| 1. |
- Bouillon, Kim, et al.
(författare)
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Measures of frailty in population-based studies: An overview
- 2013
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 13:64
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although research productivity in the field of frailty has risen exponentially in recent years, there remains a lack of consensus regarding the measurement of this syndrome. This overview offers three services: first, we provide a comprehensive catalogue of current frailty measures; second, we evaluate their reliability and validity; third, we report on their popularity of use.Methods: In order to identify relevant publications, we searched MEDLINE (from its inception in 1948 to May 2011); scrutinized the reference sections of the retrieved articles; and consulted our own files. An indicator of the frequency of use of each frailty instrument was based on the number of times it had been utilized by investigators other than the originators.Results: Of the initially retrieved 2,166 papers, 27 original articles described separate frailty scales. The number (range: 1 to 38) and type of items (range of domains: physical functioning, disability, disease, sensory impairment, cognition, nutrition, mood, and social support) included in the frailty instruments varied widely. Reliability and validity had been examined in only 26% (7/27) of the instruments. The predictive validity of these scales for mortality varied: for instance, hazard ratios/odds ratios (95% confidence interval) for mortality risk for frail relative to non-frail people ranged from 1.21 (0.78; 1.87) to 6.03 (3.00; 12.08) for the Phenotype of Frailty and 1.57 (1.41; 1.74) to 10.53 (7.06; 15.70) for the Frailty Index. Among the 150 papers which we found to have used at least one of the 27 frailty instruments, 69% (n = 104) reported on the Phenotype of Frailty, 12% (n = 18) on the Frailty Index, and 19% (n = 28) on one of the remaining 25 instruments.Conclusions: Although there are numerous frailty scales currently in use, reliability and validity have rarely been examined. The most evaluated and frequently used measure is the Phenotype of Frailty.
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| 2. |
- Dahl, Anna, et al.
(författare)
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Being overweight in midlife is associated with lower cognitive ability and steeper cognitive decline in late life.
- 2010
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press (OUP). - 1758-535X .- 1079-5006. ; 65:1, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although an increasing body of evidence links being overweight in midlife with an increased risk for dementia in late life, no studies have examined the association between being overweight in midlife and cognitive ability in late life. Our aim was to examine the association between being overweight in midlife as measured by body mass index (BMI) and cognitive ability assessed over time. METHODS: Participants in the Swedish Adoption/Twin Study Aging were derived from a population-based sample. The participants completed baseline surveys in 1963 or 1973 (mean age 41.6 years, range 25-63 years). The surveys included questions about height, weight, diseases, and lifestyle factors. Beginning in 1986, the same individuals were assessed on neuropsychological tests every 3 years (except in 1995) until 2002. During the study period, 781 individuals who were 50 years and older (60% women) had at least one complete neuropsychological assessment. A composite score of general cognitive ability was derived from the cognitive test battery for each measurement occasion. RESULTS: Latent growth curve models adjusted for twinness showed that persons with higher midlife BMI scores had significantly lower general cognitive ability and significantly steeper longitudinal decline than their thinner counterparts. The association did not change substantially when persons who developed dementia during the study period were excluded from the analysis. CONCLUSIONS: Higher midlife BMI scores precede lower general cognitive ability and steeper cognitive decline in both men and women. The association does not seem to be mediated by an increased risk for dementia.
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| 3. |
- Dahl, Anna, 1975-, et al.
