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- Elgh, Eva, et al.
(författare)
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Cognitive dysfunction, hippocampal atrophy and glucocorticoid feedback in Alzheimer's disease.
- 2006
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Ingår i: Biological Psychiatry. - : Elsevier BV. - 0006-3223 .- 1873-2402. ; 59:2, s. 155-161
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The hippocampal formation is damaged early in Alzheimer's disease (AD). An association between temporal lobe volume and cognitive function has been shown in several studies. Increased limbic-hypothalamic-pituitary-adrenal (LHPA) axis function has been suggested to be related to hippocampal atrophy and cognitive impairment. Our hypothesis was that there is a clear link between hippocampal volume -- notably of the CA1 region -- memory (episodic and visuospatial) and decreased feedback sensitivity in the LHPA axis in AD. METHODS: Sixteen medication-free outpatients with mild to moderate AD were included. Hippocampal volume was measured with magnetic resonance imaging. Dexamethasone suppression tests were performed using .5 mg and .25 mg dexamethasone. Three different components in the neuropsychological battery -- Rey 15 item memory test, Alzheimer's Disease Assessment Scale (ADAS) word recall and spatial span from Wechsler Adult Intelligence Scale - Revised neuropsychological instrument (WAIS-R NI) -- were found to represent episodic and visuospatial memory. RESULTS: Low hippocampal CA1 volume and high post-dexamethasone cortisol levels in combination were significantly associated with Rey 15 item memory and spatial span test outcomes. No association was found between LHPA feedback and hippocampal volume. CONCLUSIONS: Low hippocampal volume and a disturbed negative feedback in the LHPA axis link to specific cognitive impairments in Alzheimer's disease.
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| 2. |
- Elgh, Eva, et al.
(författare)
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Memory functions and rCBF (99m)Tc-HMPAO SPET : developing diagnostics in Alzheimer's disease
- 2002
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 29:9, s. 1140-1148
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Tidskriftsartikel (refereegranskat)abstract
- Alzheimer's disease (AD) is a primary degenerative disease of the brain. The prevalence increases with age, with devastating consequences for the individual and society. The aim of this study was to evaluate whether patients with early AD show an altered regional cerebral blood flow (rCBF) compared with control persons. Furthermore, we aimed to investigate the correlation between rCBF in sublobar volumes of the brain and performance on memory tests. Memory tests were chosen to evaluate episodic and semantic memory. Fourteen patients (aged 75.2+/-8.8 years) with early AD and 15 control persons (aged 71.4+/-3.2 years) were included. rCBF measurements with single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO) were performed. The rCBF (99m)Tc-HMPAO SPET images were spatially transformed to fit a brain atlas and normalised for differences in rCBF (Computerised Brain Atlas software). Cortical and subcortical volumes of interest (VOIs) were analysed and compared. Compared with the controls, AD patients showed a significantly lower rCBF ratio in temporoparietal regions, including the left hippocampus. The diagnostic sensitivity and specificity for AD were high in temporoparietal regions. AD patients had significantly reduced performance on semantic and, in particular, episodic memory tests compared with age-matched normative data, and their performance on several episodic tests correlated with rCBF ratios in parietal and temporal regions, including the left hippocampus. The correlation between rCBF ratio and level of episodic memory performance suggests that abnormalities in rCBF pattern underlie impaired episodic memory functioning in AD.
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| 4. |
- Lidestam, Björn, 1968-, et al.
