| 1. |
- Novak, Masuma, 1969, et al.
(författare)
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Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women.
- 2020
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Ingår i: BMC geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- This study examined whether loneliness predicts cardiovascular- and all-cause mortality in older men and women.Baseline data from the Gothenburg H70 Birth Cohort Studies, collected during 2000 on 70-year-olds born 1930 and living in Gothenburg were used for analysis (n=524). Mortality data were analyzed until 2012 through Swedish national registers.Perceived loneliness was reported by 17.1% of the men and 30.9% of the women in a face-to-face interview with mental health professional. A total of 142 participants died during the 12-year follow-up period, with 5334 person-years at risk, corresponding to 26.6 deaths/1000 person-years. Cardiovascular disease accounted for 59.2% of all deaths. The cumulative rates/1000 person-years for cardiovascular mortality were 20.8 (men) and 11.5 (women), and for all-cause mortality 33.8 (men) and 20.5 (women), respectively. In Cox regression models, no significant increased risk of mortality was seen for men with loneliness compared to men without loneliness (cardiovascular mortality HR 1.52, 95% CI 0.78-2.96; all-cause HR 1.32, 95% CI 0.77-2.28). Increased risk of cardiovascular mortality was observed in women with loneliness compared to those without (HR 2.25 95% CI 1.14-4.45), and the risk remained significant in a multivariable-adjusted model (HR 2.42 95% CI 1.04-5.65).Loneliness was shown to be an independent predictor of cardiovascular mortality in women. We found no evidence to indicate that loneliness was associated with an increased risk of either cardiovascular- or all-cause mortality in men.
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| 2. |
- Novak, Masuma, 1969, et al.
(författare)
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Six-year mortality associated with living alone and loneliness in Swedish men and women born in 1930
- 2023
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Ingår i: BMC Geriatrics. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study examined how living alone and loneliness associate with all-cause mortality in older men and women. Methods: Baseline data from the Gothenburg H70 Birth Cohort Studies, including 70-year-olds interviewed in 2000 and 75-year-olds (new recruits) interviewed in 2005were used for analyses (N = 778, 353 men, 425 women). Six-year mortality was based on national register data. Results: At baseline, 36.6% lived alone and 31.9% reported feelings of loneliness. A total of 72 (9.3%) participants died during the 6-year follow-up period. Cumulative mortality rates per 1000 person-years were 23.9 for men and 9.6 for women. Mortality was increased more than twofold among men who lived alone compared to men living with someone (HR 2.40, 95% CI 1.34–4.30). Elevated risk remained after multivariable adjustment including loneliness and depression (HR 2.56, 95% CI 1.27–5.16). Stratification revealed that mortality risk in the group of men who lived alone and felt lonely was twice that of their peers who lived with someone and did not experience loneliness (HR 2.52, 95% CI 1.26–5.05). In women, a more than fourfold increased risk of mortality was observed in those who experienced loneliness despite living with others (HR 4.52, 95% CI 1.43–14.23). Conclusions: Living alone was an independent risk factor for death in men but not in women. Mortality was doubled in men who lived alone and felt lonely. In contrast, mortality was particularly elevated in women who felt lonely despite living with others. In the multivariable adjusted models these associations were attenuated and were no longer significant after adjusting for mainly depression in men and physical inactivity in women. Gender needs to be taken into account when considering the health consequences of living situation and loneliness.
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| 3. |
- Rydberg Sterner, Therese, et al.
