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  • Sämgård, Kajsa, et al. (författare)
  • Cerebrospinal fluid total tau as a marker of Alzheimer's disease intensity.
  • 2010
  • Ingår i: International Journal of Geriatric Psychiatry. - John Wiley and Sons Ltd. - 1099-1166. ; 25, s. 403-410
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The aim of this longitudinal study was to test the hypothesis that CSF biomarkers in AD patients also may be forward-looking measures that are associated not only with the degree and profile of cognitive impairment but also with changes in cognition over time. METHODS: Here, we assessed the association of CSF Abeta42, T-tau and P-tau with neuropsychological scores of disease severity, as well as the rate of disease progression, in 142 patients with Alzheimer's disease. All patients were part of a 3-year prospective longitudinal treatment study. RESULTS: A more rapid progress in MMSE score reduction was seen in AD patients with T-tau levels higher than the upper quartile (800 ng/L) compared with Alzheimer's disease patients with lower T-tau levels (p = 0.008). We also found that individuals with T-tau > 800 ng/L performed worse in total scores and especially in memory and orientation when assessed with MMSE and ADAS cog than patients with T-tau <800 ng/L. Similar results were obtained for P-tau. No associations were seen between Abeta42 and cognitive scores or disease progression. DISCUSSION: These findings support the hypothesis that increased levels of T-tau reflect the intensity of the disease and are associated with a more rapid disease progress. Copyright (c) 2009 John Wiley & Sons, Ltd.
  • Zou, Ding, 1970-, et al. (författare)
  • Insomnia and cardiorespiratory fitness in a middle-aged population: the SCAPIS pilot study.
  • 2019
  • Ingår i: Sleep & breathing = Schlaf & Atmung. - 1522-1709. ; 23:1, s. 319-326
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The relationship between insomnia and cardiorespiratory fitness (CRF), a well-established risk factor for cardiovascular disease, has not been extensively studied. We aimed to assess the independent association between insomnia and CRF in a population-based cohort of subjects aged 50 to 64 years.METHODS: Subjects participating in the Swedish CArdioPulmonary bioImaging Study (SCAPIS) pilot cohort (n = 603, men 47.9%) underwent a submaximal cycle ergometer test for estimation of maximal oxygen consumption (VO2max). Data on physical activity and sedentary time were collected via waist-worn accelerometers. An insomnia severity index score ≥ 10 was used to define insomnia.RESULTS: Insomnia was identified in 31.8% of the population. The VO2max was significantly lower in insomnia subjects compared with the non-insomnia group (31.2 ± 6.3 vs. 32.4 ± 6.5 ml* kg-1 *min-1, p = 0.028). There was no difference in objectively assessed physical activity or time spent sedentary between the groups. In a multivariate generalized linear model adjusting for confounders, an independent association between insomnia status and lower VO2max was found in men, but not in women (β = - 1.15 [95% CI - 2.23-- 0.06] and - 0.09 [- 1.09-0.92], p = 0.038 and 0.866, respectively).CONCLUSIONS: We found a modest, but significant, association between insomnia and lower CRF in middle-aged men, but not in women. Our results suggest that insomnia may link to cardiovascular disease via reduced CRF. Insomnia may require a specific focus in the context of health campaigns addressing CRF.
  • Omerov, Pernilla, et al. (författare)
  • Preparatory Studies to a Population-Based Survey of Suicide-Bereaved Parents in Sweden.
  • 2013
  • Ingår i: Crisis. - 0227-5910. ; 34:3, s. 200-210
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There is a need for evidence-based guidelines on how professionals should act following a suicide. In an effort to provide empiric knowledge, we designed a nationwide population-based study including suicide-bereaved parents.AIM: To describe the process from creating hypotheses through interviews to the development of a population-based questionnaire.METHOD: We used interviews, qualitative analysis and various means of validation to create a study-specific questionnaire to be used in a nonselected nationwide population of suicide-bereaved parents and a control population of nonbereaved (N = 2:1). The Swedish Register of Causes of Death and the Multigeneration Register were used to identify eligible individuals. All presumptive participants received a letter of invitation followed by a personal contact.RESULTS: We developed a questionnaire covering the participants' perception of participation, their daily living, psychological morbidity, professional actions, and other experiences in immediate connection to the time before and after the suicide. Almost three out of four parents (bereaved = 666, nonbereaved = 377) responded to the questionnaire.CONCLUSIONS: By involving parents early in the research process we were able to create a questionnaire that generated a high participation rate in a nationwide population-based study that might help us to answer our hypotheses about bereavement after suicide.
