| 1. |
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| 2. |
- Chan, Carol K, et al.
(författare)
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Association of Depressive Symptoms With Postoperative Delirium and CSF Biomarkers for Alzheimer's Disease Among Hip Fracture Patients.
- 2021
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 29:12, s. 1212-1221
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Tidskriftsartikel (refereegranskat)abstract
- While there is growing evidence of an association between depressive symptoms and postoperative delirium, the underlying pathophysiological mechanisms remain unknown. The goal of this study was to explore the association between depression and postoperative delirium in hip fracture patients, and to examine Alzheimer's disease (AD) pathology as a potential underlying mechanism linking depressive symptoms and delirium.Patients 65 years old or older (N=199) who were undergoing hip fracture repair and enrolled in the study "A Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" completed the 15-item Geriatric Depression Scale (GDS-15) preoperatively. Cerebrospinal fluid (CSF) was obtained during spinal anesthesia and assayed for amyloid-beta (Aβ) 40, 42, total tau (t-tau), and phosphorylated tau (p-tau)181.For every one point increase in GDS-15, there was a 13% increase in odds of postoperative delirium, adjusted for baseline cognition (MMSE), age, sex, race, education and CSF AD biomarkers (OR=1.13, 95%CI=1.02-1.25). Both CSF Aβ42/t-tau (β=-1.52, 95%CI=-2.1 to -0.05) and Aβ42/p-tau181 (β=-0.29, 95%CI = -0.48 to -0.09) were inversely associated with higher GDS-15 scores, where lower ratios indicate greater AD pathology. In an analysis to identify the strongest predictors of delirium out of 18 variables, GDS-15 had the highest classification accuracy for postoperative delirium and was a stronger predictor of delirium than both cognition and AD biomarkers.In older adults undergoing hip fracture repair, depressive symptoms were associated with underlying AD pathology and postoperative delirium. Mild baseline depressive symptoms were the strongest predictor of postoperative delirium, and may represent a dementia prodrome.
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| 3. |
- Creese, Byron, et al.
(författare)
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Determining the Association of the 5HTTLPR Polymorphism with Delusions and Hallucinations in Lewy Body Dementias
- 2014
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Ingår i: The American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1545-7214 .- 1064-7481. ; 22:6, s. 580-586
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine whether the 5HTTLPR serotonin transporter polymorphism is associated with delusions and hallucinations in people with dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD). Design: Prospective cohort study. Participants: A total of 187 individuals, recruited from centres in Norway, Sweden, and the United Kingdom were included in this study; 97 with clinically or neuropathologically diagnosed DLB/PDD and 90 cognitively normal individuals as a comparison group. Measurements: All participants with dementia underwent serial evaluation of neuropsychiatric symptoms to assess the presence of persistent delusions and hallucinations using the Columbia University Scale for Psychopathology in Alzheimer disease, the Neuropsychiatric Inventory, or the Present Behavioural Examination. Severity of cognitive impairment was measured using the Mini Mental State Examination (MMSE). Individuals were genotyped for the 5HTTLPR polymorphism. Results: Logistic regression demonstrated that homozygosity for the L/L genotype and lower MMSE were associated with an increased risk for delusions (odds ratio: 11.5 and 1.16, respectively). Neither was significantly associated with hallucinations. Conclusions: This study is the first to demonstrate the 5HTTLPR polymorphism is associated with delusions in Lewy body dementias, with important implications regarding the mechanisms underlying this symptom across the AD/DLB/PDD spectrum. Further studies are warranted to investigate this relationship further and examine treatment opportunities.
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| 4. |
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| 5. |
- Cumming, Toby B, et al.
(författare)
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The High Prevalence of Anxiety Disorders After Stroke.
- 2016
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 24:2, s. 154-60
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies indicate that post-stroke anxiety is common and persistent. We aimed to determine whether point prevalence of anxiety after stroke is higher than in the population at large, and whether the profile of anxiety symptoms is different.This case-control study was conducted in Göteborg, Sweden, with stroke patients recruited from the Sahlgrenska University Hospital and a comparison group selected from local population health studies. We included 149 stroke survivors (assessed at 20 months post-stroke) and 745 participants from the general population matched for age and sex. A comprehensive psychiatric interview was conducted, with anxiety and depressive disorders diagnosed according to DSM-III-R criteria.Those in the stroke group were significantly more likely than those in the comparison group to have generalized anxiety disorder (GAD) (27% versus 8%), phobic disorder (24% versus 8%) and obsessive-compulsive disorder (9% versus 2%). Multivariate regression indicated that being in the stroke group, female sex, and having depression were all significant independent associates of having an anxiety disorder. In terms of symptom profile, stroke survivors with GAD were significantly more likely to report vegetative disturbance than those in the comparison group with GAD but less likely to have observable muscle tension or reduced sleep.Point prevalence of anxiety disorders is markedly higher after stroke than in the general population, and this cannot be attributed to higher rates of comorbid depression.
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| 6. |
- Dekhtyar, Serhiy, et al.
(författare)
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A Life-Course Study of Cognitive Reserve in Dementia-From Childhood to Old Age.
- 2015
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Ingår i: The American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1545-7214 .- 1064-7481. ; 23:9, s. 885-896
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Tidskriftsartikel (refereegranskat)abstract
- Objective To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age. Methods 7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated. Results Dementia was diagnosed in 950 individuals (12.5%). Dementia risk was lower among individuals with higher childhood school grades (hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.68 to 0.93) and was lower among individuals in data-complex occupations (HR: 0.77; 95% CI: 0.64 to 0.92). Professional/university education predicted lower risk of dementia in minimally adjusted models (HR: 0.74; 95% CI: 0.60 to 0.91), although the effect faded with adjustment for occupational complexity. Lowest risk was found in the group with both higher childhood school performance and high occupational complexity with data (HR: 0.61; 95% CI: 0.50 to 0.75). Importantly, high occupational complexity could not compensate for the effect of low childhood grades. In contrast, dementia risk was reduced in those with higher school grades, irrespective of occupational complexity. Conclusion Higher childhood school performance is protective of dementia risk, particularly when preserved through complex work environments in adulthood, although it will remain protective even in the absence of later-life educational or occupational stimulation.
