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- Ekström, Curt, 1944-, et al.
(author)
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Association between Age-related Cataract and Mortality in Sweden : A Long-term Population-based Follow-up Study
- 2021
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In: Ophthalmic Epidemiology. - : Taylor & Francis. - 0928-6586 .- 1744-5086. ; 28:4, s. 301-305
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Journal article (peer-reviewed)abstract
- Purpose To assess the relationship of age-related cataract with all-cause mortality in a Swedish population. Methods Cox regression analyses were performed in a cohort of 746 residents 65-74 years of age, examined in a population survey in the rural district of Tierp, Sweden, 1984-86. To expand the sample size, 1,071 people were recruited by means of glaucoma case records established at the Eye Department in Tierp from 1978 to 2007. In this way, the cohort comprised 1,817 subjects, representing nearly 27,000 person-years at risk. The presence of cataract was determined based on retroillumination with lens opacities evident on slit-lamp examination. Information on deaths was obtained from the local population register. Results By the conclusion of the study in April 2020, 1,633 deaths had been reported. Of these cases, 694 were affected by lens opacities or had history of cataract surgery at baseline. In multivariate analysis, including cataract, age, sex, smoking habits, cancer, diabetes, hypertension and ischemic heart disease, no association was found between cataract and mortality (hazard ratio 0.99; 95% confidence interval 0.90-1.10). Adjustment for participation in the population survey had no effect on the estimate. Conclusion In this long-term follow-up study of subjects 65-74-years-old in Sweden, cataract was not associated with all-cause mortality.
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- Ekström, Curt, 1944-, et al.
(author)
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Association between open-angle glaucoma and Alzheimer's disease in Sweden : a long-term population-based follow-up study
- 2021
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In: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 126:1
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Journal article (peer-reviewed)abstract
- Background: Open-angle glaucoma (OAG) and Alzheimer's disease (AD) are two age-related neurodegenerative diseases of significant public health importance. Epidemiological studies have indicated that there might be an association between the disorders.Methods: Predictors of AD, including mixed and unspecified dementia, were analysed in a cohort of 712 residents aged 65-74 years, examined in a population survey in the rural district of Tierp, Sweden, from 1984 to 1986. To expand the sample size, 821 people were recruited by means of glaucoma case records established at the Eye Department in Tierp from 1978 to 2007. In this way, the cohort comprised 1,533 people, representing more than 21,000 person-years at risk. Medical records were reviewed to identify subjects diagnosed with dementia. Those with a follow-up duration shorter than 2 years were excluded.Results: By the conclusion of the study, in August 2020, 307 subjects had received a diagnosis of AD, including mixed and unspecified dementia. Of these cases, 55 were affected with definite OAG at baseline. Higher age and ischemic heart disease were the only predictors of AD identified. In multivariate analysis, adjusting for age, participation in the population survey and competing events, no association was found between OAG and AD (hazard ratio 1.08; 95% confidence interval: 0.80-1.47).Conclusion: In this long-term follow-up study of subjects aged 65-74 years old in Sweden, OAG was not associated with AD.
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- Ekström, Curt, 1944-, et al.
(author)
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Incidence and baseline risk factors for pseudoexfoliation in Sweden : a long-term follow-up study
- 2020
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In: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 98:3, s. 310-314
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Journal article (peer-reviewed)abstract
- Purpose: To estimate the incidence of pseudoexfoliation (PEX) and its associated risk factors in a defined population in Sweden.Methods: The development of PEX was studied in a cohort of 489 residents aged 65-74 years, examined in a population survey in the municipality of Tierp 1984-1986. To expand the sample size, 576 people were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In this way, the cohort comprised 1065 subjects, representing nearly 10 500 person-years at risk. Incidence rates with 95% confidence intervals (CIs) were calculated. Survival analyses were performed to identify predictors for PEX. Those with a follow-up time shorter than 1 year were excluded.Results: By the end of the study in November 2018, 179 new cases of PEX had been found. Of these, 78 had participated in the population survey, equal to an incidence rate of 14.8 per 1000 person-years (95% CI 11.5-18.1). The development of PEX was associated with higher age (hazard ratio 1.08 per year; 95% CI 1.03-1.13) and female gender (hazard ratio 1.59; 95% CI 1.16-2.18).Conclusion: In this study on a Swedish population, the incidence of PEX was high. Increasing age and female gender were the only predictors for PEX identified.
