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- Bäckman, Kristoffer, 1979, et al.
(author)
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37 years of body mass index and dementia: observations from the prospective population study of women in Gothenburg, Sweden.
- 2012
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In: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 28:1, s. 163-71
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Journal article (peer-reviewed)abstract
- Level of adiposity is linked to dementia in epidemiological studies. Overweight and obesity in mid- and late-life may increase risk for dementia, whereas decline in body weight or body mass index (BMI) and underweight in years preceding and at the time of a dementia diagnosis may also relate to dementia. Longitudinal studies with sufficient follow-up are necessary to estimate trajectories that allow better understanding of the relationship between adiposity indices and dementia over the life course. We evaluated the natural history of BMI in relationship to clinical dementia over 37 years in the Prospective Population Study of Women (PPSW) in Sweden. PPSW is a systematic sample of 1462 women born 1908, 1914, 1918, 1922, and 1930 and aged 38-60 years at baseline. Examinations occurred in 1968, 1974, 1980, 1992, 2000, and 2005. Statistical analyses were conducted using mixed effects regression models. Trajectories of BMI over 37 years as a function of age differed between women who did versus did not develop dementia. Women developing dementia evidenced a lesser increase in BMI from age 38 to 70 years. After age 70, the BMI slope decreased similarly (no "accelerated decline") irrespective of dementia status. A lower BMI before and during dementia onset was observed. Women with similar BMI at mid-life exhibited a different pattern of BMI change as they approached late-life that was related to dementia onset. BMI may be a potential marker of dementia-related neuropathologies in the brain. Dementia is related to a common risk factor, BMI, from mid-to late-life.
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- Gudmundsson, Pia, 1978, et al.
(author)
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White Matter Lesions and Temporal Lobe Atrophy Related to incidence of both Dementia and Major Depression in 70-year-olds followed over 10 years
- 2015
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In: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 22:5, s. 781-788
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Journal article (peer-reviewed)abstract
- Abstract Background: A number of studies have suggested associations between dementia and depression in older adults. One reason could be that these disorders share structural correlates, such as white matter lesions (WMLs) and cortical atrophy. No study has examined whether these lesions precede both dementia and depression independently of each other in the general population. Methods: We investigated whether WMLs and cortical atrophy on computed tomography (CT) predict dementia and depression in a population-based sample of 70-year-olds (n=380) followed over 10 years. Exclusion criteria were dementia, major depression, history of stroke and a Mini-Mental State Examination score below 26 at baseline in 2000-01. Dementia was diagnosed according to DSM-III-R and depression according to DSM-5. Primary outcomes included dementia and major depression at 10-year follow-up. Results: Adjusted logistic regression models, including both WMLs and temporal lobe atrophy, showed that moderate-to-severe WMLs (OR 3.96, 95% CI 1.23-12.76) and temporal lobe atrophy (OR 2.93, 95% CI 1.13-7.60) predicted dementia during 10-year follow-up independently of major depression. Similarly, both moderate-to-severe WMLs (OR 3.84, 95% CI 1.25-11.76) and temporal lobe atrophy (OR 2.52, 95% CI 1.06-5.96) predicted depression even after controlling for incident dementia. Conclusion: WMLs and temporal lobe atrophy preceded 10-year incidence of both dementia and depression in 70-year-olds. Shared structural correlates could explain the reported associations between dementia and depression. These brain changes may represent independent and complementary pathways to dementia and depression. Strategies to slow progression of vascular pathology and neurodegeneration could indirectly prevent both dementia and depression in older adults.
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- Guo, Xinxin, 1972, et al.
(author)
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Blood pressure components and changes in relation to white matter lesions: a 32-year prospective population study.
- 2009
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In: Hypertension. - 0194-911X. ; 54:1, s. 57-62
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Journal article (peer-reviewed)abstract
- This study aimed to examine the long-term effect of high blood pressure (systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure) on white matter lesions and to study changes in different blood pressure components in relation to white matter lesions. A representative population of women was examined in 1968 and re-examined in 1974, 1980, 1992, and 2000. The presence and severity of white matter lesions on computed tomography were rated by a visual rating scale in 1992 and 2000 in 539 women. Systolic and diastolic blood pressures were measured at all of the examinations. We found that presence and severity of white matter lesions in 1992/2000 were associated with higher diastolic blood pressure and mean arterial pressure at each examination but not with systolic blood pressure and pulse pressure. Odds ratios (95% CIs) for the presence of white matter lesions per 10-mm Hg increase in diastolic pressure were 1.4 (1.0 to 1.9) in 1968, 1.3 (1.0 to 1.8) in 1974, 1.4 (1.1 to 1.9) in 1980, and 1.3 (1.0 to 1.6) in 1992 after adjustment for confounders. The presence of white matter lesions was also associated with a 24-year increase in diastolic pressure (>10 mm Hg), systolic pressure (>40 mm Hg), pulse pressure (>24 mm Hg), and mean arterial pressure (>6 mm Hg; odds ratios [95% CIs]: 2.6 [1.3 to 5.1] for diastolic pressure; 2.0 [1.2 to 3.4] for systolic pressure; 1.8 [1.1 to 2.7] for pulse pressure; and 2.2 [1.4 to 3.4] for mean arterial pressure). Our findings suggest that lowering high diastolic blood pressure and preventing large increases in systolic and diastolic blood pressures may have a protective effect on white matter lesions.
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- Guo, Xinxin, 1972, et al.