(författare)
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Being overweight in midlife is associated with lower cognitive ability and steeper cognitive decline in late life
- 2010
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Ingår i: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 65A:1, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although an increasing body of evidence links being overweight in midlife with an increased risk for dementia in late life, no studies have examined the association between being overweight in midlife and cognitive ability in late life. Our aim was to examine the association between being overweight in midlife as measured by body mass index (BMI) and cognitive ability assessed over time. METHODS: Participants in the Swedish Adoption/Twin Study Aging were derived from a population-based sample. The participants completed baseline surveys in 1963 or 1973 (mean age 41.6 years, range 25-63 years). The surveys included questions about height, weight, diseases, and lifestyle factors. Beginning in 1986, the same individuals were assessed on neuropsychological tests every 3 years (except in 1995) until 2002. During the study period, 781 individuals who were 50 years and older (60% women) had at least one complete neuropsychological assessment. A composite score of general cognitive ability was derived from the cognitive test battery for each measurement occasion. RESULTS: Latent growth curve models adjusted for twinness showed that persons with higher midlife BMI scores had significantly lower general cognitive ability and significantly steeper longitudinal decline than their thinner counterparts. The association did not change substantially when persons who developed dementia during the study period were excluded from the analysis. CONCLUSIONS: Higher midlife BMI scores precede lower general cognitive ability and steeper cognitive decline in both men and women. The association does not seem to be mediated by an increased risk for dementia
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| 4. |
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| 5. |
- Dahl, Anna, et al.
(författare)
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Body mass index across midlife and cognitive change in late life
- 2013
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Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 0307-0565 .- 1476-5497. ; 37, s. 296-302
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High midlife body mass index (BMI) has been linked to a greater risk of dementia in late life, but few have studied the effect of BMI across midlife on cognitive abilities and cognitive change in a dementia-free sample. METHODS: We investigated the association between BMI, measured twice across midlife (mean age 40 and 61 years, respectively), and cognitive change in four domains across two decades in the Swedish Adoption/Twin Study of Aging. RESULTS: Latent growth curve models fitted to data from 657 non-demented participants showed that persons who were overweight/obese in early midlife had significantly lower cognitive performance across domains in late life and significantly steeper decline in perceptual speed, adjusting for cardio-metabolic factors. Both underweight and overweight/obesity in late midlife were associated with lower cognitive abilities in late life. However, the association between underweight and low cognitive abilities did not remain significant when weight decline between early and late midlife was controlled for. CONCLUSION: There is a negative effect on cognitive abilities later in life related to being overweight/obese across midlife. Moreover, weight decline across midlife rather than low weight in late midlife per se was associated with low cognitive abilities. Weight patterns across midlife may be prodromal markers of late life cognitive health.
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| 6. |
- Dahl, Anna K., et al.
(författare)
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Agreement between self-reported and measured height, weight and body mass index in old age : a longitudinal study with 20 years of follow-up
- 2010
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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 39:4, s. 445-451
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Tidskriftsartikel (refereegranskat)abstract
- Background: self-reported body mass index (BMI) based on self-reported height and weight is a widely used measure of adiposity in epidemiological research. Knowledge about the accuracy of these measures in late life is scarce.Objective: the study aimed to evaluate the accuracy and changes in accuracy of self-reported height, weight and BMI calculated from self-reported height and weight in late life.Design: a longitudinal population-based study with five times of follow-up was conducted.Participants: seven hundred seventy-four community-living men and women, aged 40–88 at baseline (mean age 63.9), included in The Swedish Adoption/Twin Study of Aging.Methods: participants self-reported their height and weight in a questionnaire, and height and weight were measured by experienced research nurses at an in-person testing five times during a 20-year period. BMI was calculated as weight (kilogramme)/height (metre)2.Results: latent growth curve modelling showed an increase in the mean difference between self-reported and measured values over time for height (0.038 cm/year) and BMI (0.016 kg/m2/year), but not for weight.Conclusions: there is a very small increase in the mean difference between self-reported and measured BMI with ageing, which probably would not affect the results when self-reported BMI is used as a continuous variable in longitudinal studies.
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| 7. |
- Dahl, Anna K, et al.
(författare)
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Is Self-reported Body Mass Index Less Reliable in Late Life?