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- Ekström, Curt, 1944-
(author)
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Incidence of open-angle glaucoma in central Sweden
- 2008
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In: Acta ophthalmologica. - : Wiley. - 1755-375X. ; 86:7, s. 747-754
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Journal article (peer-reviewed)abstract
- PURPOSE: To estimate the incidence rate of open-angle glaucoma (OAG) in a population in which pseudoexfoliation is a common finding. METHODS: A population-based survey of 760 people aged 65-74 years was conducted in the municipality of Tierp, in central Sweden, during 1984-86. Visual fields (VFs) were tested with the Competer 350 automated perimeter. The present report concerns 711 people, all of whom participated in the survey and were not diagnosed with glaucoma. Since 1988, a follow-up study of the 530 individuals in this cohort with normal and reliable VFs has been in progress. Incident cases of OAG were identified among study participants and patients seeking medical attention at the Eye Department in Tierp. Records of prescriptions for anti-glaucoma drugs were used to search for unidentified patients. A time-weighted mean intraocular pressure (IOP) for all visits was calculated. RESULTS: By the end of the study in May 2006, 51 new cases of definite OAG had been identified, 31 with capsular and 20 with chronic simple glaucoma. Of these, 46 cases were detected in the follow-up study, corresponding to an incidence of 7.11 (95% confidence interval 5.06-9.17) per 1000 person-years. Twelve of the 51 cases were classified as normal-tension glaucoma, all of which were found in the follow-up study. Open-angle glaucoma with a mean IOP > or = 23 mmHg tended to emerge closer to the baseline examination than OAG with a mean IOP < 23 mmHg. CONCLUSIONS: The incidence of OAG was high compared with that reported for other studies conducted in White populations.
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- Ekström, Curt, 1944-
(author)
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Prevalence of open-angle glaucoma in Central Sweden : The Tierp Glaucoma Survey
- 1996
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In: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907 .- 1600-0420. ; 74:2, s. 107-112
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Journal article (peer-reviewed)abstract
- In 1984‐86, a glaucoma survey was carried out in a municipality in central Sweden, comprising 760 subjects 65–74 years of age. Since 1988, a follow‐up study of those 527 subjects who had normal and reliable visual fields has been in progress. A visual field defect was required for a diagnosis of chronic open‐angle glaucoma. By December 1991, 10 cases of capsular glaucoma and 3 cases of chronic simple glaucoma had been found. The standardized relative risk for chronic open‐angle glaucoma was 3.4 times (95% confidence interval: 1.1 ‐ 11) greater in subjects with a baseline intraocular pressure < 21 mmHg, using the highest pressure in either eye, than in those with an intraocular pressure < 21 mmHg. Pseudoexfoliation increased the standardized relative risk 9.8‐fold (95% confidence interval: 2.5 – 38). There was indication of effect modification between intraocular pressure and pseudoexfoliation. Optic disc haemorrhages were associated with a 4.8‐fold (95% confidence interval: 0.63 – 37) increased unadjusted risk. The study supports the pressure theory of optic nerve damage in glaucoma. Pseudoexfoliation was recognized as an independent risk factor for the development of chronic open‐angle glaucoma.
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- Ekström, Curt, 1944-, et al.
(author)
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Pseudoexfoliation and aortic aneurysm : a long-term follow-up study
- 2019
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In: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 97:1, s. 80-83
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Journal article (peer-reviewed)abstract
- PURPOSE: To study the relationship between pseudoexfoliation (PEX) and aortic aneurysm in a population with a high prevalence of PEX.METHODS: Survival analyses were performed in a cohort of 735 residents aged 65-74 years, examined in a population survey in the municipality of Tierp, Sweden, 1984-1986. To expand the sample size, 1040 people were recruited by means of glaucoma case records established at the Eye Department in Tierp in 1978-2007. In this way, the cohort comprised 1775 subjects, representing more than 25 400 person-years at risk. Medical records and autopsy reports were reviewed to identify subjects diagnosed with aneurysm. Those with a follow-up time shorter than 1 year were excluded.RESULTS: By the end of the study in September 2017, 60 new cases of aortic aneurysm had been found. Of these cases, 23% (14 subjects) were affected by PEX at baseline, compared with 28% among subjects without aneurysm. No association between PEX and aortic aneurysm was found (hazard ratio 0.97; 95% confidence interval 0.53-1.77).CONCLUSION: In this population-based study, we were unable to verify a relationship between PEX and the development of aortic aneurysm.
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