| 1. |
- Falk Erhag, Hanna, et al.
(author)
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A Multidisciplinary Approach to Capability in Age and Ageing
- 2022
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Book (other academic/artistic)abstract
- This open access book provides insight on how to interpret capability in ageing – one’s individual ability to perform actions in order to reach goals one has reason to value – from a multidisciplinary approach. With for the first time in history there being more people in the world aged 60 years and over than there are children below the age of 5, the book describes this demographic trends as well as the large global challenges and important societal implications this will have such as a worldwide increase in the number of persons affected with dementia, and in the ratio of retired persons to those still in the labor market. Through contributions from many different research areas, it discussed how capability depends on interactions between the individual (e.g. health, genetics, personality, intellectual capacity), environment (e.g. family, friends, home, work place), and society (e.g. political decisions, ageism, historical period). The final chapter by the editors summarizes the differences and similarities in these contributions. As such this book provides an interesting read for students, teachers and researchers at different levels and from different fields interested in capability and multidisciplinary research.
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| 2. |
- Jonson, Mattias, et al.
(author)
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Passive and active suicidal ideation in Swedish 85-year-olds: Time trends 1986-2015
- 2021
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 290, s. 300-307
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Journal article (peer-reviewed)abstract
- Abstract Background Older adults have high suicide rates. We investigated potential time trends in the prevalence of passive and active suicidal ideation in 85-year-olds. Further, we examined factors associated with such ideation in this age group. Methods Population-based samples of 85-year-olds were interviewed in 1986 (N=347), 2008 (N=426) and 2015 (N=320). Past-month passive/active suicidal ideation was evaluated with the Paykel questions. Results Reporting any type of passive or active suicidal ideation was less common in 2008 (7.3%, p<0.001) and 2015 (7.2%, p<0.001) compared to 1986 (16.4%). The change was driven by decreases in passive ideation. Passive/active suicidal ideation was associated with higher MADRS score (OR: 1.2, 95% CI: 1.1-1.2, p<0.001), institution residence (OR: 3.9, 95% CI: 1.7-8.9, p=0.001) and feelings of loneliness (OR: 2.7, 95% CI: 1.4-5.2, p=0.003). When stratified by sex, it was associated with institution residence (OR: 3.7, 95% CI: 1.4-9.9, p=0.008) and feelings of loneliness (OR: 3.0, 95% CI: 1.4-6.3, p=0.005) in women. In men, we observed a tenfold higher risk in those without partners (OR: 9.8, 95% CI: 2.9-33.5, p<0.001). Limitations While differential three-year mortality was not observed in 1986, mortality was higher among non-participants in 2008 and 2015. This might have inflated cohort differences in passive/active suicidal ideation. Conclusion An initial decrease in the prevalence of passive/active suicidal ideation in 85-year-olds was observed but this positive trend did not persist. Results underline that preventive strategies targeting loneliness and focusing on institutional settings are needed, as are interventions for men without partners.
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| 3. |
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| 4. |
- Claesson, Lisbeth, 1955, et al.
(author)
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Cognitive impairment after stroke - impact on activities of daily living and costs of care for elderly people. The Göteborg 70+ Stroke Study.
- 2005
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In: Cerebrovascular diseases (Basel, Switzerland). - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 19:2, s. 102-9
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Journal article (peer-reviewed)abstract
- BACKGROUND AND PURPOSE: The economic burden of stroke is substantial and is likely to increase with an increasing number of elderly individuals in the population. There is thus a need for information on the use of health care resources and costs among these elderly stroke patients. We examined the impact of the cognitive impairments on the ability to perform activities of daily living (ADL) and utilization and costs of health care in a cohort of elderly stroke patients. METHODS: One hundred and forty-nine patients aged >/=70 years with acute stroke were included. The patients were assessed regarding their ability to carry out ADL and health resource utilization and cost during the first year after stroke. Cognitive impairments were assessed 18 months after the index stroke. RESULTS: Stroke severity in acute stroke and cognitive impairment at 18 months after stroke onset was associated with impairment in ADL and increased costs for utilisation of care during the first year. Patients with cognitive impairment were more dependent on personal assistance in ADL. Costs per patient during the study were three times higher for patients with cognitive impairment. Hospital care, institutional living and different kinds of support from society accounted for the highest costs. CONCLUSIONS: Costs of care utilisation during the first year after stroke were associated with cognitive impairments, stroke severity and dependence in ADL. The results should be interpreted cautiously as the assessment of cognitive function was made 18 months after stroke onset and costs were estimated for the first year after stroke.
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| 5. |
- Lindén, Thomas, 1962, et al.
