| 1. |
- Lökk, J, et al.
(författare)
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Drug and treatment costs in Parkinson's disease patients in Sweden.
- 2012
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 125, s. 142-147
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Tidskriftsartikel (refereegranskat)abstract
- Lökk J, Borg S, Svensson J, Persson U, Ljunggren G. Drug and treatment costs in Parkinson's disease patients in Sweden. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01517.x. © 2011 John Wiley & Sons A/S. Background - Parkinson's disease (PD) is a chronic neurodegenerative disease expected to cause great costs. The aim of this study was to calculate drug and treatment costs in patients with PD in Sweden. Method - All healthcare contacts of patients with PD in Stockholm County, Sweden, were extracted from registers together with information on reimbursements from the authorities to the caregivers. PD-related costs were calculated together with non-PD-related costs. Cost per patient was calculated and extrapolated to the whole Swedish population, taking population demographics into consideration. In addition, nationwide PD drug sales statistics were included. Results - The PD prevalence of Stockholm County was estimated to 196 per 100,000 inhabitants, resulting in an estimated total of about 22,000 patients with PD in Sweden. The cost per patient was estimated to SEK 76,000 of which drug costs accounted for SEK 15,880. The annual direct costs in patients with PD in Sweden were SEK 1.7 billion in 2009. Conclusion - Our study estimates high direct costs in patients with PD in Sweden, SEK 1.7 billion, 52% for inpatient care, 27% for outpatient care and 21% for drugs. With an ageing population and the medical progress, the financial burden on society will most probably increase in the future. This study might initiate and provide information for discussions about future cost allocations and healthcare priorities.
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| 2. |
- Skogar, Ö, et al.
(författare)
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Diurnal salivary cortisol concentrations in Parkinson’s disease: increased total secretion and morning cortisol concentrations
- 2011
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Ingår i: International Journal of General Medicine. - Macclesfield, UK : Dove Medical Press Ltd.. - 1178-7074. ; 18, s. 494-494
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Tidskriftsartikel (refereegranskat)abstract
- Background:Parkinson’s disease (PD) is a chronic neurodegenerative disorder. There is limited knowledge about the function of the hypothalamic-pituitary-adrenal axis in PD. The primary aim of this prospective study was to analyze diurnal salivary cortisol concentrations in patients with PD and correlate these with age, gender, body mass index (BMI), duration of PD, and pain. The secondary aim was to compare the results with a healthy reference group.Methods:Fifty-nine PD patients, 35 women and 24 men, aged 50–79 years, were recruited. The reference group comprised healthy individuals matched for age, gender, BMI, and time point for sampling. Salivary cortisol was collected at 8 am, 1 pm, and 8 pm, and 8 am the next day using cotton-based Salivette ®tubes and analyzed using Spectria®Cortisol I125. A visual analog scale was used for estimation of pain.Results:The median cortisol concentration was 16.0 (5.8–30.2) nmol/L at 8 am, 5.8 (3.0–16.4) at 1 pm, 2.8 (1.6–8.0) at 8 pm, and 14.0 (7.5–28.7) at 8 am the next day. Total secretion and rate of cortisol secretion during the day (8 am–8 pm) and the concentration of cortisol on the next morning were lower (12.5 nmol/L) in the reference group. No significant correlations with age, gender, BMI, duration of PD, Hoehn and Yahr score, Unified Parkinson’s Disease Rating Scale III score, gait, pain, or cortisol concentrations were found.Conclusion:The neurodegenerative changes in PD does not seem to interfere with the hypothalamic-pituitary-adrenal axis. Salivary cortisol concentrations in PD patients were increased in the morning compared with the reference group, and were not influenced by motor dysfunction, duration of disease, or coexistence of chronic or acute pain.
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| 3. |
- Annerbo, S, et al.
(författare)
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A clinical review of the association of thyroid stimulating hormone and cognitive impairment
- 2013
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Ingår i: ISRN endocrinology. - : Hindawi Limited. - 2090-4630 .- 2090-4649. ; 2013, s. 856017-
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Tidskriftsartikel (refereegranskat)abstract
- Clinical and subclinical hypothyroidism as well as overt hyperthyroidism in middle-aged and elderly adults are both associated with decreased cognitive functioning as memory, reaction time, and visuospatial organization. Subclinical hyperthyroidism (SH) or low serum concentrations of TSH concentrations have been associated with dementia in previous epidemiological studies, but the association in the elderly has not been established. There is little or no consensus regarding how thyroid function is associated with cognitive performance in the elderly. In this focused review, we have performed an examination between eleven studies from the last five years examining the association between thyroid function and cognitive performance in elderly people, a group who is overrepresented among individuals with minor abnormalities in serum TSH and thyroid hormone concentration. Six of the studies showed a consistent finding of an association between SH with cognitive impairment or dementia. In general, taking into account the largest and most powerfully designed studies, there is a strong body of evidence supporting the association between SH and cognitive impairment. The scarce number of publications on these topics indicates the need of more research especially regarding longitudinal and interventional studies thus hopefully enabling confirmation or rejection of causality between TSH abnormalities and dementia.
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| 4. |
- Annerbo, S, et al.
