| 1. |
- Cornelius, Christel
(author)
-
Drug use in the elderly : risk or protection? Findings from the Kungsholmen project
- 2004
-
Doctoral thesis (other academic/artistic)abstract
- This thesis deals with different aspects of drug use in a population-based study with participants 75 years and older. The study was performed within the Kungsholmen Project in Stockholm, Sweden, using data from the baseline survey (1987-89), and the first (1991-93) and second (1994-96) followups In the first two papers we used cross-sectional data (n=1810) to describe tile drug Ilse pattern ill this population (I), and to examine the association between self-reported symptoms and drug use (II). In the next papers (III-V) a dementia-free cohort (n=1301) was followed tip to six years to explore the association between the risk of Alzheimer's disease (AD) and dementia, and the use of aspirin in and NSAIDs (III), the use of glucocorticoids (IV), -and the use of calcium channel blocker s (V). We also examined whether the apolipoprotein E epsilon 4 (apoE epsilon4) allele influenced the effect of these drugs (III-V). The main findings are summarized below. Study I: Sedatives/hypnotics, diuretics, cardiac therapy agents, and minor analgesics and antipyretics were the most commonly used drug groups, accounting for mole than 40% of' the total medicines used. Women used a larger number of drugs than men (3.4 vs 2.6). Anti-thrombotic agents were the only drug group that men used more than women. People living in sheltered accomoditions used more medicines than those living in own homes or nursing homes. Study II: The most commonly reported symptoms were pain and tiredness. Women reported more symptoms than men. Many of the associations between symptoms and chug use reflected estahlished treatments. However, tiredness, loneliness, and depressed mood were associated with use of anxiolytics and hypnotics/sedatives, which might reflect inappropriate treatment. Study III: An increased risk of Alzheimer's disease (AD) was seen among aspirin users that did not carry tile apoE epsilon4 allele. A possible protective effect against AD was seen among long-term users of NSAIDs, regardless of apoE epsilon4 status. Study IV: Use of glucocorticoids was associated with a significantly higher risk of dementia in carriers of the apoE epsilon4 allele (RR 2.39, 95% CI 1.02-5.58). Study V: Use of calcium channel blockers did not protect against AD and dementia, regardless of apoE epsilon4 status. In summary, women used more medicines and reported more symptoms than men did. Self-reported tiredness associated with use of anxiolytics and sedatives/hypnotics might reflect too high or too low doses, or an inappropriate choice of drug. Experience of depressed mood was more common among users of sedatives/hypnotics, which could indicate an under-treatment or inappropriate treatment (if depression in this population. Up to three-years use of NSAIDs might protect against AD, since no one in this group developed AD three years later. The association between aspirin and an increased risk of developing AD among those with no apoE epsilon4 allele Could indicate, in alternative mechanism of developing AD in this group. Carriers of the apoE epsilon4 allele that used glucocorticoids showed all increased risk of developing dementia, which suggests a possible vulnerability to glucocorticoids ill this group. Finally, although calcium channel blockers have been found to be neuroprotective in many experimental studies, we could not find a protective effect against dementia in this population.
|
|
| 2. |
- Khanam, Masuma Akter, et al.
(author)
-
Prevalence and Patterns of Multimorbidity among Elderly People in Rural Bangladesh : A Cross-sectional Study
- 2011
-
In: Journal of Health, Population and Nutrition. - 1606-0997 .- 2072-1315. ; 29:4, s. 406-414
-
Journal article (peer-reviewed)abstract
- Data on multimorbidity among the elderly people in Bangladesh are lacking. This paper reports the prevalenceand distribution patterns of multimorbidity among the elderly people in rural Bangladesh. This crosssectionalstudy was conducted among persons aged ≥60 years in Matlab, Bangladesh. Information on theirdemographics and literacy was collected through interview in the home. Information about their assets wasobtained from a surveillance database. Physicians conducted clinical examinations at a local health centre.Two physicians diagnosed medical conditions, and two senior geriatricians then evaluated the same separately.Multimorbidity was defined as suffering from two or more of nine chronic medical conditions, suchas arthritis, stroke, obesity, signs of thyroid hypofunction, obstructive pulmonary symptoms, symptomsof heart failure, impaired vision, hearing impairment, and high blood pressure. The overall prevalence ofmultimorbidity among the study population was 53.8%, and it was significantly higher among women, illiterates,persons who were single, and persons in the non-poorest quintile. In multivariable logistic regressionanalyses, female sex and belonging to the non-poorest quintile were independently associated withan increased odds ratio of multimorbidity. The results suggest that the prevalence of multimorbidity is highamong the elderly people in rural Bangladesh. Women and the non-poorest group of the elderly people aremore likely than men and the poorest people to be affected by multimorbidity. The study sheds new lighton the need of primary care for the elderly people with multimorbidity in rural Bangladesh.
|
|
| 3. |
|
|
| 4. |
- Palmer, Katie, et al.
(author)
-
Prevalence of dementia and factors associated with dementia in rural Bangladesh : data from a cross-sectional, population-based study
- 2014
-
In: International psychogeriatrics. - : International Psychogeriatric Association. - 1041-6102 .- 1741-203X. ; 26:11, s. 1905-1915
-
Journal article (peer-reviewed)abstract
- Background: There are currently no published reports of dementia prevalence or factors associated with dementia occurrence in Bangladesh. The aims are to report the prevalence of definite and questionable dementia in rural Bangladesh, and examine factors potentially associated with dementia occurrence, including sociodemographic, clinical, social, and nutritional factors. Methods: We used data from a population-based, cross-sectional study from Matlab, in rural Bangladesh, on 471 persons aged 60+ years. Participants underwent a clinical examination including diagnosis of somatic disorders, and a structured interview including questions about sociodemographic and social factors. Nutritional status was measured with the Mini Nutritional Assessment, and blood tests were conducted to assess a range of nutritional and clinical aspects. Age-and sex-specific dementia prevalence was calculated. Crude and adjusted logistic regression was used to examine associations between dementia and clinical, social, and nutritional factors. Dementia was diagnosed using a two-step procedure by physicians according to DSM-IV criteria. Results: The prevalence of questionable dementia was 11.5% and definite dementia was 3.6%. Dementia prevalence increased with increasing years of age (adjusted OR: 1.04; 95% CI = 1.002-1.1) and decreased with more years of education (adjusted OR: 0.8; 95% CI = 0.6-0.99). Being malnourished increased the odds of dementia almost six-fold (adjusted OR: 5.9; 95% CI = 1.3-26.3), while frequent participation in social activities was associated with a decreased odds (adjusted OR: 0.5; 95% CI = 0.2-0.9). Conclusions: The prevalence of dementia in rural Bangladesh is similar to other countries in the South Asia region, but lower than reports from other world regions. Malnutrition is strongly associated with dementia occurrence, and is a relevant area for future research within low-income countries.
|
|
