| 1. |
- Guo, Xinxin, 1972, et al.
(författare)
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Increased risk for dementia both before and after stroke: A population-based study in women followed over 44 years
- 2018
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Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 14:10, s. 1253-1260
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Longitudinal studies are needed to understand the long-term associations between stroke and dementia. Methods: A population sample of 1460 women without stroke or dementia at baseline was followed over 44 years, from 1968 to 2012. Information on stroke and dementia was obtained from neuropsychiatric examinations, key-informant interviews, hospital registry, and medical records. Results: During 44 years follow-up, 362 women developed stroke and 325, dementia. The age-specific incidence of the two disorders was similar. The incidence of dementia was higher in those with stroke than among those without (33.7% vs. 18.5%; age-adjusted hazard ratio 1.44, 95% confidence interval 1.15-1.81). The increased risk of dementia started already 5 years before stroke, was highest 1 year after stroke, and continued more than 11 years after stroke. Discussion: There is an increased risk for dementia both before and after stroke. This has implications for understanding the relation between the two disorders and for prevention of dementia and stroke. (C) 2018 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.
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| 2. |
- Hörder, Helena M, et al.
(författare)
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Midlife cardiovascular fitness and dementia A 44-year longitudinal population study in women
- 2018
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 90:15, s. E1298-E1305
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years. A population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders. Compared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03-0.54) among those with high fitness and 1.41 (95% CI 0.72-2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness. Among Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.
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| 3. |
- Johansson, Lena, 1972, et al.
(författare)
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Common psychosocial stressors in middle-aged women related to longstanding distress and increased risk of Alzheimer’s disease: a 38 year longitudinal population study
- 2013
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 3:9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the relation among psychosocial stressors, long-standing distress and incidence of dementia, in a sample of women followed from midlife to late life. DESIGN: Prospective longitudinal population study. SETTING: The analyses originate from the prospective population study of women in Gothenburg, Sweden, a representative sample of women examined in 1968 (participation rate 90%) and re-examined in 1974, 1980, 1992, 2000 and 2005. PARTICIPANTS: 800 women born in 1914, 1918, 1922 and 1930 who were systematically selected for a psychiatric examination at baseline, in 1968. PRIMARY AND SECONDARY OUTCOME MEASURES: 18 psychosocial stressors (eg, divorce, widowhood, work problems and illness in relative) were obtained at baseline. Symptoms of distress were measured according to a standardised question at each study wave. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data, and measured through the whole study period. RESULTS: During the 37 years of follow-up, 153 women developed dementia (104 of those had Alzheimer's disease (AD)). Number of psychosocial stressors in 1968 was associated (HR, 95% CI) with higher incidence of dementia (1.15, 1.04 to 1.27) and AD (1.20, 1.07 to 1.35) between 1968 and 2005, in multivariate Cox regressions. Number of psychosocial stressors in 1968 was also associated (OR, 95% CI) with distress in 1968 (1.48, 1.32 to 1.67), 1974 (1.31, 1.17 to 1.46), 1980 (1.27, 1.11 to 1.45), 2000 (1.39, 1.14 to 1.70) and 2005 (1.35, 1.02 to 1.79), in multivariate logistic regressions. Number of psychosocial stressors (HR 1.17, 95% CI 1.03 to 1.33) and long-standing distress (1968-1974-1980) (HR 1.58, 95% CI 1.03 to 2.45) were independently associated with AD. CONCLUSIONS: Our study shows that common psychosocial stressors may have severe and long-standing physiological and psychological consequences. However, more studies are needed to confirm these results and investigate whether more interventions such as stress management and behavioural therapy should be initiated in individuals who have experienced psychosocial stressors.
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| 4. |
- Johansson, Lena, 1972, et al.
(författare)
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Longstanding psychological stress in relation to biomarkers of neuronal dysfunction in cerebrospinal fluid: a 25-year follow-up study in women
- 2019
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Ingår i: Neurobiology of Aging. - : Elsevier BV. - 0197-4580. ; 80, s. 111-115
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Tidskriftsartikel (refereegranskat)abstract
- Longstanding psychological stress has been associated with increased risk of neurodegenerative disorders, such as dementia and Alzheimer's disease. In a prospective population study of women (n = 81), we tested if midlife stress (mean age 49 years) was associated with late-life biomarkers of neuro-degeneration in cerebrospinal fluid (CSF) (mean age 74 years) in linear regression models. It was found that women who report of stress at baseline (n = 20) had higher levels of CSF visinin-like protein-1 (VILIP-1) (age adjusted beta = 0.113, p = 0.017) and CSF myelin basic protein (beta = 0.060, p = 0.030) compared with women without midlife stress (n = 61). There was also a trend observed for higher CSF neurofilament light (beta = 0.133, p = 0.056). In addition, longer periods of stress (i.e., stress at 2-3 midlife examinations) were associated with higher levels of CSF VILIP-1. The results suggest that longstanding stress might be associated with neurodegenerative processes in the brain, as CSF VILIP-1 is an unspecific marker for neuronal injury and CSF myelin basic protein reflects neuroaxonal demyelination. (C) 2019 Elsevier Inc. All rights reserved.