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| 7. |
- Dekhtyar, S, et al.
(författare)
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Response to Brodziak's Letter to the Editor
- 2015
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 23:11, s. 1204-1206
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 8. |
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| 9. |
- Freund-Levi, Yvonne, 1956-, et al.
(författare)
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Galantamine versus risperidone treatment of neuropsychiatric symptoms in patients with probable dementia : an open randomized trial
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 22:4, s. 341-248
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the effects of galantamine and risperidone on neuropsychiatric symptoms in dementia (NPSD) and global function.METHODS: Using a randomized, controlled and open-blind, one-center trial at an in- and outpatient clinic at a university hospital, we studied 100 adults with probable dementia and NPSD. Participants received galantamine (N = 50, target dose 24 mg) or risperidone (N = 50, target dose 1.5 mg) for 12 weeks. The primary outcome was effects on NPSD assessed by the Neuropsychiatric Inventory (NPI). Secondary measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Clinical Global Impression, and Simpson Angus scales. All tests were performed before and after treatment.RESULTS: Outcome measures were analyzed using analysis of covariance. Ninety-one patients (67% women, mean age 79 ± 7.5 years) with initial NPI score of 51.0 (± 25.8) and MMSE of 20.1 (± 4.6) completed the trial. Both galantamine and risperidone treatments resulted in improved NPSD symptoms and were equally effective in treating several NPI domains. However, risperidone showed a significant treatment advantage in the NPI domains irritation and agitation, F(1, 97) = 5.2, p = 0.02. Galantamine treatment also ameliorated cognitive functions where MMSE scores increased 2.8 points compared with baseline (95% confidence interval: 1.96-3.52). No treatment-related severe side effects occurred.CONCLUSIONS: These results support that galantamine, with its benign safety profile, can be used as first-line treatment of NPSD symptoms, unless symptoms of irritation and agitation are prominent, where risperidone is more efficient.
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| 10. |
- Freund-Levi, Yvonne, 1956-, et al.
(författare)
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Response to Bogaiksy's Letter to the Editor
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 22:9, s. 951-951
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Tidskriftsartikel (refereegranskat)abstract
- Refers to Michael Bogaisky, Galantamine Versus Risperidone Treatment of Neuropsychiatric Symptoms in Patients with Probable Dementia: An Open Randomized Trial, The American Journal of Geriatric Psychiatry, Volume 22, Issue 9, September 2014, Pages 951.
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| 11. |
- Gerritsen, Lotte, et al.
(författare)
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Influence of Negative Life Events and Widowhood on Risk for Dementia
- 2017
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 25:7, s. 766-778
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the current study was to examine the effect of negative life events and widowhood on the incidence of dementia. Methods: Data were from four Swedish longitudinal cohort studies with a total of nearly 2,000 participants and 8-25 years of follow-up. Seven stressful events were examined for which data were available in all cohorts. Clinical dementia diagnoses were made through medical and psychological examinations. Cox proportional hazards models were used to estimate the association between life events and dementia, adjusting for lifestyle and cardiovascular risk factors. Results: The experience of one stressful life event was not associated with dementia incidence, but two or more negative life events at baseline predicted higher risk for dementia (pooled HR:2.00). This was most apparent for the incidence of vascular dementia (pooled HR: 3.60) but not for Alzheimer disease (pooled HR: 1.29). Moreover, persons who were widowed and had experienced one or more negative life events were found to have a threefold risk for dementia. Conclusion: Widowhood augments the effect of negative life events on dementia incidence and negative life events specifically increase the risk for vascular dementia.
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| 12. |
- Gustafson, Lars, et al.
(författare)
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The accuracy of short clinical rating scales in neuropathologically diagnosed dementia.
- 2010
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Ingår i: The American journal of geriatric psychiatry. - 1064-7481 .- 1545-7214. ; 18:9, s. 810-820
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The overall aim was to evaluate to what extent the diagnosis of dementia subtypes, obtained by three clinical rating scales, concurred with postmortem neuropathologic (NP) diagnosis of Alzheimer disease (AD), frontotemporal dementia (FTD), vascular dementia (VaD) and mixed AD/VaD. Design: A prospective longitudinal clinical work-up with postmortem NP examination. Participants: Two hundred nine patients with dementia referred for clinical evaluation and follow-up. Methods: The diagnostic scores in a set of three short clinical rating scales for AD, FTD, and VaD were evaluated against NP diagnoses. Results: The sensitivity and specificity of the AD scale were 0.80 and 0.87, respectively, of the FTD scale 0.93 and 0.92, respectively, and of the Hachinski Ischemic Score (HIS, VaD diagnosis) 0.69 and 0.92, respectively. Cases with mixed AD/VaD generally presented a combination of high AD and ischemic scores. A preferred cutoff score of six was identified for both the AD and FTD scales. Conclusions: All three clinical rating scales showed a high sensitivity and specificity, in close agreement with final NP diagnosis-for the HIS a moderate sensitivity. These scales may thus be considered good diagnostic tools and are recommended for clinical and research center settings.
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| 13. |
- Hahn, Elizabeth A., et al.
