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| 2. |
- Fall, Per-Arne, 1943-, et al.
(författare)
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Survival time, mortality, and cause of death in elderly patients with Parkinson's disease : A 9-year follow-up
- 2003
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 18:11, s. 1312-1316
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Tidskriftsartikel (refereegranskat)abstract
- This community-based study of Parkinson's disease (PD) investigated age at death and cause of death in a cohort of 170 previously studied patients. The current study is a 9-year follow-up, and the results are compared to 510 sex- and age-matched controls from the same area. A total of 170 patients were diagnosed with PD on August 31, 1989, within a defined area of Sweden. A control group of 510 persons from the same area and with the same age and sex distribution was also examined regarding age at death and cause of death. After 9.4 years, 121 cases (71.1%) and 229 controls (44.9%) were no longer alive. Thus, the mortality rate ratio was 1.6 (95% confidence interval [CI], 1.3-1.8) when comparing PD patients with controls. The all-cause hazard ratio for cases compared to controls was 2.4 (95% CI, 1.9-3.0). The mean age at death for the cases was 81.9 (95% CI, 80.3-83.0) years and for the controls 82.9 (95% CI, 82.0-83.7) years. Survival analysis also showed a shorter survival time (P < 0.001) for PD patients. Only 53% of the death certificates for the deceased patients recorded PD as an underlying or contributory cause of death. Many PD patients reached a high age but had a shorter survival than the controls. There was a significant increase in deaths from pneumonia.
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| 5. |
- Granérus, Ann-Kathrine, 1939-
(författare)
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Parkinsons sjukdom hos äldre.
- 1999
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Ingår i: Nordisk geriatrik. - 1403-2082. ; 1, s. 48-57
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Lorefält, Birgitta, 1944-, et al.
(författare)
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Avoidance of solid food in weight losing older patients with Parkinson's disease
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:11, s. 1404-1412
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this paper was to investigate to what extent parkinsonian symptoms, including mild dysphagia and other eating problems, could influence the choice of consistency and the amount of food intake and if this could be related to weight loss as an expression of the underlying neurodegenerative process.Background. Previous studies show that patients with Parkinson's disease tend to lose body weight even early during the disease.Design. The design was a longitudinal prospective study.Methods. Twenty-six free-living Parkinson's disease patients and 26 age- and sex-matched controls were investigated twice, with one-year apart, with focus on Parkinson's disease symptoms, as well as swallowing function. Intake of food items and food consistency were assessed by food records, completed over three consecutive days at each investigation.Results. In patients with weight loss, motor symptoms, problems with activities of daily living and problems with eating, related to motor symptoms, increased and they had more dysphagia compared with their controls. They consumed lower amounts of fluid and solid food on both investigated occasions, compared with their controls. Multiple regression analysis showed that weight loss was associated with female gender, eating difficulties related to activities of daily living and preference towards soft food, but negatively correlated with age.Conclusion. Parkinson's disease patients with weight loss seemed to avoid solid food, partly because of eating difficulties. Eating problems, as well as weight loss, could be because of the underlying disease, even when it is not at an advanced stage.Relevance to clinical practice. Caring for patients with Parkinson's disease should not only include medical treatment, but also support for adequate food intake to prevent weight loss.
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| 7. |
- Lorefält, Birgitta, 1944-, et al.
(författare)
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Bone mass in elderly patients with Parkinson's disease
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 116:4, s. 248-254
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Tidskriftsartikel (refereegranskat)abstract
- Objective - The objective of the present study was to find risk factors for low bone mineral density (BMD) in patients with Parkinson's disease (PD). Material and methods - Twenty-six PD patients and 26 age-and sex-matched healthy controls were assessed twice within a 1-year period. PD symptoms, body weight, body fat mass, BMD, physical activity, smoking and serum concentrations of several laboratory analyses were investigated. Results - BMD in different locations was lower in PD patients compared with their controls and decreased during the investigated year. BMD was lower in PD patients with low body weight. BMD Z-score of trochanter in the PD group was directly correlated to the degree of physical activity and indirectly to the length of recumbent rest. Total body BMD Z-score in the PD group was directly correlated to the degree of rigidity. Serum 25-hydroxy-vitamin D was slightly lower in PD patients. Conclusion - Low body weight and low physical activity were risk factors for low BMD in PD, while rigidity seemed to be protective. © 2007 The Authors.