(författare)
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Depression and neuroticism decrease among women but not among men between 1976-2016 in Swedish septuagenarians
- 2019
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Ingår i: Acta Psychiatrica Scandinavica. - : Wiley. - 0001-690X .- 1600-0447. ; 139:4, s. 381-394
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We evaluated birth cohort differences in depressive symptom burden, prevalence of depression diagnoses, and neuroticism, among Swedish 70-year-olds examined between 1976 and 2016. Methods: We used a repeated cross-sectional design examining four representative population samples of Swedish 70-year-olds (total n=2279) with identical methods in 1976-77 (n=392), 1992-93 (n=226), 2000-02 (n=487), and 2014-16 (n=1166). Depressive symptom burden was rated with the Montgomery Åsberg Depression Rating Scale. Major depression was diagnosed according to DSM-5, and minor depression according to DSM-IV-TR research criteria. Neuroticism was rated with the Eysenck Personality Inventory. Results: For women in 2014-16, MADRS score (4.4 vs. 6.1 vs. 5.8; p<0.05) and neuroticism (6.6 vs. 7.7 vs. 9.2; p<0.05) were lower compared to 1992-93 and 1976-77, and the prevalence of any depression was lower compared to 2000-02 and 1992-93 (10.9% vs. 16.9% vs. 18.1%; p<0.05). For men, we observed no birth cohort differences in depression, while neuroticism was found to be lower in 2014-16 compared to 1976-77 among men without depression (5.1 vs. 5.9; p<0.01). The sex difference for MADRS and neuroticism declined between 1976-77 and 2014-16 (cohort*sex p<0.05). Conclusions: Depressive burden and neuroticism decreased in 70-year-old women between 1976 and 2016.
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| 4. |
- Rydberg Sterner, Therese, et al.
(författare)
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Depression in relation to sex and gender expression among Swedish septuagenarians-Results from the H70 study
- 2020
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 15:9
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Tidskriftsartikel (refereegranskat)abstract
- Objective Little is known about the role of gender expression (femininity, masculinity, or androgyny) in relation to sex differences in depression. This study tested if gender expression was associated with depression and burden of depressive symptoms in a 70-year-old population. Methods A cross-sectional population-based sample of 70-year-olds from The Gothenburg H70 Birth Cohort Study (n = 1203) was examined in 2014-16. Data were collected using psychiatric examinations and structured questionnaires, including the Positive-Negative Sex-Role Inventory to assess gender expression. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders criteria, and symptom burden was assessed with Montgomery angstrom sberg Depression Rating Scale (MADRS). Results Gender expression was related to MADRS score and depression diagnosis. In fully adjusted models, feminine traits with low social desirability (FEM-) were associated with a higher MADRS score (R(2)0.16; B 0.16; CI 0.1-0.2), while androgyny (t ratio) (R(2)0.12; B 0.42; CI 0.1-0.7) and masculine traits with high social desirability (MAS+) (R(2)0.13; B -0.06; CI -0.1--0.01) were associated with a lower MADRS score. Also, feminine traits with low social desirability (FEM-) were positively associated with depression (OR 1.04; CI 1.01-1.1). No associations between depression and masculinity or androgyny were observed in adjusted models. There were no interactions between sex and gender expression in relation to depression or MADRS score, indicating that the effects of gender expression were similar in men and women. Conclusions We found that gender expression was associated to both depression and burden of depressive symptoms. More specifically, we found that femininity was associated to higher levels of depression, irrespective of biological sex. In addition, masculinity and androgyny were associated with lower levels of depression. These results highlight the importance of taking gender expression into consideration when studying sex differences in depression among older populations in future studies.
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| 5. |
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| 6. |
- Wetterberg, Hanna, et al.
(författare)
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Representativeness in population-based studies of older adults: five waves of cross-sectional examinations in the Gothenburg H70 Birth Cohort Study
- 2022
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo describe representativeness in the Gothenburg H70 1930 Birth Cohort Study.DesignRepeated cross-sectional examinations of a population-based study.SettingGothenburg, Sweden.ParticipantsAll residents of Gothenburg, Sweden, born on specific birth dates in 1930 were invited to a comprehensive health examination at ages 70, 75, 79, 85 and 88. The number of participants at each examination was 524 at age 70, 767 at age 75, 580 at age 79, 416 at age 85, and 258 at age 88.Primary outcome measuresWe compared register data on sociodemographic characteristics and hospital discharge diagnoses between participants and (1) refusals, (2) all same-aged individuals in Gothenburg and (3) all same-aged individuals in Sweden. We also compared mortality rates between participants and refusals.ResultsRefusal rate increased with age. At two or more examination waves, participants compared with refusals had higher educational level, more often had osteoarthritis, had lower mortality rates, had lower prevalence of neuropsychiatric, alcohol-related and cardiovascular disorders, and were more often married. At two examination waves, participants compared with same-aged individuals in Gothenburg had higher education and were more often born in Sweden. At two examination waves or more, participants compared with same-aged individuals in Sweden had higher education, had higher average income, less often had ischaemic heart disease, were less often born in Sweden and were more often divorced.ConclusionsParticipants were more similar to the target population in Gothenburg than to refusals and same-aged individuals in Sweden. Our study shows the importance of having different comparison groups when assessing representativeness of population studies, which is important in evaluating generalisability of results. The study also contributes unique and up-to-date knowledge about participation bias in these high age groups.
