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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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| 4. |
- Visser, P. J., et al.
(författare)
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Development of screening guidelines and clinical criteria for predementia Alzheimer's disease
- 2008
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Ingår i: Neuroepidemiology. - : S. Karger AG. - 1423-0208 .- 0251-5350. ; 30:4, s. 254-265
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is an urgent need to identify subjects with Alzheimer's disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer's Disease Consortium. Methods: Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2 - 3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. Results: Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4.
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- Hooshmand, Babak, et al.
(författare)
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Homocysteine and holotranscobalamin and the risk of Alzheimer disease : a longitudinal study
- 2010
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Ingår i: Neurology. - 0028-3878 .- 1526-632X. ; 75:16, s. 1408-1414
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the relation between serum levels of homocysteine (tHcy) and holotranscobalamin (holoTC), the active fraction of vitamin B12, and risk of incident Alzheimer disease (AD) in a sample of Finnish community-dwelling elderly. METHODS: A dementia-free sample of 271 subjects aged 65-79 years derived from the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study was followed up for 7 years to detect incident AD. The association between serum tHcy and holoTC with AD was analyzed with multiple logistic regression after adjusting for several potential confounders, including common vascular risk factors. RESULTS: The odds ratios (ORs) (95% confidence interval [CI]) for AD were 1.16 (1.04-1.31) per increase of 1 μmol/L of tHcy at baseline and 0.980 (0.965-0.995) for each increase of 1 pmol/L baseline holoTC. Adjustment for several potential confounders including age, sex, education, APOE ε4 allele, body mass index, Mini-Mental State Examination, smoking, stroke, and blood pressure did not alter the associations: ORs (95% CI) for AD became 1.19 (1.01-1.39) for tHcy and 0.977 (0.958-0.997) for holoTC. Adjusting for holoTC attenuated the tHcy-AD link (OR changed from 1.16 to 1.10, 95% CI 0.96-1.25). The holoTC-AD relationship was less influenced by controlling for tHcy (OR changed from 0.980 to 0.984, 95% CI 0.968-1.000). Addition of folate did not change any of the results. CONCLUSIONS: This study suggests that both tHcy and holoTC may be involved in the development of AD. The tHcy-AD link may be partly explained by serum holoTC. The role of holoTC in AD should be further investigated.
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