| 41. |
- Mellqvist Fässberg, Madeleine, et al.
(författare)
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Sense of coherence in elderly suicide attempters: the impact of social and health-related factors.
- 2011
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Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 23:6, s. 986-993
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Tidskriftsartikel (refereegranskat)abstract
- Background: An association between sense of coherence (SOC) and suicidal behavior has been suggested. The aim of this study was to identify factors associated with low SOC in elderly suicide attempters. Methods: Eighty non-demented hospital-treated suicide attempters aged 70 years and older (38 men, 42 women, mean age 79.4 years) took part in an interview with a research psychologist and completed the 29-item SOC questionnaire. The interview included questions regarding social situation and health-related factors. The Comprehensive Psychopathological Rating Scale (CPRS) provided symptom ratings that were used in a diagnostic algorithm for DSM-IV major depression. The Cumulative Illness Rating Scale for Geriatrics (CIRS-G) was used to identify individuals with serious physical illness. Results: There was a strong relationship between major depression and SOC. While we could show no relationship between severe physical illness and SOC, associations were demonstrated with social variables including too little time spent with children, too little time spent with grandchildren and having moved within the past five years. These associations remained significant in regression models adjusted for sex, age and major depression. Conclusions: A number of social variables were independently related to SOC in elderly suicide attempters. Prospective studies are needed in order to determine whether SOC-strengthening interventions can reduce the risk of suicidal behavior in seniors.
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| 42. |
- Mellqvist Fässberg, Madeleine, et al.
(författare)
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Suicidal feelings in the twilight of life: a cross-sectional population-based study of 97-year-olds
- 2013
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 3:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the occurrence of past month suicidal feelings in extreme old age. Further, to Design: Cross-sectional population-based study. Setting: Gothenburg, Sweden. Participants: 269 adults (197 women, 72 men) without dementia born in 1901-1909 who participated Main outcome measures: Death thoughts and suicidal feelings. The latter were rated in accordance Results: One quarter of the sample (26.7%) reported that they thought about their own death at least Conclusions: Suicidal feelings may occur outside the context of depression and disability in this age
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| 43. |
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| 44. |
- Mielke, Michelle M., et al.
(författare)
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The 32-year relationship between cholesterol and dementia from midlife to late life.
- 2010
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Ingår i: Neurology. - 0028-3878. ; 75:21, s. 1888-95
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cellular and animal studies suggest that hypercholesterolemia contributes to Alzheimer disease (AD). However, the relationship between cholesterol and dementia at the population level is less clear and may vary over the lifespan. Methods: The Prospective Population Study of Women, consisting of 1,462 women without dementia aged 38–60 years, was initiated in 1968–1969 in Gothenburg, Sweden. Follow-ups were conducted in 1974–1975, 1980–1981, 1992–1993, and 2000–2001. All-cause dementia was diagnosed according to DSM-III-R criteria and AD according to National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association criteria. Cox proportional hazards regression examined baseline, time-dependent, and change in cholesterol levels in relation to incident dementia and AD among all participants. Analyses were repeated among participants who survived to the age of 70 years or older and participated in the 2000–2001 examination. Results: Higher cholesterol level in 1968 was not associated with an increased risk of AD (highest vs lowest quartile: hazard ratio [HR] 2.82, 95% confidence interval [CI] 0.94–8.43) among those who survived to and participated in the 2000–2001 examination. While there was no association between cholesterol level and dementia when considering all participants over 32 years, a time-dependent decrease in cholesterol over the follow-up was associated with an increased risk of dementia (HR 2.35, 95% CI 1.22–4.58). Conclusion: These data suggest that midlife cholesterol level is not associated with an increased risk of AD. However, there may be a slight risk among those surviving to an age at risk for dementia. Declining cholesterol levels from midlife to late life may better predict AD risk than levels obtained at one timepoint prior to dementia onset. Analytic strategies examining this and other risk factors across the lifespan may affect interpretation of results.
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| 45. |
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| 46. |
- Najar, Jenna, et al.
(författare)
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Cognitive and physical activity and dementia A 44-year longitudinal population study of women
- 2019
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 92:12, s. E1322-E1330
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether cognitive and physical activities in midlife are associated with reduced risk of dementia and dementia subtypes in women followed for 44 years. Methods A population-based sample of 800 women aged 38-54 years (mean age 47 years) was followed from 1968 to 2012. Cognitive (artistic, intellectual, manual, religious, and club) and physical activity were assessed at baseline. During follow-up, dementia (n = 194), Alzheimer disease (n = 102), vascular dementia (n = 27), mixed dementia (n = 41), and dementia with cerebrovascular disease (n = 81) were diagnosed according to established criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. Cox regression models were used with adjustment for age, education, socioeconomic status, hypertension, body mass index, cigarette smoking, diabetes mellitus, angina pectoris, stress, and major depression. Results We found that cognitive activity in midlife was associated with a reduced risk of total dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.49-0.89) and Alzheimer disease (HR 0.54; 95% CI 0.36-0.82) during follow-up. Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22-0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28-0.78). The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was then also associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46-0.99). Conclusion Our findings suggests that midlife cognitive and physical activities are independently associated with reduced risk of dementia and dementia subtypes. The results indicate that these midlife activities may have a role in preserving cognitive health in old age.
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| 47. |
- Najar, Jenna, et al.
