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- Ribbe, Mats, 1985
(författare)
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Alzheimer's disease and vascular dementia in population-based studies
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Dementia, a clinical syndrome with several profiles and causes, is characterised by a decline in cognitive functions, including memory, learning, executive function, attention, language, and social ability. The most common forms of dementia are Alzheimer’s disease and vascular dementia. As life expectancy is increasing worldwide and age is one of the strongest risk factors for dementia, the prevalence of dementia will likely increase. This thesis explores pathophysiological hallmarks of Alzheimer’s disease and vascular events as well as risk factors associated with dementia development in older individuals. In study I, we explored the prevalence of dementia in the oldest old and the relationship between stroke, transient ischemic attack, and dementia. We found that dementia was very common in the oldest old, and prevalence of dementia was higher in women than in men. However, in this unique group of oldest old, the association between stroke and development of dementia diminished. In study II, we explored biological markers of Alzheimer’s disease in relation to mortality. Alzheimer’s disease has measurable pathological biomarkers in the cerebrospinal fluid (Aβ42 and T-tau). The levels of these pathological biomarkers in 85-year-olds was associated with survival. In study III, we compared two cohorts of 85-year-olds born 22 years apart. We found that 85-year-olds examined between 2008 and 2010 had lower blood pressure than 85-year-olds examined 22 years earlier. In both cohorts, participants with dementia had lower blood pressure than those without dementia. In study IV, we investigated whether high blood pressure was associated with brain atrophy in Alzheimer’s specific brain regions. We found that hypertension in 70-year-olds without dementia was related to atrophy in brain regions often affected in Alzheimer’s disease, and atrophy was more widespread in those with longer duration of hypertension. In summary, this thesis presents common risk factors for dementia and further investigates hallmarks in Alzheimer’s disease with the aim to contribute to better understanding of Alzheimer’s disease and vascular dementia.
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| 2. |
- Ribbe, Mats, 1985, et al.
(författare)
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Time trends in the relation between blood pressure and dementia in 85-year-olds
- 2021
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Ingår i: Journal of hypertension. - : Ovid Technologies (Wolters Kluwer Health). - 0263-6352 .- 1473-5598. ; 39:10, s. 1964-1971
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Blood pressure has decreased in the general population. We aimed to examine whether this is true also among the very old, and among persons with and without dementia. Further, we aimed to investigate how common undetected and untreated hypertension is in the very old, both among people with and without dementia. Method: Blood pressure was measured in representative population samples of 85-year-olds living in Gothenburg, Sweden, examined 1986-1987 (n = 484) and 2008-2010 (n = 571). Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, edition 3 revised, by the same medical doctor at both examinations. Results: Both systolic and diastolic blood pressure were lower in 85-year-olds examined 2008-2010 than in those examined 1986-1987, both among those with and without dementia. Participants with dementia had lower systolic blood pressure than those without dementia in both cohorts, and blood pressure levels related to dementia severity. Despite this, hypertension (>= 140/90 mmHg) was found in almost half (46.5%) of those with dementia in 2008-2010. Conclusion: Our findings show that time-trends of lower blood pressure in western populations also applies to the very old, and that individuals with dementia continue to have lower blood pressure compared to the rest of the population. The latter finding suggests that the pathophysiological processes in dementia affect blood pressure regulating regions in the brain independent of time trends. Still, hypertension is common in dementia and needs to be detected and treated.
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| 3. |
- Wetterberg, Hanna, et al.
(författare)
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Dementia remains the major predictor of death among octogenarians. A study of two population cohorts of 85-year-olds examined 22 years apart
- 2021
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 36, s. 507-517
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Tidskriftsartikel (refereegranskat)abstract
- Dementia is the major predictor of death in old age. The aim of this paper was to determine whether 8-year mortality among 85-year olds with and without dementia, and if the contribution of dementia to mortality relative to other common diseases has changed. We used two population-based cohorts of 85-year-olds (N = 1065), born in 1901-02 and 1923-24, which were examined with identical methods in 1986-87 and 2008-2010 and followed for 8-year mortality according to data from the Swedish Tax Agency. Dementia was diagnosed according to DSM-III-R. Other diseases were diagnosed based on self-reports, close informant interviews, somatic examinations, and the Swedish National In-patient Register. Compared to cohort 1901-02, cohort 1923-24 had a lower 8-year mortality both among those with (HR 0.7; 95% CI 0.5-0.99) and without dementia (HR 0.7; 95% CI 0.5-0.9). Dementia was associated with increased mortality in both cohorts (cohort 1901-02, HR 2.6; 95% CI 2.0-3.2, cohort 1923-24, HR 2.8; 95% CI 2.3-3.5), and remained the major predictor of death, with a population attributable risk of 31.7% in 1986-87 and 27.7% in 2008-10. Dementia remained the most important predictor of death in both cohorts. The relative risk for mortality with dementia did not change between cohorts, despite a decreased mortality rate in the population.
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