(författare)
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A Change in Sleep Pattern May Predict Alzheimer Disease
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 22:11, s. 1262-1271
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Sleep problems may adversely affect neuronal health. We examined a subjective report of change (reduced duration and/or depth) in sleep pattern in relation to subsequent risk of incident all-cause dementia and Alzheimer disease (AD) over 9 years. Methods: This longitudinal study used data from a population-based sample of 214 Swedish adults aged 75 and over who were dementia-free both at baseline and at first follow-up (3 years later). The sample was 80% female and, on average, 83.4 years of age at baseline. All participants underwent a thorough clinical examination to ascertain all-cause dementia and AD. Results: Forty percent of participants reported a change in sleep duration at baseline. Between the 6th and 9th year after baseline, 28.5% were diagnosed with all-cause dementia, 22.0% of whom had AD. Reduced sleep was associated with a 75% increased all-cause dementia risk (hazard ratio: 1.75; 95% confidence interval: 1.04-2.93; Wald = 4.55, df = 1, p = 0.035) and double the risk of AD (hazard ratio: 2.01; 95% confidence interval: 1.12-3.61; Wald = 5.47, df = 1, p = 0.019) after adjusting for age, gender, and education. The results remained after adjusting for lifestyle and vascular factors but not after adjusting for depressive symptoms. No evidence supported a moderating effect of the use of sleeping pills, and the sleepedementia relationship remained after controlling for the presence of the apolipoprotein E epsilon 4 allele. Conclusion: Self-reported sleep problems may increase the risk for dementia, and depressive symptoms may explain this relationship. Future research should determine whether treatment, in particular, behavioral or nonpharmacologic treatment, may represent one avenue toward reduction of dementia risk in late life.
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| 14. |
- Hughes, Tiffany F, et al.
(författare)
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Midlife fruit and vegetable consumption and risk of dementia in later life in Swedish twins.
- 2010
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214 .- 1064-7481. ; 18:5, s. 413-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Diet may be associated with risk of dementia and Alzheimer disease (AD). The authors examined the association between fruit and vegetable consumption in midlife and risk for all types of dementia and AD. METHODS: Participants were 3,779 members of the Swedish Twin Registry who completed a diet questionnaire approximately 30 years before cognitive screening and full clinical evaluation for dementia as part of the study of dementia in Swedish Twins (HARMONY) study. Among the participants, 355 twins were diagnosed with dementia. Among these, 81 twin pairs were discordant for dementia (50 discordant for AD). Data were analyzed with logistic regression for the entire sample using generalized estimating equations to adjust for relatedness of twins and with conditional logistic regression for the co-twin control design. RESULTS: In fully adjusted models, a medium or great proportion of fruits and vegetables in the diet, compared with no or small, was associated with a decreased risk of dementia and AD. This effect was observed among women and those with angina. Similar, but nonsignificant, odds ratios were found in the co-twin control analyses. CONCLUSION: The findings suggest that higher fruit and vegetable consumption may reduce the risk of dementia, especially among women and those with angina pectoris in midlife.
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| 15. |
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| 16. |
- Kallin, Kristina, et al.
(författare)
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Factors associated with falls among older, cognitively impaired people in geriatric care settings : a population-based study
- 2005
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Ingår i: The American journal of geriatric psychiatry. - 1064-7481 .- 1545-7214. ; 13:6, s. 501-509
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The authors studied factors associated with falls among cognitively impaired older people in geriatric care settings.Method: This was a study using all geriatric care settings in a county in northern Sweden. Residents were assessed by means of the Multi-Dimensional Dementia Assessment Scale, supplemented with questions concerning the use of physical restraints, pain, previous falls during the stay, and falls and injuries during the preceding week. Data about both falls and cognition were collected in 3,323 residents age 65 and older. Of these residents 2,008 (60.4%) were cognitively impaired, and they became the study population. Of the participants, 69% were women; mean age: 83.5 years.RESULTS: Of 2,008 cognitively impaired residents, 189 (9.4%) had fallen at least once during the preceding week. Being able to get up from a chair, previous falls, needing a helper when walking, and hyperactive symptoms were the factors most strongly associated with falls.CONCLUSION: Preventing falls in cognitively impaired older people is particularly difficult. An intervention strategy would probably have to include treatment of psychiatric and behavioral symptoms, improvement of gait and balance, and adjustment of drug treatment, as well as careful staff supervision.
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| 17. |
- Karlsson, Björn, et al.
(författare)
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Depression and Depression Treatment in a Population-Based Study of Individuals Over 60 Years Old Without Dementia
- 2016
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 24:8, s. 615-623
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To estimate the prevalence of depression in a population-based sample of older adults, and to identify the individual profile of people who received depression treatment. Design: Cross-sectional. Setting: Central area (Kungsholmen) in Stockholm, Sweden. Participants: A randomized population-based sample of individuals aged 60 years and older (N = 3,084) without dementia from the Swedish National Study of Aging and Care in Kungsholmen examined between 2001 and 2004. Measurements: Experienced physicians carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. Depression was diagnosed according to DSM-IV-TR and DSM-5 criteria. Information regarding drug treatment and psychotherapy was collected during the examination and is based on self-report. Results: The prevalence of depression was 5.9% (major depression: 0.8%, minor depression: 5.1%). In the total sample, 8.3% were prescribed an antidepressant and 0.9% were treated with psychotherapy. Among individuals with depression, fewer than one-third received treatment with psychotherapy or antidepressants, but almost half were prescribed anxiolytic or hypnotic drugs. Individuals with self-reported depression and anxiety were more likely to receive depression treatment whereas individuals with depression who reported insomnia were less likely to receive depression treatment. Conclusions: Our findings indicate that even in a central urban area of a country with an advanced healthcare system depression in old age is often unrecognized and untreated. In addition, almost half of those with depression received potentially inappropriate drug treatment with anxiolytics or hypnotics.
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| 18. |
- Karlsson, Björn, 1981, et al.