(författare)
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Reproductive period and dementia: A 44-year longitudinal population study of Swedish women
- 2020
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Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 16:8, s. 1153-1163
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Longitudinal studies examining the effect of endogenous estrogens on dementia risk are needed to understand why women have higher dementia incidence than men after age 85. Methods: A population-based sample of women with natural menopause (N = 1364) from Gothenburg, Sweden, was followed from 1968-2012. Information on endogenous estrogens (age at menarche and menopause, number of pregnancies, and months of breastfeeding) was obtained from interviews in 1968-1992. Dementia was diagnosed according to established criteria based on information from neuropsychiatric examinations and close informant interviews. Results: We found that longer reproductive period was associated with increased risk of dementia (hazard ratio [HR] per year 1.06, 95% confidence interval [CI] 1.03-1.20) and Alzheimer's disease (AD) (1.06, 1.02-1.11), particularly for those with dementia (1.10, 1.04-1.17) and AD (1.15, 1.06-1.26) onset after age 85. Discussion: These results may explain why women have higher dementia incidence compared to men after age 85, the age with the highest number of dementia cases.
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| 48. |
- Nilsson, Johan, 1978, et al.
(författare)
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Changes in the expression of worries, anxiety, and generalized anxiety disorder with increasing age: A population study of 70 to 85-year-olds
- 2019
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 34:2, s. 249-257
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The prevalence of generalized anxiety disorder (GAD) is supposed to decrease with age. Reasons suggested include that emotional control increases and that anxiety and worry are expressed differently in older adults. The aim of this study was to examine how the expression of anxiety and worry changes with age and how this influences diagnoses in current classification systems. Method: Semistructured psychiatric examinations were performed in population-based samples of 70- (n=562), 75- (n=770), 79/80- (n=603), and 85-year-olds (n=433). Individuals with dementia were excluded. GAD was diagnosed according to DSM-5 (DSM5 GAD) and ICD-10 (ICD10 GAD) criteria. Individual symptoms were assessed according to severity and frequency. Functioning was measured with Global Assessment of Functioning (GAF). Results: The prevalence of clinical anxiety, autonomic arousal, muscle tension, and irritability decreased with age, while that of worry and fatigue increased. Concentration difficulties and sleep disturbances remained stable. The prevalence of ICD10 GAD tended to decrease, while that of DSM5 GAD did not change with age. Core symptoms and diagnoses of GAD were related to lower GAF scores. However, in those with autonomic arousal and ICD10 GAD, GAF scores increased with age. Conclusions: The prevalence of ICD10 GAD tended to decrease with increasing age while the prevalence of DSM5 GAD remained stable. This difference was partly due to a decreased frequency of severe anxiety and autonomic arousal symptoms, and that worries increased, suggesting changes in the expression of GAD with increasing age.
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| 49. |
- Nilsson, Johan, 1978, et al.
(författare)
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The 1-Month Prevalence of Generalized Anxiety Disorder According to DSM-IV, DSM-V, and ICD-10 Among Nondemented 75-Year-Olds in Gothenburg, Sweden.
- 2012
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 20:11, s. 963-72
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Tidskriftsartikel (refereegranskat)abstract
- To examine the 1-month prevalence of generalized anxiety disorder (GAD) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Diagnostic and Statistical Manual of Mental, Fifth Edition (DSM-V), and International Classification of Diseases, Tenth Revision (ICD-10), and the overlap between these criteria, in a population sample of 75-year-olds. We also aimed to examine comorbidity between GAD and other psychiatric diagnoses, such as depression.
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| 50. |
- Olesen, Pernille J, et al.
(författare)
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Temporal lobe atrophy and white matter lesions are related to major depression over 5 years in the elderly.
- 2010
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Ingår i: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. - : Springer Science and Business Media LLC. - 1740-634X. ; 35:13, s. 2638-45
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Tidskriftsartikel (refereegranskat)abstract
- The influence of organic brain changes on the development of depression in the elderly is uncertain. Cross-sectional studies, most often from clinical samples, report associations with brain atrophy and cerebrovascular disease, while longitudinal population studies have given mixed results. Our aim was to investigate whether cortical atrophy and white matter lesions (WMLs) on computed tomography (CT) predict occurrence of depression in the elderly. This is a prospective population-based study with 5-year follow-up. The baseline sample included 525 elderly subjects, aged 70-86 years, without dementia or major depression, with a score on the Mini-Mental State Examination above 25, and without dementia at follow-up. Cortical atrophy and WMLs were evaluated at baseline using CT. The main outcome measure was development of major or minor depression at follow-up according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition, as evaluated using neuropsychiatric examinations and hospital discharge registers. Logistic regression was used to estimate risk. Over the period of 5 years, 20 individuals developed major and 63 minor depression. Presence of temporal lobe atrophy (odds ratio (OR)=2.81, 95% confidence interval (CI) 1.04-7.62) and moderate-to-severe WMLs (OR=3.21, 95% CI 1.00-10.26) independently predicted major, but not minor, depression after controlling for various confounders. Other brain changes did not predict occurrence of depression. Our findings suggest that temporal lobe atrophy and WMLs represent relatively independent and complementary pathways to major depression in the elderly. This may have implications for prevention, as both neurodegeneration and cerebrovascular disease have been related to preventable factors.
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