| 1. |
- Edlund, A, et al.
(author)
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Clinical profile of delirium in patients treated for femoral neck fractures
- 1999
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 10:5, s. 325-329
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Journal article (peer-reviewed)abstract
- The incidence of delirium, its predisposing factors, clinical profile, associated symptoms and consequences were investigated in 54 consecutive patients, 19 men and 35 women, mean age 77.1 years, admitted to an 'ortho-geriatric unit' with femoral neck fractures. The incidence of postoperative delirium was 15/54 (27.8%) and a logistic regression model found that dementia and a prolonged waiting time for the operation increased the risk of postoperative delirium. Delirium during the night was most common but in 5 patients the delirium was worst in the morning. Patients with delirium suffered more anxiety, depressed mood, emotionalism, delusions and hallucinations. A larger proportion of patients with delirium could not return to their previous dwelling, and a larger proportion of delirious patients were either dead, wheelchair-bound or bedridden at the 6-month follow-up (p < 0.005). The conclusion is that delirium is common and has a serious impact on the outcome after hip fracture surgery.
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| 2. |
- Molander, Lena, et al.
(author)
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Longitudinal associations between blood pressure and dementia in the very old
- 2010
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 30:3, s. 269-276
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIMS: Midlife hypertension is associated with an increased risk for dementia, but the association between blood pressure and dementia in very old age is unclear. METHODS: In a population-based cohort study, a total of 102 individuals aged 85, 90 or ≥ 95 years participated in 2 examinations with a 5-year interval. The investigations consisted of a structured interview, blood pressure measurement, rating scales such as the Mini-Mental State Examination (MMSE) and an investigation of medical charts. RESULTS: The majority of participants exhibited a decline in blood pressure. Baseline systolic blood pressure (SBP), diastolic blood pressure or pulse pressure (PP) were not associated with incident dementia or with decline in MMSE scores in multiple regression analyses adjusted for age and sex. However, incident dementia cases exhibited a greater decline in SBP (p = 0.02) and PP (p = 0.04), and decline in SBP was associated with a decline in MMSE score (p = 0.008). CONCLUSION: In this small longitudinal study on the very old, no association between baseline blood pressure and incident dementia was found, but individuals who developed dementia exhibited a greater blood pressure decline. Low blood pressure could be an effect of dementia in the very old.
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| 3. |
- Molander, Lena, 1983-, et al.
(author)
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Low blood pressure is associated with cognitive impairment in very old people
- 2010
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 29:4, s. 335-341
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIMS: Hypertension is an established risk factor for dementia. However, the association between blood pressure and cognition in the very old is not fully determined and important to study considering the ageing population and the morbidity associated with cognitive impairment. METHODS: This cross-sectional study included 575 individuals aged 85, 90 or 95 years and above and living in northern Sweden or Finland. Participants were interviewed and assessed using a structured protocol. Systolic (SBP) and diastolic blood pressures (DBP) were measured and pulse pressure (PP) calculated. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Data were also collected from medical charts and caregivers. RESULTS: After adjustment for several demographic variables and diagnoses, SBP was significantly associated with MMSE in a nonlinear fashion; both high and low pressures were associated with poorer results. There was also a linear and positive association between PP and MMSE scores, but no association with DBP was found. Participants with dementia had lower blood pressure. CONCLUSION: After adjustment for a number of health factors, there was an association between low blood pressure and cognitive impairment. The direction of any causal relationship between blood pressure and cognition remains to be determined.
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| 4. |
- Öhlin, Jerry, et al.
(author)
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Physical activity in late middle- to older-aged people and dementia, cognitive, and physical function two decades later
- 2022
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In: Dementia and Geriatric Cognitive Disorders. - : S. Karger. - 1420-8008 .- 1421-9824. ; 51, s. 135-141
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Journal article (peer-reviewed)abstract
- Introduction: Low physical activity (PA) is a potential risk factor for dementia and cognitive impairment. However, few studies have focused on very old people (aged ≥80 years), the age group with highest prevalence of dementia. The aim was to investigate if PA associated with subsequent dementia, cognitive function, and gait speed (GS), in very old people.Methods: A population-based survey was conducted in 1999 and followed-up between 2016 and 2019 in participants ≥80 years. Altogether 541 individuals (56.2% women), 64.9 ± 4.2 years of age at baseline participated. Self-rated baseline PA was categorized into low, medium, or high. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), executive function with the Frontal Assessment Battery (FAB), and GS (in meters/second) was measured over 2.4 m at follow-up.Results: During a mean of 19.0 ± 1.1 years, 175 (32.3%) developed dementia. Low or medium PA compared to high PA did not associate with subsequent dementia, and PA did not associate with future cognitive function (MMSE). PA associated with executive function (FAB) (unstandardized beta [95% confidence interval]) (0.67 [0.07–1.27]), but not after adjustments. PA associated with subsequent GS in the unadjusted model and after adjustment for age, sex, smoking, and education (0.06 [0.02–0.09], and 0.04 [0.01–0.08], respectively), but not after adding adjustment for hypertension, obesity, and glucose intolerance.Conclusion: No support was found for the hypothesis that low PA is a potential risk factor for dementia in very high age. However, PA and executive function were associated in unadjusted analyses which indicate that PA may be important for at least one aspect of cognitive function. The association between PA and GS around 2 decades later seems attenuated by cardiometabolic risk factors. Future investigations regarding PA, dementia, and cognitive decline may consider cardiometabolic risk factors such as hypertension, obesity, and glucose intolerance, and include repeated measures of PA over the life course.
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