(författare)
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DSM-IV and DSM-5 Prevalence of Social Anxiety Disorder in a Population Sample of Older People
- 2016
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 24:12, s. 1237-1245
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine the prevalence of social anxiety disorders (SAD) with (DSM-IV) and without (DSM-5) the person's own assessment that the fear was unreasonable, in a population sample of older adults. Further, to determine whether clinical and sociodemographic correlates of SAD differ depending on the criteria applied. Design: Cross-sectional. Setting: General population in Gothenburg, Sweden. Participants: A random population-based sample of 75- and 85-year olds (N = 1200) without dementia. Measurements: Psychiatric research nurses carried out a semi-structured psychiatric examination including the Comprehensive Psychopathological Rating Scale. DSM-IV SAD was diagnosed with the Mini International Neuropsychiatric Interview. SAD was diagnosed according to DSM-IV and DSM-5 criteria. The 6-month duration criterion in DSM-5 was not applied because of lack of information. Other assessments included the Global Assessment of Functioning (GAF), the Brief Scale for Anxiety (BSA), and the Montgomery Asberg Depression Rating Scale (MADRS). Results: The 1-month prevalence of SAD was 2.5% (N = 30) when the unreasonable fear criterion was defined in accordance with DSM-IV and 5.1% (N = 61) when the DSM-5 criterion was applied. Clinical correlates (GAF, MADRS, and BSA) were worse in SAD cases identified by either procedure compared with all others, and ratings for those reporting unreasonable fear suggested greater (albeit nonsignificant) overall psychopathology. Conclusions: Shifting the judgment of how reasonable the fear was, from the individual to the clinician, doubled the prevalence of SAD. This indicates that the DSM-5 version might increase prevalence rates of SAD in the general population. Further studies strictly applying all DSM-5 criteria are needed in order to confirm these findings.
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| 19. |
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| 20. |
- Kodesh, Arad, et al.
(författare)
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Exposure to antidepressant medication and the risk of incident dementia
- 2019
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 27:11, s. 1177-1188
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To test competing hypotheses that monotherapeutic antidepressant exposure is associated with an increased versus a decreased risk of dementia.Methods: A prospective national matched cohort study from Israel (N = 71,515) without dementia (2002–2012) aged 60 and over were followed up for incident dementia from May 2013 to October 2017. Exposure to antidepressant monotherapy was classified with Anatomical Therapeutic Chemical Codes (N06A) from January 1, 2013 to December 31, 2016. The association between antidepressant monotherapy and the risk of incident dementia was quantified with hazard ratios (HR) and their 95% confidence intervals (CI) obtained from Cox regression models unadjusted and adjusted for 42 covariates. The robustness of the results was tested with 24 sensitivity analyses: 19 analyses restricted to subsamples with plausible differential dementia risks (e.g., anxiety and depression), and 5 analyses across and within antidepressant drug classes.Results: In the primary analysis, the risk of incident dementia for the group exposed to antidepressant monotherapy compared to the group unexposed to antidepressants was estimated with an unadjusted HR = 4.09 (df = 1, 95% Wald CI = 3.64, 4.60) and an adjusted HR = 3.43 (df = 1, 95% Wald CI = 3.04, 3.88). Across the 24 sensitivity analyses the estimated adjusted HR values ranged from 1.99 to 5.47.Conclusion: In this study, monotherapeutic antidepressant exposure in old age was associated with increased incident dementia. Clinicians, caregivers, and patients may wish to consider this potentially negative consequence of antidepressant exposure and aim to balance the costs and benefits of treatment.
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| 21. |
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| 22. |
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| 23. |
- Liu, Xiaomei, et al.
(författare)
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Cognitive Benefit of a Multidomain Intervention for Older Adults at Risk of Cognitive Decline : A Cluster- Randomized Controlled Trial
- 2023
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 31:3, s. 197-209
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We sought to assess cognitive benefits of a community-based multi -domain intervention for improving cognition among older adults at risk of cog-nitive decline (COMBAT). Design: A two-armed cluster-randomized controlled trial. Setting and Participants: Community-dwelling older adults aged 60 years or older and were at risk of cognitive decline (n = 209). Intervention: In this 9-month intervention study, 10 community hospitals in Beijing, China, were randomized (1:1) to receive either a multidomain inter-vention of meditation, cognitive training, exercise, and nutrition counseling or usual care. The intervention was delivered with weekly 1-hour group training sessions and weekly home homework. Measurements: Primary outcome was change in cognition as measured by a composite Z score of seven cognitive tests. Secondary outcomes included subjective cognitive abilities, positive and nega-tive affective experiences, physical activity, and dietary habits. Assessments were administered at baseline, end of the intervention, and 1 year after com-pleting the intervention (1-year follow-up). Results: Immediately after the intervention, the intervention group showed significant enhancement in cogni-tive performance (p = 0.026). The between-group difference in the Z score of change of cognition was 0.20 (95% CI: 0.053, 0.35), with a Hedges' g of 0.40 (95% CI: 0.29, 0.50). However, this cognitive benefit was not significant at
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| 24. |
- Ludvigsson, Mikael, et al.
