| 1. |
- Bramell-Risberg, Eva, et al.
(författare)
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Lower Gait Speed in Older Women with Dementia Compared with Controls.
- 2005
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 20:5, s. 298-305
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Tidskriftsartikel (refereegranskat)abstract
- Movement time is increased in patients with Alzheimer’s disease. <i>Objectives:</i> To study differences in movement time and ability to increase speed in older women with dementia. <i>Methods:</i> Four tests were performed at self-selected and maximal speed: walking 2 ×15 m, walking between parallel lines, ‘get up and go’ (GUG) and rising from lying supine. Twenty-two patients and 22 controls (mean ages 81 and 86 years, respectively) were included in the study. <i>Results:</i> In the groups over 80 years, walking and GUG at both speeds and rising from lying supine from the left at self-selected speed were significantly slower among patients (20–30%). Both patients and controls were able to increase movement speed when changing from self-selected to maximal speed (13–27%). Patients with Alzheimer’s disease had lower self-selected walking speed compared with patients with other types of dementia (p = 0.048). <i>Conclusion:</i> Testing physical performance in two different speeds was feasible in patients with dementia. Patients had slower gait speed and were slower in the functional tests, such as GUG, but the capacity to increase speed seemed intact.
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| 2. |
- Bramell-Risberg, Eva, et al.
(författare)
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Slowing of Alternating Forearm Movements Is Associated with Cognitive Impairment in Community-Dwelling Older People.
- 2010
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 29:5, s. 457-466
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Motor impairment is an important aspect of cognitive decline in older adults. It has been suggested that complex motor control is affected earlier than gross motor control. The aims were to investigate if complex hand motor function was more affected than gross motor function in cognitively impaired older subjects, and to present reference values. Methods: Alternating forearm movements and grip strength were studied in 301 cases, 419 intermediates and 1,207 controls, aged 60-93 years, controlling for demographic, health-related and functional factors and comorbidity. Global cognitive function was assessed by the Mini-Mental State Examination, and episodic memory by 3-word delayed recall. Grip strength was assessed by the Grippit(R). The frequency of alternating movements during 10 s was registered electronically. Results: Alternating movements but not grip strength was associated with cognitive impairment (right: p = 0.006; left: p = 0.022). The mean alternating movements for the 70-year-old male cases compared to the controls were 2.3 versus 2.5 Hz for the right, and 2.2 versus 2.4 Hz for the left arm (p < 0.05), and for the 60-year-old women 2.0 versus 2.3 Hz for the right arm (p < 0.05). Conclusion: Complex but not gross hand motor function is associated with early cognitive impairment.
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| 3. |
- Dahlrup, Beth, et al.
(författare)
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Health Economic Analysis on a Psychosocial Intervention for Family Caregivers of Persons with Dementia.
- 2014
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 37:3-4, s. 181-195
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Psychosocial intervention has shown positive effects on the caregivers' burden and satisfaction. The aims of this study were to describe the cost and cost-effectiveness of such an intervention. Methods: We analyzed resource use and costs of formal care for 308 persons with dementia and their caregivers' health-related quality of life (HRQoL). Results: The costs of home help services were lower in the subgroup of spouse caregivers in the intervention group and the cost of nursing home placement was lower in the intervention group. While the person with dementia lived at home, caregivers in the intervention group reported a higher HRQoL (p < 0.01). After the person with dementia had moved to a nursing home, spouses in the control group had a lower HRQoL (p < 0.001). Conclusion: The result can be interpreted as a positive effect of the intervention focusing on the identified specific needs of the family caregivers. © 2013 S. Karger AG, Basel.
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| 4. |
- Elmståhl, Sölve, et al.
