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| 2. |
- Hansson, Oskar, et al.
(author)
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Evaluation of Plasma A beta as Predictor of Alzheimer's Disease in Older Individuals Without Dementia: A Population-Based Study
- 2012
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In: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 28:1, s. 231-238
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Journal article (peer-reviewed)abstract
- Amyloid-beta (A beta) pathology is a major component in the mechanisms behind Alzheimer's disease (AD). Measurement of A beta(42) in cerebrospinal fluid predicts cognitive decline in patients with mild cognitive impairment and identifies AD in patients with dementia. However, studies on A beta in plasma are contradictory. In this prospective population-based study, plasma A beta(42) and A beta(40) were measured at baseline in 730 adults aged 70 years or older and without dementia. After five years, plasma levels were analyzed again and participants were assessed for development of dementia. During follow-up, 53 individuals (7%) developed dementia of which 37 (5%) were classified as AD. No difference in baseline plasma A beta(42), A beta(40), or A beta(42)/A beta(40) ratio levels were observed between converters to dementia or AD compared to the cognitively stable individuals. However, individuals with plasma A beta(40) levels above the median level for the group at baseline had an increased risk of developing dementia and AD during the follow-up, even after adjustment for age, gender, APOE genotype, and educational level (odds ratio = 2.2, 95% confidence interval = 1.0-4.7, p < 0.05). Neither plasma A beta(42) nor the A beta(42)/A beta(40) ratio influenced the risk of developing dementia or AD. Moreover, A beta(42) and A beta(40) levels increased over the 5 years, whereas the A beta(42)/A beta(40) ratio decreased (p < 0.001). In conclusion, this study suggests that measurement of plasma A beta should not be used clinically to predict dementia or AD. However, plasma A beta(40) may possibly be regarded as a moderate risk marker comparable to other risk markers for AD such as first-degree family history of dementia.
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| 3. |
- Karlsson, Björn, 1981, et al.
(author)
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DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People
- 2016
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In: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 24:12, s. 1237-1245
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Journal article (peer-reviewed)abstract
- Objectives: To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Design: Cross-sectional. Setting: General population in Gothenburg, Sweden. Participants: A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Measurements: Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Asberg Depression Rating Scale (MADRS). Results: The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Conclusions: Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings.
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| 4. |
- Östling, Svante, 1953, et al.
(author)
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Is the prevalence of psychosis in the very old decreasing? A comparison of 85-year-olds born 22 years apart
- 2019
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 34:12, s. 1776-1783
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Journal article (peer-reviewed)abstract
- Objective To elucidate whether there is a decrease of psychotic symptoms in 85-years-olds without dementia and if factors associated with psychotic symptoms have changed, we studied two birth cohorts of 85-year-olds born 22 years apart. Methods Every second, 85-year-olds in Gothenburg, Sweden was invited to neuropsychiatric examinations in 1986 to 1987 (participation 63.1%, N = 494) and in 2008 to 2010 (60.5%, N = 571). A close informant was interviewed by a psychiatrist or a research psychologist. Results The prevalence of psychotic symptoms in 85-years-olds without dementia decreased from 10.1% in 1986 to 1987 to 3.2% in 2008 to 2010 (P < .001). Disability in daily life (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.1-4.5), depressed mood (OR, 3.9; 95% CI, 2.1-7.1), irritability (OR, 3.6; 95% CI, 1.2-10.5), and suicidal ideation (OR, 4.1; 95% CI, 2.1-8.0) were associated with psychotic symptoms in both cohorts. Mean mini-mental state examination (MMSE) score was lower in those with psychotic symptom compared with those with no psychotic symptoms (Cohort 1986-1987, 26.4 vs 27.8, Cohort 2008-2009, 26.1 vs 27.7, t value -4.24, Pr > t < 0.001). Conclusion The prevalence of psychotic symptoms decreased between 1986 to 1987 and 2008 to 2010 among 85-years-olds without dementia. These symptoms were associated with broad psychopathology, worse performance in cognitive testing, and with disability of daily life in both cohorts.
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| 5. |
- Thorvaldsson, Valgeir, 1976, et al.
