| 11. |
- Lind, Karin, 1952, et al.
(författare)
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Increased saliva cortisol awakening response in patients with mild cognitive impairment
- 2007
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 24:5, s. 389-395
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> It is unknown whether HPA-axis dysfunction is present in patients with mild cognitive impairment (MCI). The aim of the present study was to investigate whether cortisol levels are elevated among patients with MCI and/or whether the individuals have adequate feedback control of their HPA axis. <i>Material and Methods:</i> 27 patients with MCI and 15 healthy controls were included in the study. Saliva samplings were performed 5 times a day before intake of 0.5 mg dexamethasone, and 5 times a day after intake of dexamethasone, respectively. <i>Results:</i> Significantly higher cortisol levels were found 15 min after awakening among patients with MCI in comparison with the controls, both before and after dexamethasone administration (p < 0.05). Also, the ratio between cortisol at awakening time and 15 min after awakening was lower in the patient group after dexamethasone administration (p < 0.05). There were no significant differences in basal cortisol levels before or after dexamethasone between groups. <i>Conclusion:</i> The results indicate that there is an HPA-axis disturbance, with normal basal cortisol levels and increased awakening response among patients with MCI. The dissociation between basal values and the awakening response may be of pathophysiological importance for the cognitive impairment.
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| 12. |
- Lindén, Thomas, 1962
(författare)
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Demens efter stroke.
- 2007
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Ingår i: E-publikation Vårdalinstitutets hemsida "Tematiska rum" 2007.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Magnil, Maria, 1952, et al.
(författare)
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Prevalence of depressive symptoms and associated factors in elderly primary care patients: a descriptive study
- 2008
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Ingår i: Primary Care Companion to The Journal of Clinical Psychiatry. - 1523-5998. ; 104:6, s. 462-468
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Tidskriftsartikel (refereegranskat)abstract
- ACKGROUND: Depressive symptoms are common in older adults. A majority will be seen in primary care. The aim was to study the prevalence of and to explore factors associated with depressive symptoms in elderly primary care patients. METHOD: In consecutive patients aged 60 years and older attending a Swedish primary care center between February and December of 2003, depressive symptoms were identified as >/= 13 points on the Montgomery-Asberg Depression Rating Scale-Self-Rated version (MADRS-S). Somatic symptoms measured according to PRIME-MD, age, socioeconomic status, gender, somatic diagnoses, and medication were analyzed in relation to presence of depressive symptoms. RESULTS: Forty-six of 302 patients (15%) rated themselves in the depressed range. There were no differences between depressed and nondepressed patients concerning socioeconomic status, other illnesses, or medication except for use of sedatives/hypnotics being more common (OR = 2.7, 95% CI = 1.3 to 5.6) in depressed patients. Patients in the group scoring >/= 13 on the MADRS-S were more likely to have become widowed during the last year (OR = 6.0, 95% CI = 1.7 to 20.8) or to have indicated significant life events (OR = 4.3, 95% CI = 2.0 to 9.0), but were less likely to report having leisure time activities (OR = 0.2, 95% CI = 0.08 to 0.41) or perception of good health (OR = 0.1, 95% CI = 0.05 to 0.3). Patients being treated for depression did not have increased depression scores (OR = 1.4, 95% CI = 0.66 to 3.1). CONCLUSION: In a group of unselected primary care elderly patients, the prevalence of depressive symptoms was high. Use of sedatives/hypnotics was remarkably common in patients with depressive symptoms. Patients with ongoing treatment of depression did not have increased depression scores, indicating the good prognosis for treated depression in the elderly.
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| 14. |
- Nilsson, Christer, et al.
(författare)
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Transitorisk global amnesi - godartat tillstånd som även kan drabba unga
- 2005
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Ingår i: Läkartidningen. - 0023-7205. ; 102:24, s. 7-1905
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Tidskriftsartikel (refereegranskat)abstract
- Transient global amnesia (TGA) occurs mostly in middle-aged and elderly individuals, and is generally believed to be very rare in individuals less than 40 years of age. We present three cases of TGA in young persons (16-22 years). They all had a medical history and presented symptoms fulfilling the criteria for TGA. Physical examinations and investigations were all normal. All three presented their symptoms while playing football. Reviewing the literature the suggested causes are partly different for TGA in old and young people, respectively. The present report confirms that TGA may also occur in younger individuals. We propose that single TGA is a benign condition also in younger persons and that the investigation should be similar to that of TGA in older age groups.
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| 15. |
- Nägga, Katarina, 1962-, et al.
(författare)
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Evaluation of factors of importance for clinical dementia diagnosis
- 2005
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:5-6, s. 289-298
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Tidskriftsartikel (refereegranskat)abstract
- Diagnosing clinical dementia is based on an assessment of different variables, such as the patient’s medical history, known risk factors, and biochemical features. Partial least squares discriminant analysis was used to evaluate variables of importance for diagnosing dementia in a clinical dementia population. Polymorphism for genotypes of glutathione S-transferase (GST) and sulfotransferase 1A1, hypothetically of importance in dementia disorders, was also included in the analysis. The study population consisted of 73 patients with Alzheimer’s disease (AD), 14 with mixed dementia, 75 patients with vascular dementia, and 28 control cases. We found that several of the variables, such as the presence of ApoE4 allele, high cerebrospinal fluid levels of total tau protein, low levels of β-amyloid<sub>(1–42)</sub>, and a low score on the Mini-Mental State Examination, facilitated a discrimination between the diagnoses compared with the controls. The different diagnoses overlapped. There were indications that genotypes of GSTs contributed to a subgrouping within AD.
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| 16. |
- Wallin, Anders, 1950, et al.
