| 1. |
- Agüero-Torres, H, et al.
(författare)
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Dementia is the major cause of functional dependence in the elderly : 3-year follow-up data from a population-based study
- 1998
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Ingår i: American Journal of Public Health. - : American Public Health Association. - 0090-0036 .- 1541-0048. ; 88:10, s. 1452-1456
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this investigation was to study the role of dementia and other common age-related diseases as determinants of dependence in activities of daily living (ADL) in the elderly. METHODS: The study population consisted of 1745 persons, aged 75 years and older, living in a district of Stockholm. They were examined at baseline and after a 3-year follow-up interval. Katz's index was used to measure functional status. Functional dependence at baseline, functional decline, and development of functional dependence at follow-up were examined in relation to sociodemographic characteristics and chronic conditions. RESULTS: At baseline, factors associated with functional dependence were age, dementia, cerebrovascular disease, heart disease, and hip fracture. However, only age and dementia were associated with the development of functional dependence and decline after 3 years. In a similar analysis, including only nondemented subjects. Mini-Mental State Examination scores emerged as one of the strongest determinants. The population attributable risk percentage of dementia in the development of functional dependence was 49%. CONCLUSIONS: In a very old population, dementia and cognitive impairment make the strongest contribution to both the development of long-term functional dependence and decline in function.
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| 2. |
- Forsell, Y, et al.
(författare)
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Prevalence and correlates of depression in a population of nonagenarians
- 1995
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Ingår i: British Journal of Psychiatry. - : Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 167:1, s. 61-64
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Clinicians see many more nonagenarian patients now and there is a need for epidemiological data relating to this group. The aim of the present study was to investigate the prevalence of depressive symptoms and syndromes in this age group.METHOD The DSM-IV and the ICD-10 criteria for depression were used and correlated with physical health, disability in daily life, gender, use of drugs, social circumstances and cognitive dysfunction. Data were derived from 329 persons aged 90 and over, registered in a parish of Stockholm, who had been extensively examined by physicians and nurses.RESULTS/CONCLUSIONS The prevalence of Major Depressive Episode as defined in DSM-IV was 7.9%; and of mild, moderate and severe Depressive Episode (combined); as defined in ICD-10 9.1%. No gender difference was found. Disability in daily life and the use of psychotropic drugs were found to correlate with depressive symptoms and syndromes.
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| 3. |
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| 4. |
- Fratiglioni, L, et al.
(författare)
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Very Old Women at Highest Risk of Dementia and Alzheimer's Disease : Incidence Data from the Kungsholmen Project, Stockholm
- 1997
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Ingår i: Neurology. - : American Academy of Neurology. - 0028-3878 .- 1526-632X. ; 48:1, s. 132-138
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the incidence of different types of dementia in the very old, and to explore the relation with age and gender. Design: A dementia-free cohort was followed for an average of three years in Stockholm, Sweden. At the end of the follow-up, the subjects were interviewed by nurses, clinically examined by physicians, and cognitively assessed by psychologists. Deceased cohort members were studied using death certificates, hospital clinical records, and discharge diagnoses. Dementia diagnoses were made according to the DSM-III-R criteria independently by two physicians. Participants: The cohort consisted of 1,473 subjects (75+ years old), of which 987 were clinically examined at follow-up, 314 died before the examination, and 172 refused to participate. Results: During the follow-up, 148 subjects developed dementia. In the age-group 75 to 79, the incidence rates for dementia were 19.6 for women and 12.4 for men per 1,000 person-years, whereas for 90+ year-old subjects the corresponding figures were 86.7 and 15.0 per 1,000 person-years. A similar pattern of distribution by age and gender was seen for Alzheimer's disease. In each age stratum, the incidence rates of dementia and Alzheimer's disease were higher for women than for men. The age-adjusted odds ratio for women was 1.9 for dementia and 3.1 for Alzheimer's disease. Conclusions: (1) The incidence of dementia increases with age, even in the oldest age groups; (2) women have a higher risk of developing dementia than men, especially at very old ages; (3) this pattern is mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.
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| 5. |
- Gip, C, et al.
(författare)
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Prevalence of dementia in nonagenarians
- 1997
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Ingår i: Alzheimer’s disease. - : John Wiley & Sons. - 0471969648 ; , s. 45-48
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Marengoni, A, et al.
(författare)
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The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons : A community-based, longitudinal study
- 2009
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Ingår i: Journal of Internal Medicine. - : Wiley-Blackwell. - 0954-6820 .- 1365-2796. ; 265:2, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Objective. We aimed to disentangle the effect of chronic multimorbidity and disability on 3-year functional decline and survival in the elderly.Design. Prospective cohort study with a mean of follow-up of 2.8 years.Setting. Swedish elderly persons from the Kungsholmen Project (1987–2000).Subjects. A total of 1099 subjects, 77–100 years old, living in the community and institutions.Main outcome measurements. Medical diagnoses (based on clinical examination, drug use, medical records and blood tests), and functional assessment (according to Katz Index) at baseline were investigated in relation to functional decline and death occurring during follow-up.Results. At baseline, 12.1% of participants had disability, and 52.3% were affected by multimorbidity. During follow-up, 363 persons died and 85 worsened in functioning. The number of chronic conditions incrementally increased the risk of functional decline [hazard ratio (HR) increased from 1.5 in subjects with one disease to 6.2 in persons with 4+ diseases]. However, this was not the case for mortality, as the HR of death was the same for people with one disease as well as 4+ diseases (HR = 2.3). Baseline disability had the highest impact on survival, independently of number of diseases [HR = 8.1; 95% confidence interval (CI) = 4.8–13.7 in subjects with one disease and HR = 7.7; 95% CI = 4.7–12.6 in those with 2+ diseases].Conclusions. In the elderly subjects, chronic disability rather than multimorbidity emerged as the strongest negative prognostic factor for functionality and survival.