(författare)
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In-Car Warnings of Emergency Vehicles Approaching: Effects on Car Drivers' Propensity to Give Way
- 2020
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Ingår i: Frontiers in Sustainable Cities. - : Frontiers Media SA. - 2624-9634. ; 2:19
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Tidskriftsartikel (refereegranskat)abstract
- Emergency driving entails substantially higher risk rates than ordinary driving, and it is crucial that other road users notice the emergency vehicles on call. Sirens and emergency lights are used to warn and demand that other road users give way and provide safe passage, but accidents still occur. The purpose of this study was to test the effect of a broadcast hyper local Emergency Vehicle Approaching (EVA) message via RDS radio, noticing that an emergency vehicle on call is approaching and demands that others give way, on the propensity of individual drivers to give way. In two simulator experiments, a total of 90 car drivers participated. In Experiment 1, drivers were passed three times by an ambulance in traffic conditions where it was easy to detect the ambulance early, and two versions of EVA message were compared to a baseline condition without a broadcast message. In Experiment 2, drivers were passed only once by an ambulance and in traffic conditions that made it difficult to detect the ambulance early, and either received an EVA message, or no message. The results showed that EVA messaging made drivers give way earlier and learned to give way earlier even without an EVA message. The main finding was that EVA messaging was necessary for making inexperienced drivers give way to an approaching emergency vehicle on call. Most of them did not know that they are obliged to give way, and some did not notice the emergency vehicle before it passed them. In conclusion, the study suggests that EVA messaging to alert and instruct drivers how to give way properly is beneficial for traffic safety and for enabling time-efficient emergency transports.
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| 5. |
- Liwing, Johan, et al.
(författare)
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Improved survival in myeloma patients : starting to close in on the gap between elderly patients and a matched normal population
- 2014
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Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048 .- 1365-2141. ; 164:5, s. 684-693
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Tidskriftsartikel (refereegranskat)abstract
- The outcome for multiple myeloma patients has improved since the introduction of bortezomib, thalidomide and lenalidomide. However, studies comparing new and conventional treatment include selected patient groups. We investigated consecutive patients (n = 1638) diagnosed in a defined period and compared survival with a gender- and age-matched cohort Swedish population (n = 9 340 682). Median overall survival for non-high-dose treated patients was 2.8 years. The use of bortezomib, thalidomide or lenalidomide in first line therapy predicted a significantly longer overall survival (median 4.9 years) compared to conventional treatment (2.3 years). Among non-high-dose treated patients receiving at least 2 lines with bortezomib, thalidomide or lenalidomide, 69% and 63% have survived at 3 and 5 years as compared to 48% and 22% with conventional drugs and 88% and 79% in the matched cohort populations, respectively. The median overall survival in high-dose treated patients was 6.9 years. Of these patients, 84% survived at 3 years and 70% at 5 years as compared to 98% and 95% in the matched cohort population. Overall survival in the best non-high-dose treated outcome group is closing the gap with the matched cohort. Upfront use of new drugs is clearly better than waiting until later lines of treatment.
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| 8. |
- Niklasson, Johan, et al.
(författare)
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Higher morale is associated with lower risk of depressive disorders five years later among very old people
- 2017
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 69, s. 61-68
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, p<0.001). The association remained after adjusting for social isolation (p<0.1 association with depressive disorders five years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group.
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| 9. |
- Nyqvist, Fredrica, et al.
(författare)
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The association between leisure engagement and loneliness before and during the COVID-19 pandemic : a Nordic population-based study
- 2023
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Ingår i: Scandinavian Journal of Public Health. - London : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:5, s. 744-753
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The main aim of this study was to examine leisure engagement and loneliness among older adults before and during the COVID-19 pandemic by analysing population-based data from western Finland and northern Sweden.Methods: The data originated from the Gerontological Regional Database (GERDA) postal questionnaire study conducted in 2016 (n=7996) and 2021 (n=8148) among older adults aged 65, 70, 75, 80 and 85 years. Associations between loneliness and leisure engagement were analysed using logistic regression.Results: In total, 10% and 9% of the older adults reported loneliness in 2016 and 2021, respectively. The results showed that a lack of engagement in socialising and pleasure was independently associated with loneliness in both study years, while a lack of engagement in cultural activities was associated with loneliness in 2016 only. In 2021, the likelihood of experiencing loneliness was higher in the Finnish region than in the Swedish region. In addition, those reporting a decrease in hobby and socialising leisure activities due to the COVID-19 pandemic were more likely to report loneliness.Conclusions: Most leisure activities decreased during the pandemic, suggesting an increase in social isolation. However, this did not reflect an increase in loneliness in the studied regions. The evidence suggests that leisure engagement, especially socialising activities, continued to be important for well-being among older adults during the pandemic. Further, loneliness was affected by contextual factors as well as individual-level characteristics. Thus, according to the measures reported here, the pandemic seemed to have a slightly weakened well-being impact in Finland.
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