(författare)
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Direct Costs of Very Old Persons with Subsyndromal Depression : A 5-Year Prospective Study
- 2018
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 26:7, s. 741-751
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThis study aimed to compare, over a 5-year period, the prospective direct healthcare costs and service utilization of persons with subsyndromal depression (SSD) and non-depressive persons (ND), in a population of very old persons. A second aim was to develop a model that predicts direct healthcare costs in very old persons with SSD.Design and SettingA prospective population-based study was undertaken on 85-year-old persons in Sweden.MeasurementsDepressiveness was screened with the Geriatric Depression Scale at baseline and at 1-year follow-up, and the results were classified into ND, SSD, and syndromal depression. Data on individual healthcare costs and service use from a 5-year period were derived from national database registers. Direct costs were compared between categories using Mann-Whitney U tests, and a prediction model was identified with linear regression.ResultsFor persons with SSD, the direct healthcare costs per month of survival exceeded those of persons with ND by a ratio 1.45 (€634 versus €436), a difference that was significant even after controlling for somatic multimorbidity. The final regression model consisted of five independent variables predicting direct healthcare costs: male sex, activities of daily living functions, loneliness, presence of SSD, and somatic multimorbidity.ConclusionsSSD among very old persons is associated with increased direct healthcare costs independently of somatic multimorbidity. The associations between SSD, somatic multimorbidity, and healthcare costs in the very old need to be analyzed further in order to better guide allocation of resources in health policy.
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| 25. |
- Macfarlane, M. D., et al.
(författare)
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Shape abnormalities of the caudate nucleus correlate with poorer gait and balance: Results from a subset of the ladis study
- 2015
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481. ; 23:1, s. 59-
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Tidskriftsartikel (refereegranskat)abstract
- Objective Functional deficits seen in several neurodegenerative disorders have been linked with dysfunction in frontostriatal circuits and with associated shape alterations in striatal structures. The severity of visible white matter hyperintensities (WMHs) on magnetic resonance imaging has been found to correlate with poorer performance on measures of gait and balance. This study aimed to determine whether striatal volume and shape changes were correlated with gait dysfunction. Methods Magnetic resonance imaging scans and clinical gait/balance data (scores from the Short Physical Performance Battery [SPPB]) were sourced from 66 subjects in the previously published LADIS trial, performed in nondisabled individuals older than age 65 years with WMHs at study entry. Data were obtained at study entry and at 3-year follow-up. Caudate nuclei and putamina were manually traced using a previously published method and volumes calculated. The relationships between volume and physical performance on the SPPB were investigated with shape analysis using the spherical harmonic shape description toolkit. Results There was no correlation between the severity of WMHs and striatal volumes. Caudate nuclei volume correlated with performance on the SPPB at baseline but not at follow-up, with subsequent shape analysis showing left caudate changes occurred in areas corresponding to inputs of the dorsolateral prefrontal, premotor, and motor cortex. There was no correlation between putamen volumes and performance on the SPPB. Conclusion Disruption in frontostriatal circuits may play a role in mediating poorer physical performance in individuals with WMHs. Striatal volume and shape changes may be suitable biomarkers for functional changes in this population. © 2015 American Association for Geriatric Psychiatry.
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| 26. |
- Murri, Martino Belvederi, et al.
(författare)
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Risk Prediction Models for Depression in Community-Dwelling Older Adults
- 2022
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 30:9, s. 949-960
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To develop streamlined Risk Prediction Models (Manto RPMs) for late-life depression.Design: Prospective study.Setting: The Survey of Health, Ageing and Retirement in Europe (SHARE) study.Participants: Participants were community residing adults aged 55 years or older.Measurements: The outcome was presence of depression at a 2-year follow up evaluation. Risk factors were identified after a literature review of longitudinal studies. Separate RPMs were developed in the 29,116 participants who were not depressed at baseline and in the combined sample of 39,439 of non-depressed and depressed subjects. Models derived from the combined sample were used to develop a web-based risk calculator.Results: The authors identified 129 predictors of late-life depression after reviewing 227 studies. In non-depressed participants at baseline, the RPMs based on regression and Least Absolute Shrinkage and Selection Operator (LASSO) penalty (34 and 58 predictors, respectively) and the RPM based on Artificial Neural Networks (124 predictors) had a similar performance (AUC: 0.730–0.743). In the combined depressed and non-depressed participants at baseline, the RPM based on neural networks (35 predictors; AUC: 0.807; 95% CI: 0.80–0.82) and the model based on linear regression and LASSO penalty (32 predictors; AUC: 0.81; 95% CI: 0.79–0.82) had satisfactory accuracy.Conclusions: The Manto RPMs can identify community-dwelling older individuals at risk for developing depression over 2 years. A web-based calculator based on the streamlined Manto model is freely available at https://manto.unife.it/ for use by individuals, clinicians, and policy makers and may be used to target prevention interventions at the individual and the population levels.
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| 27. |
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| 28. |
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| 29. |
- Rizzuto, Debora, et al.
(författare)
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Personality and Survival in Older Age : The Role of Lifestyle Behaviors and Health Status
- 2017
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 25:12, s. 1363-1372
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We intended to assess the relationship between personality and survival in an older population and to explore the role of lifestyle behaviors and health status as potential mediators. Design: Population-based cohort study. Setting: Swedish National Study of Aging and Care in Kungsholmen, Sweden. Participants: 2,298 adults aged 60 or more years, without dementia or depression, followed for 11 years. Measurements: Personality (extraversion, neuroticism, and openness) was assessed with a shortened version of the NEO-Five Factor Inventory. We tested whether personality affected mortality and examined the potential mediating effect of health status (body mass index, number of chronic diseases, impairment in instrumental activities of daily living, and C-reactive protein) and lifestyle behaviors (leisure activities, social network, smoking, and alcohol consumption). Results: Over 11 years of follow-up, higher levels of extraversion were associated with a 14% reduction in mortality. Examination of different combinations of personality traits showed that independent of levels of neuroticism and openness, high extraversion were associated with up to 65% lower mortality. Decomposing the effect of extraversion on mortality, we found that the majority (44%) of the beneficial effect was mediated by healthy lifestyle behaviors. Health status accounted for 5% of the association. Conclusions: Extroverted people, who are characterized by higher optimism and high self-efficacy, are prone to healthier behaviors and better health, which may result in longer survival. These results highlight the importance of a healthy lifestyle in survival.