(författare)
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A study of regional cerebral blood flow using 99mTc-HMPAO-SPECT in elderly women with senile dementia of alzheimer’s type
- 1994
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 5:6, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Thirteen women with senile dementia of Alzheimer’s type (SDAT) according to NINCDS-ADRDA and 21 age-matched control women, aged 75-96 years, were investigated with clinical examination, dementia rating scales and single photon emission computed tomography (SPECT) using99mTc-hexamethylpropyleneamine oxime (HM-PAO) as a tracer of regional cortical blood flow. The aim was to study whether typical SPECT findings of SDAT were seen also in the very old having the disease for a longer period. Neuropsychological assessment with vocabulary and spatial tests was performed in the control women, and the results were divided in three subgroups, normal, borderline and abnormal. Regional perfusion values, expressed as a ratio between cortical and cerebellar HM-PAO uptake, were lower in frontal, temporoparietal and occipital cortices in SDAT patients than in controls. The SDAT patients had the lowest uptake in the posterior temporoparietal region (0.67 ± 0.06) and the corresponding value in the controls (0.79 ± 0.05) differed significantly, p < 0.0001. The interhemispheric ratio between right and left posterior temporoparietal regions was 0.99 ± 0.05. Nine of the control women (43%) had pathological SPECT with hemispheric asymmetries in 6 cases and bilateral temporooccipital reductions in 3 women. The neuropsychological assessment matched the findings in 7 of these women. One of the control women was judged as pathological and 10 women as borderline according to the spatial and vocabulary tests. Four of the 10 women with borderline results had normal SPECT. The sensitivity of the assessment to detect abnormalities compared to SPECT was 78% if borderline and abnormal results were expressed as true-positive cases. The specificity was 67%. The results showed a high degree of pathological findings according to SPECT and neuropsychological assessment in otherwise healthy elderly women.
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| 5. |
- Elmståhl, Sölve, et al.
(författare)
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Postural hypotension and EEG variables predict cognitive decline : Results from a 5-Year follow-up of healthy elderly women
- 1997
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 8:3, s. 180-187
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Tidskriftsartikel (refereegranskat)abstract
- Quantified electroencephalographic activity (EEG) has been used to study normal ageing and dementia. Few studies have described longitudinal changes in the very old. A cognitive decline has been described in subjects with white-matter lesions and hypertension but the association with hypotension is unclear. Our aim was to study the predictive value of quantified EEG for the development of cognitive decline and associations with postural hypotension. Participants: Thirty-three healthy women aged 75–95 years, with no signs of cerebrovascular disease, dementia or acute illness at baseline examination took part in a longitudinal 5-year follow-up study. The women were recruited from a random selection using the Municipal Registry. Quantified EEG was assessed twice and recorded on a Siemens-Elema connected to a Biological Banker. The medical and neuropsychological examination was conducted twice. Dementia was classified according to DSM criteria. The assessment included Mini-Mental Scale Examination (MMSE), spatial and vocabulary tests. Blood pressure was measured in supine position and an orthostatic test was performed with continuous ECG recording. Seven women (cases) developed cognitive decline at the 5-year follow-up, defined as newly developed MMSE < 27 and dementia symptoms. Low beta activity at baseline predicted development of cognitive decline. The women who remained healthy at follow-up showed an increase of alpha and theta activity. The cases had a higher orthostatic blood pressure fall during tilting at baseline (16 mm Hg) than the controls (1 mm Hg, p < 0.01). The orthostatic reaction was correlated with increased levels of theta and alpha activity at follow-up (r = −0.47 to −0.52; p < 0.01). Low beta activity predicts for cognitive decline in the elderly and an orthostatic blood pressure reaction is a risk factor for cognitive decline.
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| 6. |
- Overton, Marieclaire, et al.