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| 7. |
- Zettergren, Anna, 1978, et al.
(författare)
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The ACE Gene Is Associated with Late-Life Major Depression and Age at Dementia Onset in a Population-Based Cohort.
- 2017
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 25:2, s. 170-177
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Tidskriftsartikel (refereegranskat)abstract
- Depression and dementia in the elderly have been suggested to share similar risk factors and pathogenetic background, and recently the authors reported that the APOEɛ4 allele is a risk factor for both disorders in the general population. The aim of the present study was to examine the influence of the well-known polymorphisms rs1799752 in the angiotensin-converting enzyme (ACE) and rs5186 in the angiotensin receptor II type 1 (AGTR1) on late-life depression and dementia in a population-based Swedish cohort of older individuals followed over 12 years.In 2000-2001, 900 individuals underwent neuropsychiatric and neuropsychological examinations. Follow-up evaluations were performed in 2005-2006 and 2009-2010, and register data on dementia to 2012 were included. Cross-sectional associations between genotypes/alleles and depression and dementia at baseline and between genotypes/alleles and depression on at least one occasion during the study period and dementia onset to 2012 were investigated.As previously found for rs1799752 in ACE, rs5186 in AGTR1 was associated with dementia at baseline (OR: 3.25 [CI: 1.42-7.06], z=2.90, p=0.004). These associations became substantially weaker, or disappeared, when dementia onset to 2012 was included. For rs1799752 this could be explained by a significant association with age at onset (mean: 79.5 [SD: 6.45] years for risk-genotype carriers and 81.7 [SD: 7.12] years for carriers of other genotypes, b=-2.43, t=-2.38, df=192, p=0.02). When individuals with major depression on at least one occasion were analyzed, a significant association (OR: 2.14 [95% CI: 1.13-4.20], z=2.28, p=0.02), remaining after exclusion of dementia, with rs1799752 in ACE was found.In this population-based sample of older individuals, genetic variations in ACE seem to be important both for late-life major depression and dementia.
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| 8. |
- Gudmundsson, Pia, 1978, et al.
(författare)
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Depression in Swedish women: relationship to factors at birth.
- 2011
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Ingår i: European journal of epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 26:1, s. 55-60
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Tidskriftsartikel (refereegranskat)abstract
- Depression is a common and serious disorder that may have developmental origins. Birth-related factors have been related to childhood and adult occurrence of somatic as well as psychiatric disorders, but studies on the relationship between birth-related factors and depression are few and show mixed results. In addition, varying methods have been used to assess depression. Standardized clinical criteria to diagnose depression, combined with birth data collected from midwife records have not been used in most studies. Participants in the Prospective Population Study of Women in Sweden (803 women), born 1914, 1918, 1922 and 1930, provide information on birth factors and depression. Women participated from 1968 at mid-life ages of 38-60years, to 2000, when they were age 78-92years. Original birth records containing birth weight, length, head circumference, and gestational time, as well as social factors were obtained. Lifetime depression was diagnosed via multiple information sources. Symptoms were assessed using the Comprehensive Psychopathological Rating Scale and diagnoses were based on DSM-III-R criteria. Over their lifetime, 44.6% of women in this sample experienced depression. Birth weights≤3500g [odds ratio (OR), age-adjusted=1.72; 95% CI 1.29-2.28, P<0.001] and shorter gestational time (OR, age-adjusted=1.13; 95% CI 1.04-1.24, P=0.005) were independently associated with a higher odds of lifetime depression in a logistic regression model adjusted for age. Lower than median birth weights and shorter gestational time were related to lifetime depression in women. Both neurodevelopmental and environmental contributions to lifetime depression may be considered.