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| 30. |
- Senra, Hugo, et al.
(författare)
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Psychological and Psychosocial Interventions for Depression and Anxiety in Patients with Age-Related Macular Degeneration : A Systematic Review
- 2019
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 27:8, s. 755-773
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Forskningsöversikt (refereegranskat)abstract
- Purpose To review the current literature on psychosocial and psychological interventions to prevent and treat depression and anxiety in patients with age-related macular degeneration (AMD). Methods We conducted a systematic review of literature evaluating psychosocial and psychological interventions for depression and anxiety in AMD patients. Primary searches of PubMed, Cochrane library, EMBASE, Global Health, Web of Science, EBSCO, and Science Direct were conducted to include all papers published until April 21st. 2018. Results Of a total of 398 citations retrieved, we selected 12 eligible studies published between 2002 and 2016. We found 9 randomized controlled trials (RCT), and 3 non-randomised intervention (NRI) studies. RCT studies suggested that interventions using group self-management techniques, and individual behavioural activation plus low vision rehabilitation can be effective to treat and prevent depression in AMD patients, and one study suggested that a stepped-care intervention using cognitive-behavioural techniques can be effective to manage anxiety and depression over time. NRI studies highlighted a positive effect of self-help and emotion-focused interventions to reduce depression. Conclusions Clinical practice with AMD patients can rely on some tailored cognitive-behavioural therapeutic protocols to improve patients’ mental health, but further clinical trials will generate the necessary evidence-based knowledge to improve those therapeutic techniques and offer additional tailored interventions for AMD patients.
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| 31. |
- Siennicki-Lantz, Arkadiusz, et al.
(författare)
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Decreasing Blood Pressure Over Time is the Strongest Predictor of Depressive Symptoms in Octogenarian Men.
- 2013
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Ingår i: The American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1545-7214 .- 1064-7481. ; :Jan.,2013
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to examine the longitudinal impact of blood pressure variations and vascular risk factors on depressive symptoms in the elderly. DESIGN: Longitudinal and cross-sectional cohort study. SETTING: Urban population of elderly men, city of Malmö, Sweden. PARTICIPANTS: A total of 809 randomly included men took part in a prospective cohort study, "Men born in 1914", and 171 survivors reached the age of 81 years. MEASUREMENTS: Depressive symptoms were estimated at the age of 81 using the Zung Self-Rating Depression Scale (ZSDS). Vascular risk factors were identified at both 68 and 81 years of age. RESULTS: At the age of 68, diagnosis of hypertension and on-going antihypertensive therapy were more frequent in subjects with high than low ZSDS scores. In contrast, at age 81, the highest ZSDS scores correlated with low systolic blood pressure (SBP). Declining SBP between the ages of 68 and 81 was more frequent in high-scoring than in low-scoring groups. Subjects with high ZSDS scores took more drugs and had more clinical diagnoses at age 81. Those taking hypnotics and sedatives had higher ZSDS scores, lower SBP at 81, and showed more frequent decrease in SBP during the observation period. CONCLUSION: Depressive symptoms in octogenarian men could be predicted by hypertension earlier in life, and were strongly associated with decreasing SBP during the last decade.
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| 32. |
- Sjöberg, Linnea, et al.
(författare)
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Low Mood and Risk of Dementia : The Role of Marital Status and Living Situation
- 2020
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 28:1, s. 33-44
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims to explore whether low mood is related to an increased dementia risk in two cohorts of older adults of different generations, and whether marital status and living situation modify this association. Methods: Participants (>= 70 years), free from dementia and living at home, were identified from two population-based studies: the Kungsholmen Project (KP; n = 1,197) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; n = 1,402). Low mood was obtained by self-report (KP and SNAC-K) at baseline in 1987-89 (KP) and 2001-04 (SNAC-K). Incident dementia cases were ascertained over 9 years, using the same diagnostic procedures and comparable criteria for the two cohorts (DSM-III-R in KP and DSM-IV-TR in SNAC-K). Hazard ratios (HR) were derived from Cox proportional hazards models. Results: Those having low mood at baseline were at higher risk of dementia in both cohorts combined (HR: 1.2, 95% confidence interval (CI): 1.0-1.4) than those without low mood. However, an increased risk was detected only in those who did not have a partner (HR: 1.5, 95% CI: 1.2-1.9), or lived alone (HR: 1.5, 95% CI: 1.2-1.9), but not among those who had a partner or lived with someone (HR: 0.8, 95% CI: 0.5-1.2). Conclusion: Marital status and living situation have the potential to buffer the detrimental effects of low mood on dementia onset. Thus, specific attention from health care should target individuals having low mood and who do not have a partner or live alone.
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| 33. |
- Skoog, Ingmar, 1954
(författare)
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Bridge Over Troubled Water.
- 2017
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 25:4, s. 340-341
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Tidskriftsartikel (refereegranskat)
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| 34. |
- Stickley, Andrew, et al.
(författare)
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Childhood hunger and thoughts of death or suicide in older adults
- 2018
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 26:10, s. 1070-1078
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Tidskriftsartikel (refereegranskat)abstract
- Objective There is little research on the effects of childhood hunger on adult mental health. This study examined the association between childhood hunger and recurrent thoughts of death or suicide in older adults. Design Data were analyzed from adults aged 60 and above collected during the Estonian Health Interview Survey 2006 (N=2455). Retrospective information was obtained on the frequency (never, seldom, sometimes, often) of going to bed hungry in childhood, and on the presence of recurrent thoughts of death or suicide in the past 4 weeks. Multivariate logistic regression analysis was used to examine associations between the variables. Results Experiencing hunger in childhood was common (37.6%) with 14.3% of the respondents stating that they often went to bed hungry. In a univariate analysis going to bed hungry either sometimes or often more than doubled the odds for thoughts of death or suicide. Although adjustment for a range of covariates (including physical diseases and depressive episode) attenuated the associations, in the fully adjusted model going to bed hungry sometimes continued to be associated with significantly increased odds for thoughts of death or suicide in older adults (OR = 1.74, 95% CI = 1.10–2.74; Wald χ2 = 5.7, df = 1, p = 0.017). Conclusion The findings of this study suggest that the effects of childhood hunger may be long lasting and associated with mental health and well-being even in older adults.