  • Sveen, Josefin, et al. (författare)
  • They still grieve - a nationwide follow-up of young adults 2-9 years after losing a sibling to cancer
  • 2014
  • Ingår i: Psycho-Oncology. - 1057-9249 .- 1099-1611. ; 23:6, s. 658-664
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aims of this study were to assess the prevalence of unresolved grief in bereaved young adult siblings and examine possible contributing factors. Methods: The study was a Swedish population-based study of young adults who had lost a brother or sister to cancer, 2-9 years earlier. Of 240 eligible siblings, 174 (73%) completed a study-specific questionnaire. This study focused on whether the respondents had worked through their grief over the sibling's death and to what extent. Results: A majority (54%) of siblings stated that they had worked through their grief either not at all' or to some extent' at the time of investigation. In multiple regression analyses with unresolved grief as the dependent variable, 21% of the variance was explained by lack of social support and shorter time since loss. Conclusion: The majority of bereaved young adults had not worked through their grief over the sibling's death. A small group of siblings reported that they had not worked through their grief at all, which may be an indicator of prolonged grief. Lack of social support and more recent loss were associated with not having worked through the grief over the sibling's death.
  • Campbell, Ian, et al. (författare)
  • The relation between the age at diagnosis of problem behaviors related to aggression and distal outcomes in Swedish children.
  • 2019
  • Ingår i: European child & adolescent psychiatry. - 1435-165X. ; 28:7, s. 899-911
  • Tidskriftsartikel (refereegranskat)abstract
    • Severe childhood aggressive behaviors are known to predict negative outcomes later in life; however, little is known about the effect of when in childhood aggression problems are diagnosed. While an earlier first diagnosis of problematic aggressive behavior might be associated with increased severity and, thus, worse outcomes, it is also possible that an earlier diagnosis affords an earlier start of treatment programs or indicates that greater attention is being paid to behavioral problems, thus resulting in attenuation of the severity of childhood aggression's impact on distal outcomes. The current study analyzed data from the population-based Swedish Data Registries, which include data on all children formally diagnosed by the Swedish medical system with a wide range of aggression problems between ages 8 and 18 (N = 5816) during the years 1987-2013, along with a matched control. Time-to-event analyses investigated whether the age at time of diagnosis affects later life outcomes while controlling for relevant confounders. Results show that for both boys and girls, those with a later diagnosis had lower average incomes (regression coefficient b = - 0.055, p &lt; 0.005) and a higher probability of having a criminal record (odds ratio 1.126, p &lt; 0.005) than children with earlier diagnoses. The effect on suicide attempts was not significant after correcting for multiple testing (odds ratio 1.264, p = 0.016). Grade score was not significantly affected. The results warrant further research concerning the potential advantage of earlier diagnoses, especially concerning generalizability beyond the Swedish population.