- 2010
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Konferensbidrag (refereegranskat)abstract
- Objectives: Self-reported Body Mass Index (BMI) based on self-reported height and weight is a widely used measure of adiposity in epidemiological research. Knowledge about the accuracy of these measures in late life is scarce, and especially if there is intra-individual changes over time. Methods: Seven hundred seventy-four men and women, aged 40 to 88 at baseline (mean age 63.9), in The Swedish Adoption/Twin Study of Aging self-reported and had their height and weight measured by experienced research nurses five times during a twenty year period. BMI was calculated as weight (kilos)/height (meter)2. Results: There was significant correlation between self-reported and measured height (0.97-0.98), weight (0.97-0.98), and BMI (0.93-0.95) at each measurement occasion, and substantial agreement for BMI as a categorical variable (Kappa coefficient 0.72-0.81). Latent growth curve modeling showed an increase in the mean difference between self-reported and measured values over time for height (0.04 cm/year) and BMI (0.02 kg/m2/year), but not for weight. Conclusions: There is a very small significant increase in the mean difference between self-reported and measured BMI with aging, mainly due to unawareness of changes in height, which probably would not affect the results when self-reported BMI is used as a continuous variable in longitudinal studies.
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| 8. |
- Falkenberg, Helena, et al.
(författare)
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Short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health : Results from the Whitehall II study
- 2013
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 70:10, s. 688-696
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health for women and men in different employment grades.Methods Minor psychiatric disorder and self-rated health among 6710 British civil servants (1993 women and 4717 men) in three employment grades from the Whitehall II study were examined from 1985 to 1988 under stable employment conditions. The short-term effects of organisational change were investigated in 1991–1993 after a time of major restructuring aiming at increasing the influence of market forces in the civil service and the long-term effects were investigated in 1997–1999.Results Those who had experienced organisational change and those who anticipated organisational change reported more negative short-term health effects (minor psychiatric disorder and poor self-rated health) compared with those who reported no change. No major differences were found depending on employment grade or gender. The negative health effects had diminished during 1997–1999 for those who reported that a major change had happened before 1991–1993. Those who anticipated an organisational change in 1991–1993 still reported more ill-health in 1997–1999 (both minor psychiatric disorder and self-reported health) than those in the comparison group.Conclusions The results indicate that organisational change affects employees’ health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.
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| 9. |
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| 10. |
- Fransson, Eleonor, et al.
(författare)
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Association between change in body composition and change in inflammatory markers : An 11-year follow-up in the Whitehall II study
- 2010
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 95:12, s. 5370-5374
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Tidskriftsartikel (refereegranskat)abstract
- Context: Obesity is associated with low-grade inflammation, but the long-term effects of weight change on inflammation are unknown.Objective: The aim was to examine the association of change in weight, body mass index (BMI), and waist circumference with change in C-reactive protein (CRP) and IL-6 and to assess whether this association is modified by baseline obesity status.Design and Setting: The design was a prospective cohort study among civil servants (the Whitehall II Study, UK). We used data from two clinical screenings carried out in 1991–1993 and 2002–2004 (mean follow-up, 11.3 yr).Participants: We studied 2496 men and 1026 women [mean age, 49.4 (SD = 6.0) yr at baseline] with measurements on inflammatory markers and anthropometry at both baseline and follow-up.Main Outcome Measures: We measured change in serum CRP and IL-6 during follow-up.Results: The mean increases in CRP and IL-6 were 0.08 [95% confidence interval (CI), 0.07–0.09] mg/liter and 0.04 (95% CI, 0.03–0.05) pg/ml per 1-kg increase in body weight during follow-up. Study members with a BMI less than 25 kg/m2 at baseline had an average increase in CRP of 0.06 (95% CI, 0.05–0.08) mg/liter per 1-kg increase in body weight, whereas the increase in those who were overweight (25 BMI < 30 kg/m2) and obese (BMI 30 kg/m2) was greater: 0.08 (95% CI, 0.06–0.09) mg/liter and 0.11 (95% CI, 0.07–0.14) mg/liter, respectively (P value for interaction = 0.002). Similar patterns were observed for changes in BMI and waist circumference.Conclusions: Those who were overweight or obese at baseline had a greater absolute increase in CRP per unit increase in weight, BMI, and waist circumference than people who were normal weight.
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