(författare)
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The significance of thyroid-stimulating hormone and homocysteine in the development of Alzheimer's disease in mild cognitive impairment: a 6-year follow-up study
- 2006
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Ingår i: American journal of Alzheimer's disease and other dementias. - : SAGE Publications. - 1533-3175 .- 1938-2731. ; 21:3, s. 182-8
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Tidskriftsartikel (refereegranskat)abstract
- Mild cognitive impairment (MCI) represents a transition between normal aging and Alzheimer’s disease (AD). The aim of this study was to investigate the predictive value of vitamin B12/folate, homocysteine, standard laboratory parameters, and concomitant diseases for development of AD in persons with an MCI diagnosis. Development of dementia was followed for 6 years in 93 consecutively recruited MCI persons. Information concerning the above factors was obtained from medical journals. Thirty-four percent of participants converted to AD within 6 years. A forward stepwise logistic regression was performed. The odds ratio (OR) for the Mini-Mental State Examination (MMSE) was 0.777; for age, 1.084; and for thyroid stimulating hormone (TSH), 0.287. The OR for homocysteine was 1.287 at 60 years of age and 1.087 at 65 years of age. Lower TSH levels together with the more established factors lower MMSE, higher homocysteine levels, and age were found to be predictive factors of AD. This may have clinical implications with regard to monitoring TSH levels and thyroxin substitution in MCI patients.
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| 6. |
- Fereshtehnejad, SM, et al.
(författare)
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Cross-cultural validity, reliability, and psychometric properties of the persian version of the scales for outcomes in Parkinson's disease-psychosocial questionnaire
- 2014
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Ingår i: Neurology research international. - : Hindawi Limited. - 2090-1852 .- 2090-1860. ; 2014, s. 260684-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Considering the influence of different motor and nonmotor features of Parkinson’s disease (PD), it is important to evaluate the psychosocial functioning of the patients. For this purpose, the scales for outcomes in Parkinson’s disease-psychosocial questionnaire (SCOPA-PS) has been previously designed. The aim of our study was to assess the cross-cultural validation and psychometric properties of the Persian version of the SCOPA-PS.Methods. One hundred and ten nondemented idiopathic Parkinson’s disease (IPD) patients were consecutively recruited from an outpatient referral movement disorder clinic. Eligible patients filled up a number of questionnaires including the Persian version of SCOPA-PS during the face-to-face interview session and clinical examination to measure disease severity, nonmotor psychiatric symptoms, and health-related quality of life (HRQoL).Results. The highest and lowest correlation coefficients of internal consistency were reported for item 7 on “asking for help”(r=0.765)and item 5 on “sexual problems”(r=0.553). Cronbach’s alpha reliability coefficient of the entire scale was 0.87 (95% CI: 0.83–0.90). The Hoehn and Yahr stage(r=0.34, P<0.001), Schwab and England ADL scale(r=-0.55, P<0.001), anxiety(r=0.64, P<0.001), depression(r=0.71, P<0.001), and fatigue(r=0.35, P<0.001)were significantly correlated with the total score of the SCOPA-PS questionnaire.Conclusions. The Persian version of SCOPA-PS is a highly reliable and valid scale to measure psychosocial functioning in IPD patients with different sex, age-group, and educational level, which could be applied in future researches. Disease severity scales, depression, anxiety, fatigue, and different domains of HRQoL were all associated with psychosocial functioning in PD patients.
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| 7. |
- Karlstedt, Michaela, et al.
(författare)
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Psychometric properties of the mutuality scale in Swedish dyads with Parkinson's disease
- 2017
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 136:2, s. 122-128
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The 15-item mutuality scale (MS) has been used in several neurological conditions assessing the quality of relationship associations with negative effects of the caregiving situation. The aim of this study was to translate the original MS into Swedish and assess its psychometric properties in Parkinson's disease (PD).MATERIALS AND METHODS: Following the forward-backward translation method, the scale was evaluated regarding linguistic correctness at a conceptual level and user-friendliness. The scale was filled out by a sample of 50 care dyads where one was having PD. Scale assumptions and scale structure were evaluated using floor/ceiling effect and principal component analyses (PCA) with promax rotation. Internal consistency was evaluated using Cronbach's alpha and mean inter-item correlation coefficients.RESULTS: The Swedish MS was evaluated as user-friendly and relevant by the participants. The scale demonstrated no floor/ceiling effect and showed high internal consistency (α≥0.93) with a mean inter-item correlation coefficient of ≥0.5. Through the PCA, a two factor solution emerged, which accounted for 67% and 64% of the variance of the MS score by PD-partners and PD-patients, respectively. However, some variables were complex and discarded in the final solution.CONCLUSION: Our findings provide initial support of the Swedish MS as a user-friendly and useful instrument with acceptable psychometric properties even though more research is needed to evaluate the existence of subscales.
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| 8. |
- Kivipelto, M, et al.
(författare)
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Homocysteine and holo-transcobalamin and the risk of dementia and Alzheimers disease : a prospective study.