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| 5. |
- Johansson, Lena, 1972, et al.
(författare)
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Longstanding smoking associated with frontal brain lobe atrophy: a 32-year follow-up study in women
- 2023
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Ingår i: BMJ OPEN. - 2044-6055. ; 13:10
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo examine the association between midlife tobacco smoking and late-life brain atrophy and white matter lesions.MethodsThe study includes 369 women from the Prospective Population Study of Women in Gothenburg, Sweden. Cigarette smoking was reported at baseline 1968 (mean age=44 years) and at follow-up in 1974-1975 and 1980-1981. CT of the brain was conducted 32 years after baseline examination (mean age=76 years) to evaluate cortical atrophy and white matter lesions. Multiple logistic regressions estimated associations between midlife smoking and late-life brain lesions. The final analyses were adjusted for alcohol consumption and several other covariates.ResultsSmoking in 1968-1969 (adjusted OR 1.85; 95% CI 1.12 to 3.04), in 1974-1975 (OR 2.37; 95% CI 1.39 to 4.04) and in 1980-1981 (OR 2.47; 95% CI 1.41 to 4.33) were associated with late-life frontal lobe atrophy (2000-2001). The strongest association was observed in women who reported smoking at all three midlife examinations (OR 2.63; 95% CI 1.44 to 4.78) and in those with more frequent alcohol consumption (OR 6.02; 95% CI 1.74 to 20.84). Smoking in 1980-1981 was also associated with late-life parietal lobe atrophy (OR 1.99; 95% CI 1.10 to 3.58). There were no associations between smoking and atrophy in the temporal or occipital lobe, or with white matter lesions.ConclusionLongstanding tobacco smoking was mainly associated with atrophy in the frontal lobe cortex. A long-term stimulation of nicotine receptors in the frontal neural pathway might be harmful for targeted brain cell.
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| 6. |
- Johansson, Lena, 1972, et al.
(författare)
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Midlife personality and risk of Alzheimer disease and distress: A 38-year follow-up.
- 2014
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Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 83:17, s. 1538-44
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the association between midlife neuroticism and extraversion and development of late-life dementia and long-standing distress in a sample of women followed for 38 years. METHODS: A population-based sample of 800 women, aged 38 to 54 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, 2000, and 2005. Neuroticism and extraversion were assessed using the Eysenck Personality Inventory at baseline. Distress was measured according to a standardized question at each study wave. Dementia was diagnosed according to DSM-III-R criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. RESULTS: During the 38-year follow-up, 153 women developed dementia; Alzheimer disease (AD) dementia was diagnosed in 104 of these. A higher degree of neuroticism in midlife was associated with increased risk of AD dementia and long-standing distress over 38 years. The association between neuroticism and AD dementia diminished after adjusting for long-standing distress. Extraversion was associated with a lower degree of long-standing distress, but had no impact on AD dementia. When the 2 personality dimensions were combined, high neuroticism/low extraversion showed the highest risk of AD dementia. CONCLUSIONS: Our study suggests that midlife neuroticism is associated with increased risk of AD dementia, and that distress mediates this association. The results have clinical implications because a group of women at risk of AD dementia is identified.
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| 7. |
- Johansson, Lena, 1972, et al.
(författare)
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Midlife Psychological Distress Associated With Late-Life Brain Atrophy and White Matter Lesions: A 32-Year Population Study of Women.
- 2012
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Ingår i: Psychosomatic medicine. - 0033-3174. ; 74:2, s. 120-125
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Tidskriftsartikel (refereegranskat)abstract
- Long-standing psychological distress increases the risk of dementia, especially Alzheimer's disease. The present study examines the relationship between midlife psychological distress and late-life brain atrophy and white matter lesions (WMLs), which are common findings on neuroimaging in elderly subjects. A population-based sample of 1462 women, aged 38 to 60 years, was examined in 1968, with subsequent examinations in 1974, 1980, 1992, and 2000. Computed tomography (CT) of the brain was done in 379 survivors in 2000, and of those, 344 had responded to a standardized question about psychological distress in 1968, 1974, and 1980. WMLs, cortical atrophy, and central atrophy (ventricular sizes) were measured at CT scans. Compared with women reporting no distress, those reporting frequent or constant distress at one examination or more (in 1968, 1974, and 1980) more often had moderate-to-severe WMLs (multiadjusted odds ratio = 2.39, 95% confidence interval = 1.16-4.92) and moderate-to-severe temporal lobe atrophy (multiadjusted odds ratio = 2.51, 95% confidence interval = 1.04-6.05) on brain CT in 2000. Frequent/constant distress was also associated with central brain atrophy, that is, higher bicaudate ratio, higher cella media ratio, and larger third-ventricle width. Long-standing psychological distress in midlife increases risks of cerebral atrophy and WMLs on CT in late life. More studies are needed to confirm these findings and to determine potential neurobiological mechanisms of these associations.