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| 35. |
- Tan, Edwin C. K., et al.
(författare)
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Do Acetylcholinesterase Inhibitors Prevent or Delay Psychotropic Prescribing in People With Dementia? Analyses of the Swedish Dementia Registry
- 2020
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 28:1, s. 108-117
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate whether acetylcholinesterase inhibitor (AChEI) use prevents or delays subsequent initiation of psychotropic medications in people with Alzheimer's disease (AD) and Lewy body dementia (LBD). Methods: Cohort study of 17,763 people with AD and LBD, without prior psychotropic use at time of dementia diagnosis, registered in the Swedish Dementia Registry from 2007 to 2015. Propensity score-matched regression models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between time-dependent AChEI use and risk of psychotropic initiation. Results: Compared with matched comparators, AChEI users had a lower risk of antipsychotic ( HR: 0.85, 95%CI: 0.75-0.95) and anxiolytic (HR: 0.76, 95%CI: 0.72-0.80) initiation. In subanalyses, this association remained significant at higher AChEI doses, and in AD but not LBD. There were no associations between AChEI use and initiation of antidepressants or hypnotics. Conclusion: AChEI use may be associated with lower risk of antipsychotic and anxiolytic initiation in AD, particularly at higher doses. Further investigation into aceytylcholinesterase inhibitors in behavioral and psychological symptoms of dementia management in LBD is warranted.
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| 36. |
- Tappen, Ruth M, et al.
(författare)
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Use of the MC-FAQ and MMSE-FAQ in Cognitive Screening of Older African Americans, Hispanic Americans, and European Americans.
- 2012
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Ingår i: The American journal of geriatric psychiatry. - 1064-7481 .- 1545-7214. ; 20:11, s. 955-62
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: : The purpose of this study was to examine the performance of the Mini-Cog-Functional Activities Questionnaire (MC-FAQ) and the Mini-Mental State Examination-Functional Activities Questionnaire (MMSE-FAQ) in cognitive screening of a multiethnic sample of older adults.DESIGN: : This is a descriptive psychometric study.SETTING: : Cognitive screening was done in senior centers, at health fairs, and within the nine participating memory disorder centers in the State of Florida.PARTICIPANTS: : African American, Hispanic American, and European American older adults who participated in this screening were matched on gender, age within 3 years and education within 3 years yielding a sample of 225.MEASUREMENTS: : The MC-FAQ is a combination of the Mini-Cog and Functional Activities Questionnaire. The MMSE-FAQ combines the MMSE with the FAQ. The Geriatric Depression Scale was used to assess depressive symptoms.RESULTS: : African Americans reported significantly less depressive symptoms (F[2, 217] = 10.31, p <0.001) and European Americans had significantly higher mean MMSE scores than the other two groups (F[2, 222] = 3.33, p = 0.037). Participants did not differ by ethnic group on the MC-FAQ or MMSE-FAQ classifications of normal, mild cognitive impairment, or dementia. Age, years of education, and depressive symptoms were significant predictors of MC-FAQ and MMSE-FAQ classifications.CONCLUSIONS: : The results suggest that these combinations of screening measures may have less culture bias than the MMSE alone. Sensitivity and specificity should be evaluated in these groups with confirmatory neurological and psychiatric diagnosis.
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| 37. |
- Tian, Na, et al.
(författare)
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Association of Triglyceride-Glucose Index With Cognitive Function and Brain Atrophy : A Population-Based Study
- 2024
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Ingår i: The American journal of geriatric psychiatry. - 1064-7481 .- 1545-7214. ; 32:2, s. 151-162
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the associations of triglyceride-glucose (TyG) index, a reliable surrogate marker for insulin resistance, with the function of various cognitive domains and brain structures among older adults.Design: A population-based cross-sectional study.Setting: Older adults living in the rural communities in China.Participants: About 4,541 rural-dwelling dementia-free participants (age ≥65 years; 56.37% women) undertook examinations in March–September 2018 for MIND-China.Measurements: TyG index was calculated as ln[fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. A neuropsychological test battery was used to assess memory, attention, verbal fluency, and executive function. Volumetric brain measures were assessed on magnetic resonance imaging (MRI) in a subsample (n = 1,019). Data were analyzed with restricted cubic spline and multivariable general linear models.Results: An inverted J-shaped association was observed between TyG index and z-scores of multiple cognitive domains, such that among individuals with TyG index ≥8.57 (median), a higher TyG index was significantly associated with lower z-scores of memory, attention, verbal fluency, executive function, and global cognition (all p < 0.05); among people with TyG index <8.57, a higher TyG index was significantly associated with a higher executive function z-score (p < 0.05), but not with any of the other examined cognitive domains. In the MRI subsample, a higher TyG index was significantly associated with lower volumes of total brain tissue, gray matter, and white matter as well as greater cerebrospinal fluid volume (p < 0.05), but not with white matter hyperintensity volume.Conclusions: Insulin resistance, as indicated by a high TyG index, was associated with poor function in multiple cognitive domains and global brain atrophy.
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| 38. |
- Van Orden, Kimberly A, et al.
(författare)
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Reasons for Attempted Suicide in Later Life.