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| 7. |
- Mecocci, P, et al.
(författare)
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Cognitive Impairment Is the Major Risk Factor for Development of Geriatric Syndromes during Hospitalization : Results from the GIFA Study
- 2005
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Ingår i: Dementia and Geriatric Cognitive Disorders. - Basel : Karger. - 1420-8008 .- 1421-9824. ; 20:4, s. 262-269
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To detect the main factors associated with the occurrence of specific geriatric syndromes (namely pressure sores, fecal incontinence, urinary incontinence and falls) in elderly patients during hospitalization. Design: Observational prospective study. Setting: Eighty-one community and university hospitals throughout Italy. Participants: 13,729 patients aged 65 years and more, consecutively admitted to medical or geriatric acute wards during 20 months in the period between 1991 and 1998. Measurements: Occurrence of pressure sores, fecal incontinence, urinary incontinence and falls during the stay in hospital. Results: Pressure sores were already present in 3% of hospitalized subjects, fecal incontinence in 7.3%, while urinary incontinence, evaluated on a subgroup of total population (4,268 subjects), had a prevalence of 22.3%. During hospitalization (mean stay of 15 days), 74 subjects developed new pressure sores, 55 became fecal and 35 urinary incontinent, and 279 subjects had at least one episode of fall. In multivariate analyses, cognitive impairment, advanced age (85+ years), length of stay (more than 3 weeks) and severe disability were the main independent predictors of development of the four geriatric syndromes, with cognitive impairment as the most significant risk factor for all the four outcomes (OR 4.9, 95% CI 2.4–9.9 for pressure sores; OR 6.3, 95% CI 3.0–13.0 for fecal incontinence; OR 5.3, 95% CI 2.3–12.0 for urinary incontinence; OR 1.6, 95% CI 1.2–2.3 for falls). Conclusion: Very old people have a significant increased risk of several geriatric syndromes during the stay in hospital, particularly if it is long and they are cognitively impaired. A standardized comprehensive geriatric evaluation at admission could be helpful in detecting all subjects at risk and preventing the development of hospital-acquired geriatric syndromes.
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| 8. |
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| 9. |
- Morse, D E, et al.
(författare)
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Dental caries in persons over the age of 80 living in Kungsholmen, Sweden : findings from the KEOHS Project
- 2002
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Ingår i: Community Dental Health. - 0265-539X. ; 19:4, s. 262-267
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, communitydwelling persons over the age of 80 living in Kungsholmen, an area in central Stockholm. This paper reports findings regarding the prevalence and severity of dental caries among the dentate participants. Basic research design: Caries examinations were conducted on eligible persons participating in the Kungsholmen Project, an ongoing, longitudinal study of older adults. Setting: Caries examinations were carried out between 1994 and 1996 at two local clinics by three standardised examiners using defined visual, tactile criteria. Participants: Among 296 potentially eligible participants, 159 were examined, and a total of 129 had at least one tooth. Main outcome measures: The caries examination identified decayed and filled surfaces and missing teeth. Results: Of the dentate subjects examined, 80% had teeth in both arches; 98% had at least one coronal filling; 81% had one or more restored root surfaces. Depending upon age and gender, between 36% and 56% of those examined had untreated coronal caries, and between 54% and 75% had untreated root caries. Conclusions: These findings document the substantial and ongoing impact of dental caries in a sample of generally healthy, community-dwelling older adults and underscore the importance of continued caries prevention and treatment in the aged.
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| 10. |
- Ngandu, T, et al.
(författare)
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Education and dementia : What lies behind the association?
- 2007
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Ingår i: Neurology. - : Lippincott Williams & Wilkins. - 0028-3878 .- 1526-632X. ; 69:14, s. 1442-1450
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low education seems to be associated with an increased risk of dementia and Alzheimer disease (AD). People with low education have unhealthier lifestyles and more cardiovascular risk factors, but it is unclear how this affects the association between education and dementia.Methods: Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were derived from random, population-based samples previously studied in a survey in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals (72%) aged 65 to 79 participated in a re-examination in 1998.Results: Compared to individuals with formal education of 5 years or less, those with 6 to 8 years of education had OR of 0.57 (95% CI 0.29 to 1.13), and those with 9 years of education or more had OR of 0.16 (95% CI 0.06 to 0.41) for dementia. The corresponding ORs for AD were 0.49 (0.24 to 1.00) and 0.15 (0.05 to 0.40). The associations remained unchanged after adjustments for several demographic, socioeconomic, vascular, and lifestyle characteristics. The results were similar among both men and women. ApoE4 did not modify the association, but the risk of dementia and AD was very low among ApoE4 noncarriers with high education.Conclusions: The association between low education and dementia is probably not explained by the unhealthy lifestyles of the less educated compared with higher educated persons. Higher educated persons may have a greater cognitive reserve that can postpone the clinical manifestation of dementia. Unhealthy lifestyles may independently contribute to the depletion of this reserve or directly influence the underlying pathologic processes.GLOSSARY: AD = Alzheimer disease; CAIDE = Cardiovascular Risk Factors, Aging and Dementia; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; MMSE = Mini-Mental State Examination; NINCDS-ADRDA = National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association; SBP = systolic blood pressure.
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