(author)
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Onset and rate of cognitive change before dementia diagnosis: findings from two Swedish population-based longitudinal studies
- 2011
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In: Journal of the International Neuropsychological Society. - 1469-7661 .- 1355-6177. ; 17:1, s. 154-62
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Journal article (peer-reviewed)abstract
- We used data from two population-based longitudinal studies to estimate time of onset and rate of accelerated decline across cognitive domains before dementia diagnosis. The H70 includes an age-homogeneous sample (127 cases and 255 non-cases) initially assessed at age 70 with 12 follow-ups over 30 years. The Kungsholmen Project (KP) includes an age-heterogeneous sample (279 cases and 562 non-cases), with an average age of 82 years at initial assessment, and 4 follow-ups spanning 13 years. We fit mixed linear models to the data and determined placement of change points by a profile likelihood method. Results demonstrated onset of accelerated decline for fluid (speed, memory) versus crystallized (verbal, clock reading) abilities occurring approximately 10 and 5 years before diagnosis, respectively. Although decline before change points was greater for fluid abilities, acceleration was more pronounced for crystallized abilities after the change points. This suggests that onset and rate of acceleration vary systematically along the fluid-crystallized ability continuum. There is early onset in fluid abilities, but these changes are difficult to detect due to substantial age-related decline. Onset occurred later and acceleration was greater in crystallized abilities, suggesting that those markers may provide more valid identification of cases in later stages of the prodromal phase.
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| 6. |
- Billstedt, Eva, 1961, et al.
(author)
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A 37-year prospective study of neuroticism and extraversion in women followed from mid-life to late life.
- 2014
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In: Acta psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 129:1
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Personality traits are presumed to endure over time, but the literature regarding older age is sparse. Furthermore, interpretation may be hampered by the presence of dementia-related personality changes. The aim was to study stability in neuroticism and extraversion in a population sample of women who were followed from mid-life to late life. METHOD: A population-based sample of women born in 1918, 1922 or 1930 was examined with the Eysenck Personality Inventory (EPI) in 1968-1969. EPI was assessed after 37 years in 2005-2006 (n = 153). Data from an interim examination after 24 years were analysed for the subsample born in 1918 and 1922 (n = 75). Women who developed dementia at follow-up examinations were excluded from the analyses. RESULTS: Mean levels of neuroticism and extraversion were stable at both follow-ups. Rank-order and linear correlations between baseline and 37-year follow-up were moderate ranging between 0.49 and 0.69. Individual changes were observed, and only 25% of the variance in personality traits in 2005-2006 could be explained by traits in 1968-1969. CONCLUSION: Personality is stable at the population level, but there is significant individual variability. These changes could not be attributed to dementia. Research is needed to examine determinants of these changes, as well as their clinical implications.
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| 7. |
- Billstedt, Eva, 1961, et al.
(author)
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Secular changes in personality: study on 75-year-olds examined in 1976-1977 and 2005-2006.
- 2013
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 28:3, s. 298-304
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Journal article (peer-reviewed)abstract
- OBJECTIVE: In order to study secular changes in personality factors neuroticism and extroversion, representative population samples of non-demented 75-year-olds underwent psychiatric examinations in 1976-1977 (total n = 223, 138 women, 85 men) and 2005-2006 (total n = 556, 322 women and 234 men). METHODS: Eysenck Personality Inventory was used at both occasions. Demographic factors (educational level, marital status, having children) were registered. RESULTS: Seventy-five-year-olds examined in 2005-2006 had higher values on extroversion and lower values on the Lie scale compared with those examined in 1976-1977. Neuroticism did not differ between the two birth cohorts. Neuroticism scores were higher in women than in men both in 1976-1977 and 2005-2006, and Lie score was higher in women than in men in 2005-2006. CONCLUSIONS: Our findings suggest that present cohorts of 75-year-olds are more extroverted and less prone to respond in a socially desirable manner than those born three decades earlier. Neuroticism levels remained unchanged, suggesting this trait may be less influenced by environmental factors than the other traits studied.
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| 8. |
- Bäckman, Kristoffer, 1979, et al.
(author)
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37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden.