  • Bergenheim, Tommy A, et al. (författare)
  • Selective peripheral denervation for cervical dystonia long-term follow-up
  • 2015
  • Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - 0022-3050. ; 86:12, s. 1307-1313
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: 61 procedures with selective peripheral denervation for cervical dystonia were retrospectively analysed concerning surgical results, pain, quality of life (QoL) and recurrences.METHODS: The patients were assessed with the Tsui torticollis scale, Visual Analogue Scale (VAS) for pain and Fugl-Meyer scale for QoL. Evaluations were performed preoperatively, early postoperatively, at 6 months, then at a mean of 42 (13-165) months. All patients underwent electromyogram at baseline, which was repeated in cases who presented with recurrence of symptoms after surgery.RESULTS: Six months of follow-up was available for 55 (90%) of the procedures and late follow-up for 34 (56%). The mean score of the Tsui scale was 10 preoperatively. It improved to 4.5 (p&lt;0.001) at 6 months, and 5.3 (p&lt;0.001) at late follow-up. VAS for pain improved from 6.5 preoperatively to 4.2 (p&lt;0.001) at 6 months and 4 (p&lt;0.01) at late follow-up. The Fugl-Meyer score for QoL improved from 43.3 to 46.6 (p&lt;0.05) at 6 months, and to 51.1 (p&lt;0.05) at late follow-up. Major reinnervation and/or change in the dystonic pattern occurred following 29% of the procedures, and led in 26% of patients to reoperation with either additional denervation or pallidal stimulation.CONCLUSIONS: Selective peripheral denervation remains a surgical option in the treatment of cervical dystonia when conservative measures fail. Although the majority of patients experience a significant relief of symptoms, there is a substantial risk of reinnervation and/or change in the pattern of the cervical dystonia.
  • Bergh, Cecilia, 1972-, et al. (författare)
  • Stress resilience in male adolescents and subsequent stroke risk cohort study
  • 2014
  • Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - BMJ Publishing Group Ltd. - 0022-3050. ; 85:12, s. 1331-1336
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Exposure to psychosocial stress has been identified as a possible stroke risk, but the role of stress resilience which may be relevant to chronic exposure is uncertain. We investigated the association of stress resilience in adolescence with subsequent stroke risk.Methods Register-based cohort study. Some 237 879 males born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Cox regression estimated the association of stress resilience with stroke, after adjustment for established stroke risk factors.Results Some 3411 diagnoses of first stroke were identified. Lowest stress resilience (21.8%) compared with the highest (23.7%) was associated with increased stroke risk, producing unadjusted HR (with 95% CIs) of 1.54 (1.40 to 1.70). The association attenuated slightly to 1.48 (1.34 to 1.63) after adjustment for markers of socioeconomic circumstances in childhood; and after further adjustment for markers of development and disease in adolescence (blood pressure, cognitive function and pre-existing cardiovascular disease) to 1.30 (1.18 to 1.45). The greatest reduction followed further adjustment for markers of physical fitness (BMI and physical working capacity) in adolescence to 1.16 (1.04 to 1.29). The results were consistent when stroke was subdivided into fatal, ischaemic and haemorrhagic, with higher magnitude associations for fatal rather than non-fatal, and for haemorrhagic rather than ischaemic stroke.Conclusions Stress susceptibility and, therefore, psychosocial stress may be implicated in the aetiology of stroke. This association may be explained, in part, by poorer physical fitness. Effective prevention might focus on behaviour/lifestyle and psychosocial stress.
  • Bos, Isabelle, et al. (författare)
  • The frequency and influence of dementia risk factors in prodromal Alzheimer's disease
  • 2017
  • Ingår i: Neurobiology of Aging. - Elsevier. - 0197-4580. ; 56, s. 33-40
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated whether dementia risk factors were associated with prodromal Alzheimer's disease (AD) according to the International Working Group-2 and National Institute of Aging-Alzheimer's Association criteria, and with cognitive decline. A total of 1394 subjects with mild cognitive impairment from 14 different studies were classified according to these research criteria, based on cognitive performance and biomarkers. We compared the frequency of 10 risk factors between the subgroups, and used Cox-regression to examine the effect of risk factors on cognitive decline. Depression, obesity, and hypercholesterolemia occurred more often in individuals with low-AD-likelihood, compared with those with a high-AD-likelihood. Only alcohol use increased the risk of cognitive decline, regardless of AD pathology. These results suggest that traditional risk factors for AD are not associated with prodromal AD or with progression to dementia, among subjects with mild cognitive impairment. Future studies should validate these findings and determine whether risk factors might be of influence at an earlier stage (i.e., preclinical) of AD.
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