(author)
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Visual neglect and cognitive impairment in elderly patients late after stroke.
- 2005
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In: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 111:3, s. 163-8
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To investigate the prevalence of visual neglect and its relationship to cognitive impairment and dementia in elderly stroke patients 20 months after stroke. METHODS: Of 243 stroke patients aged 70-91 years, 149 underwent neuropsychiatric testing, 138 with the Star Cancellation Test for visual neglect. RESULTS: Fifteen per cent (n = 21) had visual neglect, 9% (n = 12) severe and 9% (n = 12) lateralized. Cognitive impairments were twice as common in patients with neglect as in patients without it and threefold more common when the neglect was severe. Neglect was related to apraxia, impaired visual field, and a previous stroke. Severe neglect was related to dementia, amnesia and impaired visual field. CONCLUSIONS: Chronic neglect is common after stroke in elderly patients. So are cognitive impairments, especially in those with neglect. This calls for high alertness to impairments in spatial attention when treating patients with dementia and other cognitive impairments.
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| 6. |
- Sindi, S., et al.
(author)
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Sleep disturbances and later cognitive status: a multi-centre study
- 2018
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In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 52:December, s. 26-33
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Journal article (peer-reviewed)abstract
- Objective: To investigate the associations between sleep disturbances in mid-life and late-life and late-life cognitive status. Methods: In four population-based studies (three Swedish studies: H70 study, Kungsholmen Project (KP) and The Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD); and one Finnish study: Cardiovascular Risk Factors, Aging and Dementia (CAIDE)), participants provided self-reports on insomnia, nightmares and general sleep problems. Late-life cognitive status was measured by the Mini Mental State Exam (MMSE). The associations between late-life sleep disturbances and cognition 3-11 years later were investigated across all studies (n = 3210). Mean baseline ages were 70 (CAIDE, H70 and SWEOLD), and 84 years (KP). Additional analyses examined the association between midlife sleep and late-life cognition using CAIDE (21 and 31 years follow-up, n = 1306, mean age 50 years), and SWEOLD (20-24 years follow-up, n = 2068, mean age 58 years). Ordered logistic regressions, adjusted for potential baseline confounders, were used in the analyses. Results: Late-life sleep disturbances were associated with poorer cognition after 3-11 years (fully adjusted beta = -0.12, 95% CI = -0.24 to -0.01). Midlife nightmares and insomnia were also associated with lower MMSE scores (fully adjusted beta = -0.28, 95% CI = -0.49 to -0.07 and beta = -0.20, 95% CI = -0.39 to -0.01), although the latter association was attenuated after adjusting for lifestyle/health-related confounders. Midlife general sleep problems were not associated with late-life MMSE performance. Conclusions: Sleep disturbances and midlife nightmares were associated with lower MMSE scores, which suggests that sleep disturbances in earlier life stages can be associated with worse late-life cognition. (c) 2017 Published by Elsevier B.V.
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| 7. |
- Wu, Yu-Tzu, et al.
(author)
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The changing prevalence and incidence of dementia over time - current evidence.
- 2017
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In: Nature reviews. Neurology. - : Springer Science and Business Media LLC. - 1759-4766 .- 1759-4758. ; 13:6
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Journal article (peer-reviewed)abstract
- Dementia is an increasing focus for policymakers, civil organizations and multidisciplinary researchers. The most recent descriptive epidemiological research into dementia is enabling investigation into how the prevalence and incidence are changing over time. To establish clear trends, such comparisons need to be founded on population-based studies that use similar diagnostic and research methods consistently over time. This narrative Review synthesizes the findings from 14 studies that investigated trends in dementia prevalence (nine studies) and incidence (five studies) from Sweden, Spain, the UK, the Netherlands, France, the USA, Japan and Nigeria. Besides the Japanese study, these studies indicate stable or declining prevalence and incidence of dementia, and some provide evidence of sex-specific changes. No single risk or protective factor has been identified that fully explains the observed trends, but major societal changes and improvements in living conditions, education and healthcare might have favourably influenced physical, mental and cognitive health throughout an individual's life course, and could be responsible for a reduced risk of dementia in later life. Analytical epidemiological approaches combined with translational neuroscientific research could provide a unique opportunity to explore the neuropathology that underlies changing occurrence of dementia in the general population.
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| 8. |
- Jonson, Mattias, et al.