- 2012
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In: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 28:1, s. 163-71
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Journal article (peer-reviewed)abstract
- Level of adiposity is linked to dementia in epidemiological studies. Overweight and obesity in mid- and late-life may increase risk for dementia, whereas decline in body weight or body mass index (BMI) and underweight in years preceding and at the time of a dementia diagnosis may also relate to dementia. Longitudinal studies with sufficient follow-up are necessary to estimate trajectories that allow better understanding of the relationship between adiposity indices and dementia over the life course. We evaluated the natural history of BMI in relationship to clinical dementia over 37 years in the Prospective Population Study of Women (PPSW) in Sweden. PPSW is a systematic sample of 1462 women born 1908, 1914, 1918, 1922, and 1930 and aged 38-60 years at baseline. Examinations occurred in 1968, 1974, 1980, 1992, 2000, and 2005. Statistical analyses were conducted using mixed effects regression models. Trajectories of BMI over 37 years as a function of age differed between women who did versus did not develop dementia. Women developing dementia evidenced a lesser increase in BMI from age 38 to 70 years. After age 70, the BMI slope decreased similarly (no "accelerated decline") irrespective of dementia status. A lower BMI before and during dementia onset was observed. Women with similar BMI at mid-life exhibited a different pattern of BMI change as they approached late-life that was related to dementia onset. BMI may be a potential marker of dementia-related neuropathologies in the brain. Dementia is related to a common risk factor, BMI, from mid-to late-life.
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| 9. |
- Börjesson-Hanson, Anne, 1959, et al.
(author)
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One-Month Prevalence of Mental Disorders in a Population Sample of 95-Year Olds.
- 2011
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In: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 19:3, s. 284-91
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Journal article (peer-reviewed)abstract
- OBJECTIVE:: To determine the 1-month prevalence of mental disorders among 95-year olds. DESIGN:: Cross-sectional population sample of 95-year olds. SETTING:: All 95-year olds born in the period 1901-1903 living in Gothenburg, Sweden, were invited. Elderly living in both community settings and nursing homes were included. PARTICIPANTS:: In total, 338 95-year olds (response rate: 65%) were examined (263 women, 75 men). MEASUREMENTS:: All participants were examined by psychiatrists using the Comprehensive Psychopathological Rating Scale and cognitive tests. Mental disorders were classified according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria. RESULTS:: Two-third of all 95-year olds had a mental disorder. In the total sample of 95-year olds, the 1-month prevalence was 52% for dementia, 8% for depression, 4% for anxiety, and 3% for psychotic disorders. Almost one-third (29%) of the nondemented 95-year olds fulfilled criteria for a psychiatric disorder: 17% had depression, 9% anxiety, and 7% psychotic disorder. CONCLUSIONS:: The combined prevalence of mental disorders was high among 95-year olds, even after excluding dementia. These findings emphasize the importance of research, care, and detection of psychiatric problems in this age group.
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| 10. |
- Gudmundsson, Pia, 1978, et al.
(author)
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Depression in Swedish women: relationship to factors at birth.
- 2011
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In: European journal of epidemiology. - : Springer Science and Business Media LLC. - 1573-7284 .- 0393-2990. ; 26:1, s. 55-60
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Journal article (peer-reviewed)abstract
- Depression is a common and serious disorder that may have developmental origins. Birth-related factors have been related to childhood and adult occurrence of somatic as well as psychiatric disorders, but studies on the relationship between birth-related factors and depression are few and show mixed results. In addition, varying methods have been used to assess depression. Standardized clinical criteria to diagnose depression, combined with birth data collected from midwife records have not been used in most studies. Participants in the Prospective Population Study of Women in Sweden (803 women), born 1914, 1918, 1922 and 1930, provide information on birth factors and depression. Women participated from 1968 at mid-life ages of 38-60 years, to 2000, when they were age 78-92 years. Original birth records containing birth weight, length, head circumference, and gestational time, as well as social factors were obtained. Lifetime depression was diagnosed via multiple information sources. Symptoms were assessed using the Comprehensive Psychopathological Rating Scale and diagnoses were based on DSM-III-R criteria. Over their lifetime, 44.6% of women in this sample experienced depression. Birth weights ≤ 3500 g [odds ratio (OR), age-adjusted = 1.72; 95% CI 1.29-2.28, P < 0.001] and shorter gestational time (OR, age-adjusted = 1.13; 95% CI 1.04-1.24, P = 0.005) were independently associated with a higher odds of lifetime depression in a logistic regression model adjusted for age. Lower than median birth weights and shorter gestational time were related to lifetime depression in women. Both neurodevelopmental and environmental contributions to lifetime depression may be considered.
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