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- Caracciolo, B, et al.
(författare)
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The symptom of low mood in the prodromal stage of mild cognitive impairment and dementia : a cohort study of a community dwelling elderly population
- 2011
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 82:7, s. 788-793
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the symptom of low mood as a predictor of mild cognitive impairment (MCI) and its progression to dementia, taking into account: (i) MCI severity, (ii) time of assessment and (iii) interaction with other factors.Methods 764 cognitively healthy elderly subjects living in the community, from the Kungsholmen Project. Participants were assessed by direct interview to detect low mood. Subjects were then followed for 6 years to identify those who developed MCI. People with incident MCI were followed for a further 3 years to assess progression to dementia.Results People with low mood at baseline had a 2.7-fold (95% CI 1.9 to 3.7) increased risk of developing MCI at follow-up. The association was stronger for amnestic MCI (aMCI: HR 5.8; 95% CI 3.1 to 10.9) compared with global cognitive impairment (other cognitive impairment no dementia, oCIND: HR 2.2; 95% CI 1.5 to 3.3). ApoE-ε4 interacted with low mood in a synergistic fashion, increasing the risk of aMCI, while no interaction with psychiatric, vascular, frailty related or psychosocial factors was observed. Low mood at baseline, as opposed to low mood co-occurring with MCI, was associated with a 5.3-fold (95% CI 1.2 to 23.3) increased risk of progression to dementia in aMCI. In contrast, no association was found in oCIND.Conclusion Low mood was more strongly associated with aMCI than with global cognitive impairment. Progression towards dementia was predicted only by low mood manifest in the prodromal stage of MCI. These findings indicate that low mood is particularly prominent in the very early stages of cognitive decline.
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- Lagergren, M., et al.
(författare)
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A longitudinal study integrating population, care and social services data : The Swedish National study on Aging and Care (SNAC)
- 2004
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Ingår i: Aging Clinical and Experimental Research. - Milano : Kurtis. - 1594-0667 .- 1720-8319. ; 16:2, s. 158-168
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: A large, national, long-term, longitudinal, multi-purpose study has been launched in Sweden - the Swedish National study on Aging and Care (SNAC). The study involves four research centers collecting data in four different areas of Sweden.Methods: The study consists of two parts: the population part and the care and services part. In the population part, a large, representative panel of elders in different age cohorts is followed over time to record and describe the aging process from different aspects. In the care and services part, a systematic, longitudinal, individually-based collection of data is performed concerning provision of care and services together with functional ability, specific health care problems, and living conditions of the recipients living in the area.Resuits: The data collection in the population part of the SNAC is not yet completed. In the present article, some preliminary results are reported from the care and services part. These pertain to comparisons between the participating areas with respect to the prevalence of disability among those receiving care and social services in their ordinary homes and those receiving care in special accommodation. A comparison is also presented with regard to the amount of home help provided to subjects with a given disability.Conclusions: This project has several advantages. It is expected to generate a rich data base relevant for future research on aging and care and to have a direct impact on the future Swedish system of care and services for the elderly.
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- Wills, P, et al.
(författare)
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Drug use by demented and non-demented elderly people
- 1997
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Ingår i: Age and Ageing. - 0002-0729 .- 1468-2834. ; 26, s. 383-91
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Tidskriftsartikel (refereegranskat)abstract
- Aim: to determine the use of drugs by demented and non-demented elderly people in a population, by dementiastatus and type, age, sex and accommodation type. Method: data were obtained from the Kungsholmen project, a longitudinal community study of people over 75 inStockholm, Sweden. Results: 85% used at least one medicinal drug, and of these 12% were demented. Mean numbers of drugs used were2.8 for demented and 3-2 for non-demented people. 45% of demented people and 38% of non-demented peopleused psychotropic agents. Psychotropic use was higher in women and increased with institutionalization.Antipsychotic agents were used more by demented (22%) than by non-demented (35%) people: this was largelyexplained by differences in accommodation type. The odds ratio (OR) for use of antipsychotics by those ininstitutions compared with those living in their own homes was 9-32. Opioids were commonly prescribed fordemented people. The proportions taking opioids in those using analgesics were 42% in demented and 23% in nondementedpeople (OR 2.07). Laxatives were used by 18% of the demented people in institutions compared with39% of non-demented people in institutions. Conclusion: being in an institution had a stronger association with the use of certain drugs (e.g. psychotropics)than did dementia status. Demented people, especially those in institutions, used a large number of antipsychoticsand opioids, but fewer laxatives and minor analgesics. Prescribers and institutional staff should be aware of thesefactors so they can optimize patient treatment.
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- Agüero-Torres, H, et al.
(författare)
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Dementia is the major cause of functional dependence in the elderly : 3-year follow-up data from a population-based study
- 1998
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Ingår i: American Journal of Public Health. - : American Public Health Association. - 0090-0036 .- 1541-0048. ; 88:10, s. 1452-1456
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this investigation was to study the role of dementia and other common age-related diseases as determinants of dependence in activities of daily living (ADL) in the elderly. METHODS: The study population consisted of 1745 persons, aged 75 years and older, living in a district of Stockholm. They were examined at baseline and after a 3-year follow-up interval. Katz's index was used to measure functional status. Functional dependence at baseline, functional decline, and development of functional dependence at follow-up were examined in relation to sociodemographic characteristics and chronic conditions. RESULTS: At baseline, factors associated with functional dependence were age, dementia, cerebrovascular disease, heart disease, and hip fracture. However, only age and dementia were associated with the development of functional dependence and decline after 3 years. In a similar analysis, including only nondemented subjects. Mini-Mental State Examination scores emerged as one of the strongest determinants. The population attributable risk percentage of dementia in the development of functional dependence was 49%. CONCLUSIONS: In a very old population, dementia and cognitive impairment make the strongest contribution to both the development of long-term functional dependence and decline in function.
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