- 2009
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Ingår i: European journal of neurology : the official journal of the European Federation of Neurological Societies. - : Wiley. - 1468-1331 .- 1351-5101. ; 16:7, s. 808-813
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Elevated total homocysteine (tHcy) levels may be caused by vitamin B12 deficiency and are linked to Alzheimers disease (AD) in some studies, although the evidence is mixed. Another marker of vitamin B12 deficiency, holo-transcobalamin (holo-TC), has not been studied in a prospective setting. OBJECTIVE: To investigate the association between tHcy and holo-TC and the subsequent development of dementia and AD in a prospective study. METHODS: A sub-sample of 228 non-demented subjects was taken from the Kungsholmen Project, a population-based longitudinal study amongst persons 75+ years. tHcy and holo-TC were analysed at baseline. RESULTS: Increasing tHcy levels were related to an increased risk of dementia (n = 83) and AD (n = 61) after a mean follow-up time of 6.7 years. Persons with high tHcy (the fourth quartile) had more than twice as high a risk of developing AD than persons with low tHcy, even after adjusting for confounding or mediating factors. The third quartile of holo-TC was associated with a reduced risk of AD, after adjusting for Hcy and other confounders. CONCLUSIONS: These results suggest that Hcy is involved in the development of dementia and AD. The role of holo-TC was less clear and this marker needs to be studied further.
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- Lökk, J, et al.
(författare)
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Controversies Around Vitamin B12 in Sweden
- 1997
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Ingår i: Hematology (Amsterdam, Netherlands). - : Informa UK Limited. - 1024-5332 .- 1607-8454. ; 2:4, s. 341-50
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Tidskriftsartikel (refereegranskat)
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| 29. |
- Salman Roghani, R, et al.
(författare)
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Neuropathic Pain Prevalence of Older Adults in an Urban Area of Iran: A Population-Based Study
- 2019
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Ingår i: Pain research and treatment. - : Hindawi Limited. - 2090-1542 .- 2090-1550. ; 2019, s. 9015695-
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Tidskriftsartikel (refereegranskat)abstract
- Background. Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. Objectives. This study, therefore, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. Methods. 5326 older people, aged ≥ 60 years, were randomly chosen by a multistage, cluster sampling method. The selected people then were interviewed by using the following instruments: a standard questionnaire about pain, questions of interview part of Douleur Neuropathique 4 Questions (DN4) and its comorbidities, GHQ-28, and a sociodemographic checklist. Descriptive statistics and multiple regression analysis were conducted to analyze the gathered data. Results. The average of the participants’ age was 68.92 ± 7.02 years. Of 5326 participants, 2529 (47.5%) of participants were male. About one-third of this population had chronic pain. Chronic neuropathic pain prevalence was 13.7% and nociceptive in 30%. Knee pain (20.6%) and feet dysesthesia (7.8%) were the most common sites of nociceptive and neuropathic pain, respectively. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. Neuropathic pain experiences were significantly associated with GHQ-28 scores (t=-11.42, P<0.001). Conclusions. In addition to neuropathic pain, other subtypes of pain prevalence and the comorbidities are determined in the community-dwelling elder adults. This study highlights the importance of neuropathic pain and its adverse consequences and can be used to manage this populations’ needs in Iran effectively.
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| 30. |
- Samuelsson, K. S., et al.
(författare)
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Inappropriate drug use in elderly patients is associated with prolonged hospital stay and increased postoperative mortality after colorectal cancer surgery : a population-based study
- 2016
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Ingår i: Colorectal Disease. - : Wiley. - 1462-8910 .- 1463-1318. ; 18:2, s. 155-162
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Tidskriftsartikel (refereegranskat)abstract
- Aim The study aimed to investigate whether continuing potentially inappropriate medication (PIM) is associated with length of hospital stay (LOS) and postoperative mortality in elderly people undergoing colorectal cancer surgery.Method The Swedish National Colorectal Cancer Register and the Swedish Prescribed Drug Register provided matched data on 7279 patients aged 75 years or more who had undergone bowel resection for colorectal cancer between 2007 and 2010. Patients were divided into two groups depending on whether or not they were taking PIM at the time of surgery. The primary efficacy variables were the LOS and 30-day postoperative mortality.Results Of the 7279 patients, 22.5% (1641) of the patients were exposed to at least one PIM and the total number of drugs taken in this group was six, compared with three in the non-PIM group (P<0.001). Postoperative mortality was higher in the PIM group (7.1% vs 4.5%, P<0.001), and LOS was longer (10days vs 9, P=0.001). When adjusted for independent predictors, the differences in LOS (odds ratio 1.14; 95% confidence interval 1.00-1.29, P=0.046) and postoperative mortality (odds ratio 1.43; 95% confidence interval 1.11-1.85, P=0.006) remained significant.Conclusion The use of PIM prior to surgery is associated with increased postoperative mortality and prolonged hospital stay. Although no causal relationship is proved, the results add a further aspect to preoperative optimization of elderly patients about to have major colorectal surgery.What does this paper add to the literature? The study shows an association between the exposure to potentially inappropriate medication and increased length of stay and postoperative mortality in elderly patients undergoing colorectal cancer surgery. The finding adds an additional factor to take into account during the preoperative optimization of elderly people.
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