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- Håkansson, Krister, 1952-, et al.
(författare)
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Depressive signs in midlife : A risk factor for cognitive impairment in later life?
- 2010
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Ingår i: International Conference on Alzheimer's Disease (ICAD) 2010. - Chicago, USA : Alzheimer's Association.
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Konferensbidrag (refereegranskat)abstract
- Background: Although depression has been associated with dementia, the nature of this relation is still unclear. Establishing causality from previous studies has been complicated by the typical use of a short follow-up and participants aged over 70 already at baseline. The main purpose of this study was to evaluate if depressive signs already in midlife are related to cognitive impairment in later life. Methods: Participants were derived from random, population-based samples previously investigated in 1972, 1977, 1982, or 1987. Their mean age at baseline was 50.4 years (SD 6.0). After an average follow-up of 21 years, 1449 individuals (73%) aged 65 to 79 years were re-examined in 1998. At the re-examination some form of cognitive impairment was diagnosed in 139 of the participants: 82 with mild cognitive impairment and 57 with dementia (48 of these with Alzheimer’s disease). Signs of depression were estimated through responses to three questions concerning the perception of a hopeless future, impossible life goals and loneliness. The relation between depressive signs in midlife and cognitive impairment in later life was analyzed with logistic regression with adjustments for age, gender, apolipoprotein e4 status and a number of midlife health and lifestyle indicators, including blood pressure, cholesterol and marital status. Results: Depressive signs in midlife, as measured in this study, were significantly related to general cognitive impairment in later life, but also separately to both mild cognitive impairment and Alzheimer’s disease. When dichotomized into high versus low levels of depressive signs the odds ratios were 2.19 (1.1 to 4.3) for mild cognitive impairment and 3.81 (1.3 to 11.5) for Alzheimer’s disease. Significant associations were also found between the separate measures of hopelessness and loneliness on the one hand and the separate outcomes of mild cognitive impairment and Alzheimer’s disease on the other. Conclusions: The results support a causal relation between depressive signs relatively early in life and cognitive function in later life. Clinical relevance includes the long-term health implications of depressive signs in midlife also for the risk of dementia.
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| 2. |
- Håkansson, Krister, 1952-, et al.
(författare)
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Association between mid-life marital status and cognitive function in later life : population based cohort study
- 2009
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Ingår i: The BMJ. - : BMJ. - 1756-1833 .- 0959-8138 .- 1468-5833. ; 339:July, s. Article number: b2462-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate whether mid-life marital status is related to cognitive function in later life. Design Prospective population based study with an average follow-up of 21 years. Setting Kuopio and Joensuu regions in eastern Finland. Participants Participants were derived from random, population based samples previously investigated in 1972, 1977, 1982, or 1987; 1449 individuals (73%), aged 65-79, underwent re-examination in 1998. Main outcome measures Alzheimer's disease and mild cognitive impairment. Results People cohabiting with a partner in mid-life (mean age 50.4) were less likely than all other categories (single, separated, or widowed) to show cognitive impairment later in life at ages 65-79. Those widowed or divorced in mid-life and still so at follow-up had three times the risk compared with married or cohabiting people. Those widowed both at mid-life and later life had an odds ratio of 7.67 (1.6 to 40.0) for Alzheimer's disease compared with married or cohabiting people. The highest increased risk for Alzheimer's disease was in carriers of the apolipoprotein E e4 allele who lost their partner before mid-life and were still widowed or divorced at follow-up. The progressive entering of several adjustment variables from mid-life did not alter these associations. Conclusions Living in a relationship with a partner might imply cognitive and social challenges that have a protective effect against cognitive impairment later in life, consistent with the brain reserve hypothesis. The specific increased risk for widowed and divorced people compared with single people indicates that other factors are needed to explain parts of the results. A sociogenetic disease model might explain the dramatic increase in risk of Alzheimer's disease for widowed apolipoprotein E e4 carriers.
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| 3. |
- Håkansson, Krister, 1952-, et al.
(författare)
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Feelings of hopelessness in midlife are associated with dementia risk in later life
- 2012
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Ingår i: 12th International Stockholm/Springfield Symposium on Advances in Alzheimer Therapy. ; , s. 165-165
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Although an association between depressive feelings and dementia has been estab- lished previously, the nature of this relation remains unclear. Establishing causality has been com- plicated by the typical use of a short follow-up and aged participants already at baseline. The aim with this study was to investigate the association between feelings of hopelessness in midlife and cognitive impairment in later life.Methods: From a representative population in Eastern Finland, originally investigated between 1972-1987, a random sample of 2000 survivors was invited for re-examination in 1998, averagely 21 years later. The mean age of the 1449 persons who accepted the invitation was 50.4 (range 39-64) at baseline and 71.3 years (range 65-80) at follow-up. Baseline scores of hopelessness were related to cognitive status at follow-up, mainly through logistic regression. Adjustments were made for age, years of education, gender, APOE4 and a number of health and life style factors at baseline. In addition we analyzed differences in hopelessness scores between baseline and follow-up within the different outcome groups.Results: Participants with high levels of hopelessness at midlife had more than a doubled risk of cognitive impairment in later life as expressed by an odds ratio of 2.24 (1.4-3.6), even higher spe- cifically for Alzheimers disease. Persons with high levels of hopelessness at midlife and who in addition carried the apolipoprotein allele 4 (ApoE ε4) had a highly elevated risk of Alzheimers dis- ease. There were no significant differences in levels of hopelessness between baseline and follow-up within any of the outcome groups.Conclusions: The results confirm previous studies showing elevated scores of depressive feelings in persons diagnosed with dementia, compared to cognitively healthy persons. On the other hand, the results also suggest that the major portion of this difference could have existed already decades before the dementia diagnosis; Carrying feelings of hopelessness in midlife may have long-term implications for cognitive health in later life. Background: Although an association between depressive feelings and dementia has been estab- lished previously, the nature of this relation remains unclear. Establishing causality has been com- plicated by the typical use of a short follow-up and aged participants already at baseline. The aim with this study was to investigate the association between feelings of hopelessness in midlife and cognitive impairment in later life.Methods: From a representative population in Eastern Finland, originally investigated between 1972-1987, a random sample of 2000 survivors was invited for re-examination in 1998, averagely 21 years later. The mean age of the 1449 persons who accepted the invitation was 50.4 (range 39-64) at baseline and 71.3 years (range 65-80) at follow-up. Baseline scores of hopelessness were related to cognitive status at follow-up, mainly through logistic regression. Adjustments were made for age, years of education, gender, APOE4 and a number of health and life style factors at baseline. In addition we analyzed differences in hopelessness scores between baseline and follow-up within the different outcome groups.Results: Participants with high levels of hopelessness at midlife had more than a doubled risk of cognitive impairment in later life as expressed by an odds ratio of 2.24 (1.4-3.6), even higher spe- cifically for Alzheimers disease. Persons with high levels of hopelessness at midlife and who in addition carried the apolipoprotein allele 4 (ApoE ε4) had a highly elevated risk of Alzheimers dis- ease. There were no significant differences in levels of hopelessness between baseline and follow-up within any of the outcome groups.Conclusions: The results confirm previous studies showing elevated scores of depressive feelings in persons diagnosed with dementia, compared to cognitively healthy persons. On the other hand, the results also suggest that the major portion of this difference could have existed already decades before the dementia diagnosis; Carrying feelings of hopelessness in midlife may have long-term implications for cognitive health in later life.
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