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| 8. |
- Lorefält, Birgitta, 1944-, et al.
(författare)
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Food habits and intake of nutrients in elderly patients with Parkinson's disease
- 2006
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 52:3, s. 160-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: Weight loss is reported frequently in patients with Parkinson´s disease also early during the disease.Objective: To investigate food habits and nutrient intake in elderly Parkinson´s disease patients compared with matched controls, as well as to compare PD patients with and without weight loss.Methods: Twenty-six elderly free-living patients with PD, and 26 sex- and age-matched healthy controls, were assessed twice with one year interval between. All food consumed was recorded over 3 consecutive days. Food habits were assessed with the Food Based Concept for Classification of Eating Episodes and intakes of energy and nutrients were calculated. PD symptoms, olfaction, swallowing function, daily activities and serum concentration of different nutri ents were investigated.Results: After 1 year, the PD patients decreased their intakes of daily high quality snacks from 0.5 ± 0.7 to 0.3 ± 0.3 (p < 0.05) and their prepared complete meals from 0.8 ± 0.3 to 0.6 ± 0.3 (p < 0.05), while their daily number of prepared incomplete meals increased from 0.2 ± 0.2 to 0.3 ± 0.3 (p < 0.01). PD patients with weight loss increased their daily intakes of fat by 12 ± 34 g and their energy intake per kg body weight increased by 21 ± 31 kJ (p < 0.05), respectively, and this was higher than in those without weight loss (p < 0.01). PD patients required more help with buying and cooking food compared with the controls.Conclusions: PD patients’ food habits changed so that they consumed a lower number of prepared complete meals. PD patients with weight loss had a higher intake of fat and energy than those without weight loss, although this was obviously not sufficient to prevent weight loss. Impaired absorption of fat in PD should be discussed.
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| 10. |
- Pålhagen, Sven, 1943-, et al.
(författare)
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Does l-dopa treatment contribute to reduction in body weight in elderly patients with Parkinson's disease?
- 2005
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 111:1, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Objective – Many patients with Parkinson's disease (PD) lose weight also early during the disease. The objective of the study was to investigate possible causative factors for this loss.Materials and methods – In this report, 28 PD patients and 28 age- and sex-matched controls were repeatedly assessed with the focus on body weight, body fat mass, dysphagia, olfaction, physical activity, PD symptomatology and drug treatment.Results – Weight loss was seen in PD patients both before and during l-dopa treatment.Conclusion – The underlying disease could play a role, but our results also suggest that l-dopa per se could contribute to the weight loss.
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| 11. |
- Sjögren, Magnus, et al.
(författare)
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Both total and phosphorylated tau are increased in Alzheimer's disease.
