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- Wallin, Anders, 1950, et al.
(författare)
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Cognitive medicine - a new approach in health care science.
- 2018
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Ingår i: BMC psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- The challenges of today's society call for more knowledge about how to maintain all aspects of cognitive health, such as speed/attention, memory/learning, visuospatial ability, language, executive capacity and social cognition during the life course.Medical advances have improved treatments of numerous diseases, but the cognitive implications have not been sufficiently addressed. Disability induced by cognitive dysfunction is also a major issue in groups of patients not suffering from Alzheimer's disease or related disorders. Recent studies indicate that several negative lifestyle factors can contribute to the development of cognitive impairment, but intervention and prevention strategies have not been implemented. Disability due to cognitive failure among the workforce has become a major challenge. Globally, the changing aging pyramid results in increased prevalence of cognitive disorders, and the diversity of cultures influences the expression, manifestation and consequences of cognitive dysfunction.Major tasks in the field of cognitive medicine are basic neuroscience research to uncover diverse disease mechanisms, determinations of the prevalence of cognitive dysfunction, health-economical evaluations, and intervention studies. Raising awareness for cognitive medicine as a clinical topic would also highlight the importance of specialized health care units for an integrative approach to the treatment of cognitive dysfunctions.
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- Ahlgren, Ewa, 1959-, et al.
(författare)
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Neurocognitive impairment and driving performance after coronary artery bypass surgery
- 2003
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 23:3, s. 334-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.
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- Cucchiara, B, et al.
(författare)
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Lack of hemispheric dominance for consciousness in acute ischaemic stroke
- 2003
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 74:7, s. 889-892
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous reports have suggested left hemispheric dominance for maintaining consciousness, although there is controversy over this claim. Objective: To compare early impairment of level of consciousness between patients with right and left hemispheric stroke. Methods: Data from 564 patients with ischaemic stroke enrolled in the placebo arm of a trial of a putative neuroprotectant were analysed. All patients had major hemispheric stroke with cortical dysfunction, visual field deficit, and limb weakness, with symptom onset within 12 hours of enrolment. Patients were prospectively evaluated on a predefined scale (1-6, 1 = fully awake, higher scores representing greater impairment) to measure level of consciousness at multiple time points over the initial 24 hours after presentation. The National Institutes of Health (NIH) stroke scale score at presentation and infarct volume at 30 days were determined. Results: Some degree of impairment in level of consciousness was observed in 409 of the 564 patients (73%). Median maximum sedation score was 2 for both right and left hemispheric stroke (p = 0.91). Mean sedation score over 24 hours was 1.5 for both right and left stroke (p = 0.75). There was no difference between level of consciousness scores in right and left stroke at any individual time point during the 24 hour monitoring period. No association between side and impairment in level of consciousness was seen after adjustment for stroke severity and infarct volume. Conclusions: In contrast to previous reports, there was no evidence for hemispheric dominance for consciousness in the setting of a major hemispheric stroke.
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- Jonsdottir, Ingibjörg H, 1966, et al.
(författare)
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Cognitive impairment in patients with stress-related exhaustion
- 2013
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Ingår i: Stress-the International Journal on the Biology of Stress. - : Informa UK Limited. - 1025-3890 .- 1607-8888. ; 16:2, s. 181-190
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Tidskriftsartikel (refereegranskat)abstract
- Patients who seek medical care for stress-related mental health problems frequently report cognitive impairments as the most pronounced symptom. The purpose of the present study was to compare cognitive function in patients with stress-related exhaustion with that in healthy controls, using a comprehensive battery of cognitive tests. We also explored whether neuropsychological findings were related to severity of illness measured using the Shirom–Melamed burnout questionnaire and hospital anxiety and depression scale. Thirty-three patients (15 males) and 37 healthy controls (11 males), mean age 46 years [standard deviation (SD) 3.9] and 47 years (SD 4.3), respectively, were included in the final analysis. Five cognitive domains were assessed: (1) speed, attention and working memory, (2) learning and episodic memory, (3) executive functions, (4) visuospatial functions and (5) language. The most pronounced difference between patients and controls was seen on executive function, when tested with a multidimensional test, including aspects of speed, control and working memory. The patients also performed poorer on Digit span, measuring attention span and working memory as well as on learning and episodic memory, when measured as delayed recall and the difference between immediate and delayed recall. Delayed recall was the only test that was significantly related to severity of burnout symptoms among the patients. This could reflect poor cognitive sustainability in the patients with the highest burnout scores, as this particular test was the last one performed during the test session. This study clearly shows that cognitive impairment should be considered when evaluating and treating patients who seek medical care for stress-related exhaustion.
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- Medin, Jennie, 1972-, et al.
