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- Alves, G., et al.
(författare)
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CSF A beta(42) predicts early-onset dementia in Parkinson disease
- 2014
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 82:20, s. 1784-1790
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To test in vivo the proposal from clinicopathologic studies that -amyloid (A) pathology shortens the time to dementia in Parkinson disease (PD), and to explore the utility of CSF A and related measures as early prognostic biomarkers of dementia in an incident PD cohort.Methods:We assessed a population-based incident cohort of 104 patients with PD who underwent lumbar puncture at diagnosis. We analyzed CSF concentrations of A42, A40, and A38 using a multiplexed immunoassay with electrochemiluminescence (ECL) detection and levels of A42, total tau, and phosphorylated tau using ELISA. Patients were followed prospectively for 5 years. Dementia was diagnosed according to published criteria.Results:CSF levels of A42 were significantly decreased in patients who developed dementia (n = 20, 19.2%) compared to those who did not (n = 84, 80.8%), as measured by ECL (-33%, p = 0.006) as well as ELISA (-36%, p < 0.001). No differences were observed for other markers. Low A42 values predicted a substantially increased risk for subsequent dementia at high sensitivity (85%), with hazard ratios of 9.9 (95% confidence interval 2.3-43.5, p = 0.002) for A42(ECL) <376 pg/mL and 7.6 (2.2-26.4, p = 0.001) for A42(ELISA) <443 pg/mL, after adjustment for baseline age and PD-mild cognitive impairment (MCI) status. A42 reductions tended to precede the onset of PD-MCI that progressed to dementia.Conclusions:These in vivo data support the role of A pathology in the etiology and highlight the potential utility of CSF A42 as an early prognostic biomarker of dementia associated with PD.
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| 3. |
- Forland, G., et al.
(författare)
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Sense of Coherence: Learning to live with chronic illness through health education
- 2018
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Ingår i: Health Education Journal. - : SAGE Publications. - 0017-8969 .- 1748-8176. ; 77:1, s. 96-108
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study examines people's experiences of how to live with a chronic disease, their learning needs and their reasons for participating in a health education programme. The aim of the study was to examine if and how a Sense of Coherence (SOC) might guide an understanding of learning processes in health education. Methods: This study has a qualitative study design with data collected through five group interviews. Interviews were analysed using qualitative content analysis to identify principal categories of response. Directed content analysis was then used to reference the categories emerging in the first step to the study's theoretical framework. Results: Three main categories were found: (1) the ability to cope with daily life, (2) assets for a better life both in the present and for the future, and (3) the need for knowledge. A synthesis of empirical findings with reference to the first stage of analysis, the three main aspects of learning, and the three dimensions of a SOC revealed that a SOC may be useful in guiding an understanding of learning processes in health education as a life-oriented mastering resource. Conclusion: SOC offers a useful framework for informing health education. Research is needed to deepen an understanding of how salutogenic theory can strengthen the development of health education programmes and understanding of participants' learning.
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