressors in middle-aged women related to longstanding distress and increased risk of Alzheimer’s disease: a 38 year longitudinal population study
  • 2013
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:9
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study the relation among psychosocial stressors, long-standing distress and incidence of dementia, in a sample of women followed from midlife to late life. DESIGN: Prospective longitudinal population study. SETTING: The analyses originate from the prospective population study of women in Gothenburg, Sweden, a representative sample of women examined in 1968 (participation rate 90%) and re-examined in 1974, 1980, 1992, 2000 and 2005. PARTICIPANTS: 800 women born in 1914, 1918, 1922 and 1930 who were systematically selected for a psychiatric examination at baseline, in 1968. PRIMARY AND SECONDARY OUTCOME MEASURES: 18 psychosocial stressors (eg, divorce, widowhood, work problems and illness in relative) were obtained at baseline. Symptoms of distress were measured according to a standardised question at each study wave. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data, and measured through the whole study period. RESULTS: During the 37 years of follow-up, 153 women developed dementia (104 of those had Alzheimer's disease (AD)). Number of psychosocial stressors in 1968 was associated (HR, 95% CI) with higher incidence of dementia (1.15, 1.04 to 1.27) and AD (1.20, 1.07 to 1.35) between 1968 and 2005, in multivariate Cox regressions. Number of psychosocial stressors in 1968 was also associated (OR, 95% CI) with distress in 1968 (1.48, 1.32 to 1.67), 1974 (1.31, 1.17 to 1.46), 1980 (1.27, 1.11 to 1.45), 2000 (1.39, 1.14 to 1.70) and 2005 (1.35, 1.02 to 1.79), in multivariate logistic regressions. Number of psychosocial stressors (HR 1.17, 95% CI 1.03 to 1.33) and long-standing distress (1968-1974-1980) (HR 1.58, 95% CI 1.03 to 2.45) were independently associated with AD. CONCLUSIONS: Our study shows that common psychosocial stressors may have severe and long-standing physiological and psychological consequences. However, more studies are needed to confirm these results and investigate whether more interventions such as stress management and behavioural therapy should be initiated in individuals who have experienced psychosocial stressors.
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27.
  • Johansson, Lena, 1972, et al. (författare)
  • Midlife personality and risk of Alzheimer disease and distress: A 38-year follow-up.
  • 2014
  • Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 83:17, s. 1538-44
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study the association between midlife neuroticism and extraversion and development of late-life dementia and long-standing distress in a sample of women followed for 38 years. METHODS: A population-based sample of 800 women, aged 38 to 54 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, 2000, and 2005. Neuroticism and extraversion were assessed using the Eysenck Personality Inventory at baseline. Distress was measured according to a standardized question at each study wave. Dementia was diagnosed according to DSM-III-R criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. RESULTS: During the 38-year follow-up, 153 women developed dementia; Alzheimer disease (AD) dementia was diagnosed in 104 of these. A higher degree of neuroticism in midlife was associated with increased risk of AD dementia and long-standing distress over 38 years. The association between neuroticism and AD dementia diminished after adjusting for long-standing distress. Extraversion was associated with a lower degree of long-standing distress, but had no impact on AD dementia. When the 2 personality dimensions were combined, high neuroticism/low extraversion showed the highest risk of AD dementia. CONCLUSIONS: Our study suggests that midlife neuroticism is associated with increased risk of AD dementia, and that distress mediates this association. The results have clinical implications because a group of women at risk of AD dementia is identified.
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28.
  • Johansson, Lena, 1972, et al. (författare)
  • Midlife psychological stress and risk of dementia: a 35-year longitudinal population study.
  • 2010
  • Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 133:8, s. 2217-2224
  • Tidskriftsartikel (refereegranskat)abstract
    • The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38-60 years were examined in 1968-69 and re-examined in 1974-75, 1980-81, 1992-93 and 2000-03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer's disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10-2.34), in 1974 (1.65, 1.12-2.41) and in 1980 (1.60, 1.01-2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer's disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71-1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01-2.95) for those reporting stress at two examinations and 2.51 (1.33-4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer's disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.
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29.
  • Karlsson, Björn, et al. (författare)
  • Prevalence of social phobia in non-demented elderly from a swedish population study.
  • 2009
  • Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 17:2, s. 127-35
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To examine the prevalence of social phobia, and how the different Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic components of social phobia influence prevalence rates, among a population sample aged 70 years and older. DESIGN: A general population sample was investigated in 2000-2001 with semistructured psychiatric examinations, including the Comprehensive Psychopathological Rating Scale, the Mini International Neuropsychiatric Interview, the Global Assessment of Functioning (GAF) scale, and the Mini Mental State Examination. SETTING: General population Participants: Randomized sample of 914 nondemented elderly, response rate 68%. The sample was stratified into two age groups: 70-year olds (N = 338 women and 224 men) and aged 78 and above (N = 352 women). MEASUREMENTS: Social phobia according to DSM-IV requiring: a) fearing social situations, b) experiencing the fear as unreasonable or excessive, c) avoiding feared social situations or enduring them with intense anxiety or distress, and d) that this causes social consequences. RESULTS: The 1-month prevalence of social phobia was 1.9% (N = 17), an additional 1.6% (N = 15) fulfilled criteria a, c, and d, but not b. Thus, 3.5% had "social phobia" that caused social consequences. This was related to lower GAF-score and concurrent depression,panic attacks, and agoraphobia. Almost one fourth (N = 220) of the total sample feared social situations. This was more common in 70-year-old women compared with 70-year-old men (29.9% versus 20.5%), and to women aged 78-92 years (21.0%). CONCLUSIONS: Our results indicate that DSM-IV criteria exclude a large group of individuals with social phobia. It could be discussed whether DSM-IV criteria should be revised to also encompass these individuals.
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30.
  • Karlsson, Björn, et al. (författare)
  • The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up.
  • 2010
  • Ingår i: Acta psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 122:1, s. 4-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Karlsson B, Sigström R, Waern M, Ostling S, Gustafson D, Skoog I. The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up. Objective: To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years. Method: A general population sample (N = 612) of non-demented men (baseline age 70) and women (baseline age 70 and 78-86) was investigated in 2000-2001 and in 2005-2006 with semi-structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria. Results: Among nine individuals with DSM-IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM-IV social phobia. Among individuals without DSM-IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM-IV social phobia in 2005. Conclusion: These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.
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