| 1. |
- Weidung, Bodil, et al.
(author)
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Temporal Dementia and Cognitive Impairment Trends in the Very Old in the 21st Century
- 2023
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In: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 93:1, s. 61-74
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Journal article (peer-reviewed)abstract
- Background: Long-increasing dementia incidence and prevalence trends may be shifting. Whether such shifts have reached the very old is unknown. Objective: To investigate temporal trends in the incidence of dementia and cognitive impairment and prevalence of dementia, cognitive impairment, Alzheimer's disease, vascular dementia, and unclassified dementia among 85-, 90-, and >= 95-year-olds in Sweden during 2000-2017.Methods: This study was conducted with Ume degrees a 85 + /Gerontological Regional Database data from 2182 85-, 90-, and >= 95-year-olds in Sweden collected in 2000-2017. Using logistic regression, trends in the cumulative 5-year incidences of dementia and cognitive impairment; prevalences of dementia, cognitive impairment, Alzheimer's disease, and vascular dementia; and Mini-Mental State Examination thresholds for dementia diagnosis were estimated.Results: Dementia and cognitive impairment incidences decreased in younger groups, which generally showed more-positive temporal trends. The prevalences of overall dementia, cognitive impairment, and Alzheimer's disease were stable or increasing; longer disease durations and increasing dementia subtype classification success may mask positive changes in incidences. Vascular dementia increased while unclassified dementia generally decreased.Conclusion: The cognitive health of the very old may be changing in the 21st century, possibly indicating a trend break.
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| 2. |
- Johansson, Hanna, et al.
(author)
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Cognitive function and walking velocity in people with dementia : a comparison of backward and forward walking
- 2017
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In: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 58, s. 481-486
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Journal article (peer-reviewed)abstract
- How forward and backward walking, both central to everyday life, relate to cognition are relatively unexplored in people with dementia. This study aimed to investigate if forward and backward walking velocity respectively, associated with global cognition and executive function in people with dementia, and whether the association differed according to walking aid use or dementia type. Using a cross-sectional design, 161 participants (77% women), a mean Mini-Mental State Examination (MMSE) score of 15, and mean age of 85.5 years and living in nursing homes were included. Self-paced forward walking (FW) and backward walking (BW) velocity over 2.4 m was measured. Global cognitive outcome measurements included MMSE and Alzheimer Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Executive function was measured using Verbal Fluency (VF). In comprehensively adjusted multivariate linear regression analyses, FW was independently associated with VF (p = 0.001), but not MMSE (p = 0.126) or ADAS-Cog (p = 0.818). BW was independently associated with VF (p = 0.043) and MMSE (p = 0.022), but not ADAS-Cog (p = 0.519). Interaction analyses showed that the association between BW velocity and executive function were stronger in participants who walked without a walking aid. No associations differed according to dementia type. In conclusion, executive function appears important to walking velocity, both forward and backward, in people with dementia with mild to moderately severe cognitive impairment. Global cognitive function was associated with backward walking only, perhaps due to it being more challenging. The association between BW velocity and executive function differed according to use of walking aids, which appeared to attenuate the association.
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| 3. |
- Akner, Gunnar, 1953-, et al.
(author)
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Personalized Geriatric Medicine
- 2014
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In: European Geriatric Medicine. - : Elsevier BV. - 1878-7649 .- 1878-7657. ; 5, s. 145-146
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Journal article (peer-reviewed)
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| 4. |
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| 5. |
- Bergdahl, Ellinor, et al.
(author)
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Depression among the very old with dementia
- 2011
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In: International psychogeriatrics. - : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 23:5, s. 756-763
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to investigate the prevalence of depression among very old individuals with dementia compared to those without dementia and to examine if there were any differences regarding associated factors between people with or without depression in these conditions.Methods: In a population-based study in Sweden, 363 participants aged 85 years and above, were evaluated for depression and dementia.Results: The prevalence of depression was significantly higher among the people with dementia than without dementia, 43% vs. 24% (p < 0.001). Approximately 2/3 of the depressed in both groups used antidepressants and of those, approximately 50% had responded. Depression in the group without dementia was, among other factors, associated with higher total number of medication, the use of significant more analgesics and benzodiazepines, loneliness, inability of going outside and recent loss of child. The loss of a child was the only factor that was independently associated with depression in those with dementia.Conclusions: The present study confirms that in the very old, depression is more common among people with dementia than without dementia. A large proportion, both with and without dementia, are under-diagnosed and untreated, and in addition many subjects in both groups studied were non-responders to treatment. Many of the factors associated with depression among people without dementia in this study were not associated with depression among those with dementia, thus supporting the theory that the spectrum of associated factors for depression in dementia seems to be different from that for depression in people without dementia.
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| 6. |
- Boman, Erika, et al.