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| 9. |
- Gudmundsson, Pia, 1978
(författare)
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Factors related to depression in women - over the life course
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- FACTORS RELATED TO DEPRESSION IN WOMEN – OVER THE LIFE COURSE Pia Gudmundsson Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden 2012 Background: Depression is a serious and common disorder that is predominant in women and has an unclear etiology. To evaluate factors related to depression is of great value and the main purpose of this thesis. A life course approach and a focus on biological factors are applied. Methods: Biological factors were investigated in relationship to depression in the Prospective Population Study of Women in Gothenburg (PPSW), a multi-disciplinary longitudinal study on a representative sample of women first examined in 1968-69 (N=1462). Psychiatric examinations were performed in a subsample of women at baseline (N=800), and at four follow-ups until year 2002. Diagnoses of depression were based on DSM-III-R criteria and multiple sources of information were used. Birth-related factors were abstracted from original midwife records (n=803), and evaluated longitudinally in relationship to lifetime depression (Paper I). In 1992, a subsample of 84 women without dementia participated in lumbar punctures and CSF was analysed for biomarkers. Levels of biomarkers were assessed cross-sectionally in relationship to depression (Paper II and III). Results: Paper I showed that 44.6% (n=358) of women experienced any lifetime depression. Birth weight <3500 gram and shorter gestational time were independently associated with a higher odds of any lifetime depression. Paper II showed that compared to women without depression (n=70), women with Major Depressive Disorder (MDD) (n=11), had higher levels of Amyloid beta-42 (Aβ42), and the CSF/serum albumin ratio. Paper III showed that women with MDD (n=11) had higher levels of Neurofilament Protein Light (NFL). A multivariate model showed that each biomarker was independently, and as a CSF biomarker profile, positively associated with MDD. Conclusion: Lower than median birth weight and shorter gestational time, higher levels of CSF Aβ42 and CSF NFL, and higher CSF/serum albumin ratio, were positively associated with depression in women. These results may suggest involvement of neurodevelopmental, neurodegenerative, and vascular factors in the pathophysiology of depression, potentially supporting a stress-related hypothesis of depression. Keywords: Depression, women, epidemiology, etiology, life course, biological factors, cerebrospinal fluid, biomarkers, birth-related, population-based, PPSW ISBN 978-91-628-8515-1
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| 10. |
- Gudmundsson, Pia, 1978, et al.
(författare)
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Is there a CSF biomarker profile related to depression in elderly women?
- 2010
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Ingår i: Psychiatry Research. - 0165-1781. ; 176:2-3, s. 174-178
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Tidskriftsartikel (refereegranskat)abstract
- In light of our previous observation of higher levels of cerebrospinal fluid (CSF) amyloid beta-42 (Aβ42) and CSF/serum albumin ratio in major depressive disorder (MDD), we analyzed two additional CSF biomarkers reflecting neurodegeneration—neurofilament protein light (NFL) and glial fibrillary acidic protein (GFAp)—in relationship to prevalent geriatric depression. Neuropsychiatric, physical, and lumbar puncture examinations, with DSM-III-R-based depression diagnoses and measurement of CSF levels of NFL and GFAp, were evaluated among a population-based sample of 78 elderly women (mean age, 73.9±3.2 years) without dementia for at least 10 years after CSF collection. Eleven (13.1%) women had MDD, and higher levels of NFL compared with women without depression. A multivariate model including age, NFL, Aβ42 and the CSF/serum albumin ratio showed that each biomarker was independently and positively associated with MDD, and that this biomarker profile explained more variation in the model compared with single or combined biomarkers. A CSF profile with higher levels of NFL, Aβ42, and CSF/serum albumin ratio may indicate neuropathological and vascular events in depression etiology. This contrasts with the well-characterized pattern of low Aβ42, higher CSF/serum albumin ratio, and higher NFL in Alzheimer's disease.
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