(författare)
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Diagnostic Stability of Mild Cognitive Impairment, and Predictors of Reversion to Normal Cognitive Functioning
- 2020
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 48:5-6, s. 317-329
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Studies that investigate predictive factors for spontaneous recovery (reversion) from mild cognitive impairment (MCI) are only beginning to emerge, and the long-term course of MCI is not properly understood. We aimed to investigate stability of the MCI diagnosis, predictors for reversion, as well as the trajectory of MCI over the course of 12 years. Materials and Methods: Data were drawn from the Swedish population study: Good Aging in Skåne with MCI defined according to the expanded Mayo Clinic criteria. A total of 331 participants, aged 60-95 years with MCI, were used to investigate 6-year MCI stability and reversion, and 410 participants were used to inspect 12-year MCI trajectory. Predictors for reversion included demographical factors, psychological status, and factors tied to the cognitive testing session and the operationalization of the MCI criteria. Results: Over half (58%, 95% CI 52.7-63.3) of the participants reverted back to normal cognitive functioning at 6-year follow-up. Of those with stable MCI, 56.5% (95% CI 48.2-64.8) changed subtype. A total of 23.9% (95% CI 13.7-34.1) of the 6-year follow-up reverters re-transitioned back to MCI at 12-year follow-up. ORs for reversion were significantly higher in participants with lower age (60-year-olds: OR 2.19, 95% CI 1.08-4.43, 70-year-olds: OR 3.11, 95% CI 1.27-7.62), better global cognitive functioning (OR 1.15, 95% CI 1.03-1.29), good concentration (OR 2.53, 95% CI 1.06-6.05), and single-domain subtype (OR 2.68, 95% CI 1.51-4.75). Conclusion: Our findings provide further support that MCI reversion to normal cognitive functioning as well as re-transitioning to MCI is fairly common, suggesting that the MCI trajectory does not necessarily lead straight to dementia. Additionally, assessment of factors associated with reversion can aid clinicians to make accurate MCI progression prognosis.
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| 7. |
- Overton, Marieclaire, et al.
(författare)
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Prevalence and Incidence of Mild Cognitive Impairment across Subtypes, Age, and Sex
- 2019
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 47:4-6, s. 219-232
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to report on the prevalence and incidence of mild cognitive impairment (MCI) across age, sex, and subtypes according to various criteria in a population-based sample. Methods: The sample was drawn from the Swedish Good Aging in Skåne (GÅS) population study, and data from 3,752 participants aged 60 years and more were used to calculate the MCI prevalence. The incidence was calculated using 2,093 participants with 6-year follow-up data. MCI was defined according to the expanded Mayo Clinic criteria: cognitive complaint, objective cognitive impairment (two different criteria depending on the severity of impairment), preserved functional abilities, and no dementia. Results: The prevalence estimates ranged from 5.13 to 29.9% depending on age and severity of impairment. The incidence rates of overall MCI were 22.6 (95% confidence interval [CI]: 19.6-25.9) and 8.67 (95% CI: 7.0-10.7) per 1,000 person-years for less severe and severe cognitive impairment, respectively. The highest prevalence and incidence estimates were found for "non-amnestic MCI single domain." The older age groups had a higher prevalence, and no sex or age differences in MCI incidence were detected. Conclusion: Our findings concur with previous research advocating that MCI is a heterogeneous concept, since the prevalence and incidence estimates differed substantially according to age, MCI subtype, and severity of cognitive impairment.
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| 8. |
- Siennicki-Lantz, Arkadiusz, et al.
(författare)
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Cerebral blood flow in white matter is correlated with systolic blood pressure and EEG in senile dementia of the Alzheimer type
- 1998
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 9:1, s. 29-38
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Tidskriftsartikel (refereegranskat)abstract
- The presence and functional significance of white matter lesions in the ageing brain and in dementia as well as their relation to blood pressure are often discussed. The aim of this study was to evaluate cerebral blood flow in white matter (WMCBF) and its relation to systemic blood pressure and multichannel EEG. WMCBF was measured in 24 elderly women with senile dementia of Alzheimer's type (SDAT, median age 85.5, range 68-93) and 20 age-matched controls (median age 86.0, range 79-93) using 99mTc-HMPAO single photon emission CT. A significant low WMCBF could be observed in all analysed regions in SDAT subjects compared to controls, with the greatest decline in the posterior region (parietotemporo-occipital area). Correlations between quantified EEG from the posterior regions and WMCBF were seen. Systolic blood pressure was significantly lower in the SDAT group and was positively correlated with WMCBF in the posterior and anterior brain regions. Whether low systemic blood pressure is the result of cerebral dysfunction is unclear.
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