(author)
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Inner strength : associated with reduced prevalence of depression among older women
- 2015
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In: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 19:12, s. 1078-1083
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to explore if inner strength is independently associated with a reduced prevalence of depression after controlling for other known risk factors associated with depression.Methods: A population-based cross-sectional study was performed, where all women living in Åland, a Finnish self-govern island community in the Baltic Sea, aged 65 years or older were sent a questionnaire including the Geriatric Depression Scale and the Inner Strength Scale along with several other questions related to depression. Factors associated with depression were analyzed by means of multivariate logistic regression.Results: The results showed that 11.2% of the studied women (n = 1452) were depressed and that the prevalence increased with age and was as high as 20% in the oldest age group. Non-depressed women were more likely to never or seldom feel lonely, have a strong inner strength, take fewer prescription drugs, feeling needed, being able to engage in meaningful leisure activities, as well as cohabit.Conclusion: Our results showed an association between stronger inner strength and being non-depressed. This can be interpreted to mean that inner strength might have a protective effect against depression. These findings are interesting from a health-promotion perspective, yet to verify these results, further longitudinal studies are required.
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| 7. |
- Hedberg, Pia, 1972-, et al.
(author)
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Depression in relation to purpose in life among a very old population : a five-year follow-up study
- 2010
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In: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 14:6, s. 757-763
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Journal article (peer-reviewed)abstract
- Objectives: To investigate the relationship between purpose in life and depression and, in a five-year follow-up investigate whether purpose in life, adjusted for different background characteristics, can prevent very old men and women from developing depression. Methods: A cross-sectional study included 189 participants (120 women and 69 men) 85–103 years of age living in a county in northern Sweden. Those who had not been diagnosed as depressed at baseline were included in the five-year follow-up study (n=78). Depression was assessed using the Geriatric Depression Scale-15, the Organic Brain Syndrome scale, the Montgomery–Åsberg Depression Rating Scale, and Diagnostic and Statistical Manual of Mental Disorders-IV criteria. Purpose in life was assessed with the Purpose in Life (PIL) scale. Results: In the cross-sectional study, 40 participants out of 189 (21.2%) were depressed, and those with depression had significantly lower PIL scores (mean score 107 vs. 99, p=0.014). In the follow-up study, 78 persons were available for the assessment of depression. Of those, 21 (26.9%) were diagnosed as depressed and their mean PIL score at baseline was 106 (SD=17.4) versus 108 (SD=16.0, p=0.750) among those not depressed. Using multivariate logistic regression analysis controlling for possible confounders, we found no association between purpose in life and the risk of developing depression after five years (OR=1.0, 95% CI 0.97–1.03). Conclusions: The results show a significant inverse relationship between purpose in life and depression in the cross-sectional study; however, a high PIL score does not seem to serve very old people as a protection against the risk of developing depression.
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| 8. |
- Mathillas, Johan, et al.
(author)
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Risk factors for depressive disorders in very old age : a population-based cohort study with a five-year follow-up
- 2014
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In: Social Psychiatry and Psychiatric Epidemiology. - : Springer. - 0933-7954 .- 1433-9285. ; 49:5, s. 831-839
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Journal article (peer-reviewed)abstract
- Depressive disorders are common among the very old, but insufficiently studied. The present study aims to identify risk factors for depressive disorders in very old age.The present study is based on the GERDA project, a population-based cohort study of people aged a parts per thousand yen85 years (n = 567), with 5 years between baseline and follow-up. Factors associated with the development of depressive disorders according to DSM-IV criteria at follow-up were analysed by means of a multivariate logistic regression.At baseline, depressive disorders were present in 32.3 % of the participants. At follow-up, 69 % of those with baseline depressive disorders had died. Of the 49 survivors, 38 still had depressive disorders. Of the participants without depressive disorders at baseline, 25.5 % had developed depressive disorders at follow-up. Baseline factors independently associated with new cases of depressive disorders after 5 years were hypertension, a history of stroke and 15-item Geriatric Depression Scale score at baseline.The present study supports the earlier findings that depressive disorders among the very old are common, chronic and malignant. Mild depressive symptoms as indicated by GDS-15 score and history of stroke or hypertension seem to be important risk factors for incident depressive disorders in very old age.
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| 9. |
- Nordström, Peter, et al.
(author)
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Bisphosphonate Use After Hip Fracture in Older Adults : A Nationwide Retrospective Cohort Study
- 2017
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In: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 18:6, s. 515-521
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age. Design, setting, and participants: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals. Main outcome measure: A new hip fracture. Results: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05). Conclusion: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.
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| 10. |
- Olofsson, Erika, et al.
(author)
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Association of depressive disorders and dementia with mortality among older people with hip fracture
- 2023
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318 .- 1471-2318. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions.AIMS: To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people.METHODS: Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates.RESULTS: In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone.CONCLUSION: DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions.TRIAL REGISTRATION: RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.
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