(author)
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Time trends in depression prevalence among Swedish 85-year-olds: Repeated cross-sectional population-based studies in 1986, 2008, and 2015
- 2023
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In: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 53:6, s. 2456-2465
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Journal article (peer-reviewed)abstract
- Background Octogenarians of today are better educated, and physically and cognitively healthier, than earlier born cohorts. Less is known about time trends in mental health in this age group. We aimed to study time trends in the prevalence of depression and psychotropic drug use among Swedish 85-year-olds. Methods We derived data from interviews with 85-year-olds in 1986-1987 (N = 348), 2008-2010 (N = 433) and 2015-17 (N = 321). Depression diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders. Symptom burden was assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS). Information on psychotropic drug use, sociodemographic, and health-related factors were collected during the interviews. Results The prevalence of major depression was lower in 2015-2017 (4.7%, p < 0.001) and 2008-2010 (6.9%, p = 0.010) compared to 1986-1987 (12.4%). The prevalence of minor depression was lower in 2015-2017 (8.1%) compared to 2008-2010 (16.2%, p = 0.001) and 1986-1987 (17.8%, p < 0.001). Mean MADRS score decreased from 8.0 in 1986-1987 to 6.5 in 2008-2010, and 5.1 in 2015-2017 (p < 0.001). The reduced prevalence of depression was not explained by changes in sociodemographic and health-related risk factors for depression. While psychoactive drug use was observed in a third of the participants in each cohort, drug type changed over time (increased use of antidepressants and decreased use of anxiolytics and antipsychotics). Conclusions The prevalence of depression in octogenarians has declined during the past decades. The decline was not explained by changes in known risk factors for depression. The present study cannot answer whether changed prescription patterns of psychoactive drugs have contributed to the decline.
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| 9. |
- Lindén, Thomas, 1962, et al.
(author)
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APOE is a strong gender-dependant risk factor for post-stroke major depression
- 2009
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In: European Stoke Conference, Stockholm, Maj.
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Conference paper (peer-reviewed)abstract
- BACKGROUND: Stroke is a major disease that annually affects 15 million people worldwide. Impaired mood is a common and serious complication. Previous studies indicate that Apolipoprotein E (APOE) alleles differently incur risks for late-life onset depression. The aim of this study was to analyse APOE as a risk factor in men and women for depressive disorders late after stroke. METHODS: Two-hundred and forty-three stroke patients over 70 years of age entered a longitudinal, naturalistic hospital-based study. One hundred and forty nine were assessed for cognitive impairments and depression and 88 were genetically tested one and a half years later. RESULTS: Thirty-three percent had any depression, 15% major depressive disorder. Genotypes 3/2 and 4/2 associated to depression. Major depressive disorder, but not all depression, related strongly to APOE carriership (OR 6.0; 95%CI 1.6 to 22), and was stronger for women (OR 17: 95% CI 1.6 to 174) than for men. CONCLUSION: In this first study to analyse the association between APOE genotypes and post-stroke depression, we found that APOE increased the risk for depression, especially in women. The results call for further studies to confirm and clarify the mechanisms for these effects as well as for the difference between sexes.
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| 10. |
- Bos, M J, et al.
(author)
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Depressive symptoms and risk of stroke: the Rotterdam Study.
- 2008
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In: Journal of neurology, neurosurgery, and psychiatry. - : BMJ. - 1468-330X .- 0022-3050. ; 79:9, s. 997-1001
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Journal article (peer-reviewed)abstract
- BACKGROUND: Previous studies that have assessed whether the presence of depressive symptoms predisposes to stroke in the general elderly population have been contradictory. Moreover, they did not distinguish between men and women and did not perform psychiatric workups in those with depressive symptoms. This study examines the association between depressive symptoms, depressive disorder and the risk of stroke in the general population. METHODS: This prospective population based cohort study included 4424 participants from the third Rotterdam Study Survey (1997-1999) who, at that time, were > or =61 years of age and free from stroke. Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale (CESD) and considered present if the CESD score was > or =16. Participants with depressive symptoms had a diagnostic interview for depressive disorder. Follow-up was complete until 1 January 2005. Data were analysed using Cox proportional hazards models with adjustment for relevant confounders. RESULTS: Men with depressive symptoms (n = 73) were at increased risk of stroke (adjusted hazard ratio (HR) 2.17; 95% CI 1.11 to 4.23) and ischaemic stroke (adjusted HR 3.21; 95% CI 1.62 to 6.38). These associations were at least partly attributable to men who reported depressive symptoms but who did not fulfil Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV diagnostic criteria for depressive disorder (n = 32): they had a very high risk of stroke (adjusted HR 2.70; 95% CI 1.15 to 6.33) and ischaemic stroke (adjusted HR 4.01; 95% CI 1.68 to 9.57). In women there was no association between presence of depressive symptoms and risk of stroke. CONCLUSIONS: Presence of depressive symptoms is a strong risk factor for stroke in men but not in women.
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