(author)
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Increased risk for dementia both before and after stroke: A population-based study in women followed over 44 years
- 2018
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In: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 14:10, s. 1253-1260
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Journal article (peer-reviewed)abstract
- Introduction: Longitudinal studies are needed to understand the long-term associations between stroke and dementia. Methods: A population sample of 1460 women without stroke or dementia at baseline was followed over 44 years, from 1968 to 2012. Information on stroke and dementia was obtained from neuropsychiatric examinations, key-informant interviews, hospital registry, and medical records. Results: During 44 years follow-up, 362 women developed stroke and 325, dementia. The age-specific incidence of the two disorders was similar. The incidence of dementia was higher in those with stroke than among those without (33.7% vs. 18.5%; age-adjusted hazard ratio 1.44, 95% confidence interval 1.15-1.81). The increased risk of dementia started already 5 years before stroke, was highest 1 year after stroke, and continued more than 11 years after stroke. Discussion: There is an increased risk for dementia both before and after stroke. This has implications for understanding the relation between the two disorders and for prevention of dementia and stroke. (C) 2018 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.
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| 8. |
- Guo, Xinxin, 1972, et al.
(author)
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Load force during manual transport in Parkinson's disease.
- 2004
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In: Acta neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 109:6, s. 416-24
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To search for a physiological method for the measurement of upper extremity dexterity during activities of daily life in Parkinson's disease (PD). MATERIALS AND METHODS: We examined load force output during manual transport in seven patients with PD and 10 healthy controls. PD patients were measured in both the non-medicated and medicated states. The test movement included two continuous sub-movements: an upward-forward transport of an object from the table to the stand, and a downward-backward transport of the object from the stand to the table. Hand movements were recorded using an optoelectronic camera, and load force was measured using a force sensor installed in the test object. RESULTS: Compared with the controls, PD patients had a different pattern of load force output characterized by slower force development and release, lower peak force, and less dynamic force generation during movement. After medication, the speed of force development and the level of peak force increased in the patients. CONCLUSIONS: These findings suggest that PD impairs the production of preprogrammed movements. The movements observed in the PD patients may result from compensatory strategies relying more on feedback mechanisms.
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| 9. |
- Guo, Xinxin, 1972, et al.
(author)
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Midlife respiratory function and Incidence of Alzheimer's disease: a 29-year longitudinal study in women
- 2007
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In: Neurobiology of Aging. ; 28, s. 343-350
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Journal article (peer-reviewed)abstract
- Neuropsychiatric Epidemiology Unit, Institute of Clinical Neurosciences, Sahlgrenska Academy at Göteborg University, SE 413 45 Göteborg, Sweden. xinxin.guo@neuro.gu.se Normal cognitive function depends on sufficient supply and efficient utilization of oxygen in the brain. Prospective studies on respiratory function and dementia are lacking. This study investigated the relationship between midlife respiratory function and incidence of dementia in a population-based sample of 1291 women followed from 1974 to 2003. Respiratory function was measured by peak expiratory flow in 1974, and forced vital capacity and forced expiratory volume in 1980. Dementia diagnoses were based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. Better respiratory function in midlife was associated with a lower late-life risk of developing dementia and Alzheimer's disease (AD). Per 1 standard deviation increase in peak expiratory flow, forced vital capacity and forced expiratory volume, hazard ratios (95% confidence intervals) for dementia were 0.77 (0.65-0.91), 0.72 (0.57-0.92) and 0.75 (0.59-0.95), respectively, and for AD 0.76 (0.62-0.94), 0.71 (0.54-0.95) and 0.74 (0.56-0.98), respectively, after adjustment for potential confounders. These data reinforce the advantages of maintaining good respiratory function in midlife, even though causation cannot be established. PMID: 16513221 [PubMed - indexed for MEDLINE]
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| 10. |
- Guo, Xinxin, 1972, et al.
(author)
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Midlife respiratory function related to white matter lesions and lacunar infarcts in late life: the Prospective Population Study of Women in Gothenburg, Sweden.
- 2006
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In: Stroke; a journal of cerebral circulation. - 1524-4628. ; 37:7, s. 1658-62
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Journal article (peer-reviewed)abstract
- BACKGROUND AND PURPOSE: Increased evidence suggests that poor respiratory function increases risk of ischemic damage to the brain. Longitudinal studies on respiratory function and cerebral small-vessel disease are lacking. We examined midlife and late-life respiratory function in relation to small-vessel disease on computed tomography (CT) in women followed for 26 years. METHODS: White matter lesions (WMLs) and lacunar infarcts were rated on brain CT scans in 2000 in 379 women 70 to 92 years of age from a longitudinal population study in Göteborg, Sweden. Respiratory function was measured by peak expiratory flow (PEF) in 1974 and 2000 and by forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in 1980 and 2000. RESULTS: Lower FVC and FEV1 in 1980 and 2000 were associated with presence and severity of WMLs and lacunar infarcts in 2000. Per 1-SD decrease of FVC in 1980, odds ratios (95% CIs) were 1.49 (1.11 to 2.02) for presence of WMLs and 1.95 (1.34 to 2.84) for lacunar infarcts after adjustment for potential confounders. Per 1-SD decrease of FEV1 in 1980, adjusted odds ratios were 1.46 (1.06 to 2.00) for presence of WMLs and 1.42 (1.02 to 1.97) for lacunar infarcts. PEF in 1974 and 2000 was not associated with WMLs or lacunar infarcts. CONCLUSIONS: WMLs and lacunar infarcts in elderly women were related to lower midlife respiratory function. Although our data may not establish causation between lower respiratory function and small-vessel disease, they imply the importance of good respiratory function in midlife.
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