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| 8. |
- Johansson, Lena, 1972, et al.
(författare)
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Midlife psychological stress and risk of dementia: a 35-year longitudinal population study.
- 2010
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156. ; 133:8, s. 2217-2224
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Tidskriftsartikel (refereegranskat)abstract
- The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38-60 years were examined in 1968-69 and re-examined in 1974-75, 1980-81, 1992-93 and 2000-03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer's disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10-2.34), in 1974 (1.65, 1.12-2.41) and in 1980 (1.60, 1.01-2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer's disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71-1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01-2.95) for those reporting stress at two examinations and 2.51 (1.33-4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer's disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.
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| 9. |
- Johansson, Lena, 1972, et al.
(författare)
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Midlife Stress in Relation to Late-Life Cerebrospinal Fluid Biomarkers of Alzheimer's Disease: A 25-Year Follow-Up Study
- 2018
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 46:1-2, s. 90-99
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background/Aims:</i></b> Psychological stress has previously been associated with higher risk of developing late-life dementia, especially Alzheimer’s disease (AD). This study tested whether longstanding midlife stress is related to cerebrospinal fluid (CSF) biomarkers of late-life AD, such as tau protein and amyloid beta (Aβ). <b><i>Methods:</i></b> The study included 79 nondemented females from the Prospective Population Study of Women in Gothenburg, Sweden, who responded to a standardized stress question at baseline (mean age 49 years) and underwent a lumbar puncture at follow-up 25 years later. Multiple linear regression models analyzed the relationships between midlife psychological stress and late-life CSF measures of total tau (t-tau), phosphorylated tau (p-tau), Aβ40, and Aβ42. <b><i>Results:</i></b> Longstanding stress in midlife was associated with higher levels of CSF t-tau (β = 0.64, <i>p</i> = 0.01) and Aβ40 (β = 0.60, <i>p</i> = 0.02) in late life. No associations were found between midlife stress and levels of p-tau or Aβ42. <b><i>Conclusion:</i></b> The findings suggest that longstanding stress stimulates unspecific neurodegenerative processes, but not the core processes of AD, at least not in the early phase of the disease. The association with higher concentration of CSF t-tau may reflect neural degeneration and the association with higher Aβ40 may be an early sign of Aβ overproduction or cerebrovascular processes in the brain.
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| 10. |
- Najar, Jenna, et al.
(författare)
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Cognitive and physical activity and dementia A 44-year longitudinal population study of women
- 2019
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Ingår i: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 92:12, s. E1322-E1330
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether cognitive and physical activities in midlife are associated with reduced risk of dementia and dementia subtypes in women followed for 44 years. Methods A population-based sample of 800 women aged 38-54 years (mean age 47 years) was followed from 1968 to 2012. Cognitive (artistic, intellectual, manual, religious, and club) and physical activity were assessed at baseline. During follow-up, dementia (n = 194), Alzheimer disease (n = 102), vascular dementia (n = 27), mixed dementia (n = 41), and dementia with cerebrovascular disease (n = 81) were diagnosed according to established criteria based on information from neuropsychiatric examinations, informant interviews, hospital records, and registry data. Cox regression models were used with adjustment for age, education, socioeconomic status, hypertension, body mass index, cigarette smoking, diabetes mellitus, angina pectoris, stress, and major depression. Results We found that cognitive activity in midlife was associated with a reduced risk of total dementia (hazard ratio [HR] 0.66; 95% confidence interval [CI] 0.49-0.89) and Alzheimer disease (HR 0.54; 95% CI 0.36-0.82) during follow-up. Physical activity in midlife was associated with a reduced risk of mixed dementia (HR 0.43; 95% CI 0.22-0.86) and dementia with cerebrovascular disease (HR 0.47; 95% CI 0.28-0.78). The results were similar after excluding those who developed dementia before 1990 (n = 21), except that physical activity was then also associated with reduced risk of total dementia (HR 0.67; 95% CI 0.46-0.99). Conclusion Our findings suggests that midlife cognitive and physical activities are independently associated with reduced risk of dementia and dementia subtypes. The results indicate that these midlife activities may have a role in preserving cognitive health in old age.
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