(författare)
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Sick leave, disability pension and health-care-seeking behaviour prior to stroke, among people aged 30–65 : a case–control study
- 2007
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 21:5, s. 457-463
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Tidskriftsartikel (refereegranskat)abstract
- Primary objective: To explore sick leave, disability pension and health-care-seeking behaviour among people 30–65 years of age prior to their stroke in 2001 in the county of Östergötland, Sweden.Research design: A register-based, retrospective case–control study for the period 1 January 1998–31 December 2000. Cases (n = 212): patients aged 30–65 with first-ever stroke in 2001. Controls (n = 4606): people aged 30–65, randomly selected from the same base population.Main outcomes and results: More than 91 days of accumulated sick leave among women was associated with increased likelihood of developing stroke (OR = 1.89). Among men, 29–90 days and more than 91 days on sick leave increased the likelihood of stroke (OR = 2.34 and OR = 3.43, respectively).Conclusion: Frequent health-care-seeking behaviour is not a tool for identifying women who develop stroke, while it may be an indicator for men. Accumulated sick leave may be a tool for identifying men and women with higher risk of stroke.Read More: http://informahealthcare.com/doi/abs/10.1080/02699050701317643
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- Nordlund, Anders, 1966-, et al.
(författare)
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EQ-5D in a general population survey - A description of the most commonly reported EQ-5D health states using the SF-36
- 2005
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 14:4, s. 1099-1109
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Tidskriftsartikel (refereegranskat)abstract
- The importance of studying health-related quality of life in the general population has increasingly been emphasized. From a public health perspective, this benefits the identification of population inequalities in health status. One of the currently most popular instruments is the EQ-5D. Evaluations of the EQ-5D generally focus on the overall preference-based index. As this index has a built-in value, exploration of the information from the underlying health states is also important. In this study, the ten most commonly reported EQ-5D health states are described using the SF-36. Data collected in 1999 by questionnaires mailed to a random sample aged 20-74 in south-eastern Sweden were used (n = 9489). Almost 43% reported the best possible EQ-5D health state and 78% were accounted for by three EQ-5D health states. The EQ-5D health state classification was largely reflected by the SF-36, with the EQ-5D items mobility, usual activities, pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning, role limitations due to physical health problems, bodily pain, and mental health, respectively. However, within the same level of EQ-5D (i.e., moderate problems) there was a rather large variation of SF-36 scale scores, particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP. © Springer 2005.
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| 17. |
- Nordlund, Anders, 1966-
(författare)
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Smoking and cancer among Swedish women
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cancer has been the second most frequent cause of death in Sweden and in other developed countries for most of the 20th century, and today accounts for about 25 per cent of all mortality. While the trend in overall cancer mortality has been increasing among men, the picture is less clear regarding women. In addition, most of the knowledge about the relationship between tobacco smoking - one of the most important among potentially preventable causes of human cancer - and cancer has been generated in studies involving men only. Recently some studies have suggested that female smokers are more susceptible than male smokers to the carcinogenic effects of tobacco smoke. In the present series of investigations, various aspects of cancer among Swedish women were studied and compared with those of Swedish men. This was achieved through the use of official statistics regarding cancer incidence, cancer mortality and smoking prevalence together with data from a large, population-based questionnaire on smoking habits in Sweden from 1963. Among men, overall cancer mortality increased between 1931 and 1992, while among women there was a slight decrease. Owing to uncertainties regarding the impact of improvements in diagnostic accuracy the results must be interpreted with some caution. Smoking prevalence was at a high level for men born around the turn of the century, remained high, but started to decrease for men born towards the middle of the century. Among women born around 1900 smoking prevalence was low, but increased steadily for those born later. Lung cancer mortality trends closely followed the pattern of smoking prevalence, with stable rates among men and successively increasing rates among women. Regarding the risk of getting different types of cancer among women, current smokers ran a higher risk than never regular smokers of getting cancer of the lung, upper aerodigestive sites, pancreas, bladder, cervix, organs of the urinary tract other than kidney and bladder, and all cancers combined. No substantial difference in dose-response gradient regarding smoking-related cancers other than lung cancer was found between male and female smokers. Furthermore, any differences in lung cancer dose-response gradient between male and female smokers are probably small. Finally, there were only small differences in overall cancer risk and risk of smoking-related cancers between different socio-economic groups in Sweden were the case. Farmers were the notable exception, running a lower risk of getting in particularly smoking-related cancers as compared to blue-collar workers. However, adjusting for smoking habits in 1963, led to decreased differences, and farmers did no longer displayed lower risk.
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| 18. |
- Nordlund, Anders, 1966-
(författare)
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Tobaksrökning och hälsa i Sverige under 1900-talet.
- 2005
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Ingår i: Svenska folkets hälsa i historiskt perspektiv. - Stockholm : Statens folkhälsoinstitut. - 917257335X ; , s. 305-361
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Sverige har i ett internationellt perspektiv en lång tradition av att bedriva´det som nu kallas folkhälsopolitik. Den mångfald av insatser som genomförts har påverkat både hälsan och medellivslängden, vilken fördubblats sedan mitten av 1700-talet. Denna utveckling går dock inte enbart, eller ens främst, att tillskriva folkhälsopolitiska insatser. Förändringar i befolkningens hälsa, sjuklighet och dödlighet måste ses i relation till samhällets struktur i olika skeden och samhällsutvecklingen i bred mening.
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