(författare)
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Donepezil in Alzheimer's disease : What to expect after 3 years of treatment in a routine clinical setting
- 2007
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Ingår i: Dementia and Geriatric Cognitive Disorders. - Basel : S. Karger AG. - 1420-8008 .- 1421-9824. ; 23:3, s. 150-160
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Clinical short-term trails have shown positive effects of donepezil treatment in patients with Alzheimer's disease. The outcome of continuous long-term treatment in the routine clinical settings remains to be investigated. Methods: The Swedish Alzheimer Treatment Study (SATS) is a descriptive, prospective, longitudinal, multicentre study. Four hundred and thirty-five outpatients with the clinical diagnosis of Alzheimer's disease, received treatment with donepezil. Patients were assessed with Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog), global rating (CIBIC) and Instrumental Activities of Daily Living (IADL) at baseline and every 6 months for a total period of 3 years. Results: The mean MMSE change from baseline was positive for more than 6 months and in subgroups of patients for 12 months. After 3 years of treatment the mean change from baseline in MMSE-score was 3.8 points (95% CI, 3.0-4.7) and the ADAS-cog rise was 8.2 points (95% CI, 6.4-10.1). This is better than expected in untreated historical cohorts, and better than the ADAS-cog rise calculated by the Stern equation (15.6 points, 95% CI, 14.5-16.6). After 3 years with 38% of the patients remaining, 30% of the them were unchanged or improved in the global assessment. Conclusion: Three-year donepezil treatment showed a positive global and cognitive outcome in the routine clinical setting. Copyright © 2007 S. Karger AG.
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| 17. |
- de Frias, Cindy M., et al.
(författare)
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Cholesterol and triglycerides moderate the effect of apolipoprotein E on memory functioning in older adults.
- 2007
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Ingår i: Journal of Gerontology: Psychological Sciences. - Washington : The gerontological society of America. - 1079-5014 .- 1758-5368. ; 62B:2, s. P112-P118
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Tidskriftsartikel (refereegranskat)abstract
- We used data from the Betula Study to examine associations between total cholesterol, triglycerides, and apolipoprotein E on 10-year changes in cognitive performance. Tests assessing episodic memory (recall and recognition), semantic memory (knowledge and fluency), and visuospatial ability (block design) were administered to 524 nondemented adults (initial age of 55-80 years); multilevel modeling was applied to the data. Higher triglyceride levels were associated with a decline in verbal knowledge. Lipid levels moderated the influence of apolipoprotein E on episodic memory, such that among epsilon 4 allele carriers, decline in recognition was noted for individuals with higher cholesterol levels. Cholesterol and triglyceride levels are pharmacologically modifiable risk factors that account for variation In normal cognitive aging.
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| 18. |
- Andin, Ulla, et al.
(författare)
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A Clinico-Pathological Study of Heart and Brain Lesions in Vascular Dementia.
- 2005
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:4, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- All vascular dementia (VaD) cases, neuropathologically verified in a longitudinal prospective dementia project, were classified according to the vascular brain lesion type and related to the dementia type and cardiovascular pathology. From 1976 to 1995, there were 175 VaD cases, 49 of which were pure, without Alzheimer pathology and only one type of cerebrovascular lesion. Furthermore, it was found that 6 cases suffered hypoxic hypoperfusive disease, while 7 were found to have large vessel disease and 36 small vessel disease. In addition to Alzheimer pathology, more than one type of vascular brain pathology was found in the remaining 126 cases. In these cases, diagnosed in accordance with the predominant type of VaD, hypoxic-hypoperfusive lesions were found in 55, large vessel lesions in 50 and small vessel lesions in 110 cases. It should be stressed that 87% of all cases with hypoxic hypoperfusive lesions also had Alzheimer pathology. Cardiovascular and aortic pathologies were more prevalent in small vessel dementia than in the other VaD groups. Clinically diagnosed arterial hypertension was significantly associated with small vessel dementia, but not with hypoxic-hypoperfusive dementia. Cardiovascular symptoms varied considerably in frequency between different dementia groups. VaD is a heterogeneous group regarding lesions caused by different pathophysiological mechanisms and with different combinations of brain pathologies. It is therefore necessary to identify the various types of vascular brain lesions for a correlation with clinical symptoms and for diagnostic purposes in the search for risk factors and therapeutic strategies.
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| 19. |
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| 20. |
- Gräsbeck, Anne, et al.
(författare)
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Dementia in First-Degree Relatives of Patients with Frontotemporal Dementia. A Family History Study.
- 2005
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 19:2-3, s. 145-153
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have found a clustering of dementia in relatives of patients with frontotemporal dementia (FTD). This study analysed the familial aggregation of FTD specifically as well as the occurrence of dementia in general in first-degree relatives of patients with FTD. A family history study was carried out on 478 first-degree relatives of 74 index patients suffering from FTD. Cases of organic dementia and of FTD were diagnosed according to internationally accepted diagnostic criteria. Age- and sex-specific incidences of organic dementia and of FTD were calculated as was the proportion of FTD in relation to organic dementia in general; comparisons with clinical and population studies were made. There was a tenfold increase in the incidence of FTD in the first-degree relatives of FTD patients compared with the incidence of FTD in a population study. The proportion of FTD in relation to all types of organic dementia was much higher in relatives of FTD patients compared to the corresponding proportions in clinical and population-based studies. There was a small, non-significant difference between the present family history study and the population studies as regards the incidence of organic dementia. The findings suggest that hereditary and/or shared environmental factors are strongly involved in the aetiology of FTD. There were no indications of familial clustering of organic dementia in general in relatives of FTD patients.
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