- 2001
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Ingår i: Journal of neurology, neurosurgery, and psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 70:5, s. 624-30
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Tidskriftsartikel (refereegranskat)abstract
- [corrected] Pathological tau protein concentrations in CSF are found in both Alzheimer's disease (AD) and frontotemporal dementia (FTD), but studies on brain tissue have suggested that the tau pathology in AD differs from that in FTD and that the difference may be related to the degree of phosphorylation. As CSF tau protein is increased after stroke, tau may also be implicated in the pathophysiology of vascular dementia, of which subcortical arteriosclerotic encephalopathy (SAE) is a putative subtype.To investigate the nature of tau protein in CSF and the involvement of total CSF tau and phosphorylated CSF tau (phosphotau) in various types of dementia.Using ELISAs for total tau and tau phosphorylated at Thr181 (phosphotau), the CSF concentrations of total tau and phosphotau were determined in patients with probable and possible AD (n=41 and 19, respectively), FTD (n=18), SAE (n=17), and Parkinson's disease (PD; n=15) and in age matched controls (n=17). All the antibodies stained the lower molecular weight bands, whereas only the antibodies that recognise phosphorylated tau stained the higher molecular bands.Both CSF tau and CSF phosphotau were increased in probable AD compared with FTD (p<0.001), SAE (p<0.001), PD (p<0.001), and controls (p<0.001). CSF phosphotau was increased in possible AD compared with FTD (p<0.001) and SAE (p<0.001). CSF tau and CSF phosphotau were positively correlated in all the groups. Molecular weight forms of tau ranging from 25 kDa to 80 kDa were found in the CSF CONCLUSION: Both phosphorylated and unphosphorylated tau isoforms were present in the CSF, and tau protein appeared in both truncated and full length forms. The results suggest that the CSF concentrations of tau and phosphotau are increased in about two thirds of patients with probable AD and in half of those with possible AD but are normal in FTD, SAE, and PD compared with normal aging. Values in the normal range do not exclude AD.
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| 12. |
- Sjögren, M, et al.
(författare)
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CSF levels of tau, beta-amyloid and GAP-43 in frontotemporal 1-42 dementia, other types of dementia and normal aging
- 2000
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Ingår i: Journal of neural transmission. - 0300-9564 .- 1435-1463. ; 107:5, s. 563-579
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Tidskriftsartikel (refereegranskat)abstract
- Cerebrospinal fluid (CSF) levels of tau, ▀-amyloid1-42 and growth-associated protein 43 (GAP-43) were studied in patients with frontotemporal dementia (FTD, n = 17), Alzheimer's disease (AD, n = 60), subcortical white-matter dementia (SWD, n = 24), Parkinson's disease (PD, n = 23) and dysthymia (n = 19) and in age-matched controls (n = 32). CSF-tau was significantly increased only in AD, and CSF-▀-amyloid1-42 was significantly decreased in AD and SWD as compared to controls, and in AD compared to FTD. CSF-GAP-43 was significantly decreased only in PD. The GAP-43/tau ratio was decreased in all the patient groups except the dysthymia group compared to controls. A positive correlation was found between CSF-GAP-43 and CSF-tau in all groups. The results suggest normal levels of CSF-tau and CSF-▀-amyloid1-42 in FTD, which will aid in the clinical separation of FTD from AD. In SWD, decreased levels of CSF-▀-amyloid1-42 suggest concomitant involvement of vascular and amyloid protein mechanisms.
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| 13. |
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| 14. |
- Wressle, Ewa, 1953-, et al.
(författare)
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Living with Parkinson´s disease : Elderly patients´ and relatives´ perspective on daily living
- 2007
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Ingår i: Australian Occupational Therapy Journal. - Richmond, Australia : Wiley. - 0045-0766 .- 1440-1630. ; 54, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- Background/aim: Parkinson's disease is a progressive neurodegenerative disorder resulting in significant disability. We examined how Parkinson's disease affects daily living from the perspective of both patients and relatives. Methods: Qualitative interviews were performed with seven patients with Parkinson's disease and nine relatives from families other than those of the interviewed patients. Patients and relatives were recruited from an outpatient geriatric unit at a university hospital in Sweden. The interviews were transcribed and analysed qualitatively. Results: A conceptual framework encompassing aggravating factors, consequences in daily living and facilitating factors is presented. Patients perceived activity restrictions, changed habits, decreased socialisation and anxiety. Relatives reported changed roles and habits, decreased socialisation, strain and anxiety about the future. Facilitating factors included accessibility, strategies and psychological support for both patients and relatives. Conclusions: The results show that Parkinson's disease affects daily living not only for patients but also for relatives. They need to be seen, heard and supported in this burden. Services must be adapted to the needs of both patients and relatives with accessibility to health-care facilities with deep knowledge about the disease and its consequences. The identified factors are areas of concern in occupational therapy.
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