- 2015
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 23:5
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Tidskriftsartikel (refereegranskat)abstract
- Using the Interpersonal Theory of Suicide as a guiding framework, we investigated older adults' causal attributions for suicidal behavior. We hypothesized that older adults who attributed their suicidal behavior to thwarted belongingness or perceived burdensomeness would be more likely to use more immediately lethal means and to re-attempt suicide during the 12-month follow-up.
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| 39. |
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| 40. |
- Wetterberg, Hanna, et al.
(författare)
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The Effect of Diagnostic Criteria on Dementia Prevalence - A Population-Based Study From Gothenburg, Sweden
- 2024
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Ingår i: AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY. - 1064-7481 .- 1545-7214. ; 32:2, s. 230-243
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine how the use of different diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders third revised, fourth, and fifth editions [DSM-III-R, DSM-IV, and DSM-5], and the 10th and 11th editions of the International Classification of Diseases [ICD-10 and ICD-11] influences the reported prevalence of dementia. Methods: Two cross-sectional populationbased studies of systematically selected 85-year-olds in Gothenburg, Sweden, (N = 774), were examined in comprehensive health examinations including comprehensive neurocognitive examinations. Five algorithms based on the diagnostic criteria in the DSM-III-R, DSM-IV, DSM-5, ICD-10, and ICD-11 were created, including 105 different variables that were operationalized in different ways to match the criteria of each classification system. Results: ICD-11 yielded the highest prevalence of dementia (36.4%), followed by DSM-5 (32.9%), DSMIV (30.7%), the clinical consensus DSM-III-R diagnosis (26.7%), DSM-III-R (21.4%), and ICD-10 (20.5%). The agreement between the DSM-5 and the ICD11 was K = 0.9. All other kappa values ranged between 0.6 and 0.9.
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| 41. |
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| 42. |
- Wiktorsson, Stefan, 1955, et al.
(författare)
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Clinical Characteristics in Older, Middle-Aged and Young Adults Who Present With Suicide Attempts at Psychiatric Emergency Departments : A Multisite Study
- 2022
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier. - 1064-7481 .- 1545-7214. ; 30:3, s. 342-351
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study age group differences in clinical characteristics in older, middle-aged and younger adults with actual suicide attempts (SA).Design: Cross-sectional cohort study.Setting: 3 Swedish university hospitals.Participants: 821 persons who presented with self-harm at psychiatric emergency departments participated. Those with non-suicidal self-injury according to the Columbia Suicide Severity Rating Scale (C-SSRS) were excluded, leaving a total of 683 with an actual SA (18–44 years, n = 423; 45-64 years, n = 164; 65+, n = 96).Measurements: Suicidal behavior was characterized with the C-SSRS and the Suicide Intent Scale (SIS); symptoms associated with suicide were rated with the Suicide Assessment Scale (SUAS). Diagnoses were set using the Mini-International Neuropsychiatric Interview. Patients self-rated their symptoms with the Karolinska Affective and Borderline Symptoms Scale (KABOSS).Results: Older adults scored higher than the younger group on SIS total score and on the subjective subscale, but no age group differences were detected for the objective subscale. Half of the 65+ group fulfilled criteria for major depression, compared to 3-quarters in both the middle-aged and young groups. Anxiety disorders, as well as alcohol and substance use disorders were also less prevalent in the 65+ group, while serious physical illness was more common. Older adults scored lower on all symptom scales; effect sizes were large.Conclusions: While older adults with an SA showed higher suicide intent than young adults, they had lower scores on all ratings of psychiatric symptomatology. Low ratings might interfere with clinicians’ assessments of the needs of older adults with intentional self-harm.
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| 43. |
- Zettergren, Anna, 1978, et al.
(författare)
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The ACE Gene Is Associated with Late-Life Major Depression and Age at Dementia Onset in a Population-Based Cohort.
- 2017
-
Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1064-7481 .- 1545-7214. ; 25:2, s. 170-177
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Tidskriftsartikel (refereegranskat)abstract
- Depression and dementia in the elderly have been suggested to share similar risk factors and pathogenetic background, and recently the authors reported that the APOEɛ4 allele is a risk factor for both disorders in the general population. The aim of the present study was to examine the influence of the well-known polymorphisms rs1799752 in the angiotensin-converting enzyme (ACE) and rs5186 in the angiotensin receptor II type 1 (AGTR1) on late-life depression and dementia in a population-based Swedish cohort of older individuals followed over 12 years.In 2000-2001, 900 individuals underwent neuropsychiatric and neuropsychological examinations. Follow-up evaluations were performed in 2005-2006 and 2009-2010, and register data on dementia to 2012 were included. Cross-sectional associations between genotypes/alleles and depression and dementia at baseline and between genotypes/alleles and depression on at least one occasion during the study period and dementia onset to 2012 were investigated.As previously found for rs1799752 in ACE, rs5186 in AGTR1 was associated with dementia at baseline (OR: 3.25 [CI: 1.42-7.06], z=2.90, p=0.004). These associations became substantially weaker, or disappeared, when dementia onset to 2012 was included. For rs1799752 this could be explained by a significant association with age at onset (mean: 79.5 [SD: 6.45] years for risk-genotype carriers and 81.7 [SD: 7.12] years for carriers of other genotypes, b=-2.43, t=-2.38, df=192, p=0.02). When individuals with major depression on at least one occasion were analyzed, a significant association (OR: 2.14 [95% CI: 1.13-4.20], z=2.28, p=0.02), remaining after exclusion of dementia, with rs1799752 in ACE was found.In this population-based sample of older individuals, genetic variations in ACE seem to be important both for late-life major depression and dementia.
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| 44. |
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| 45. |
- Brinda, Ethel M., et al.
(författare)
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Health, Social, and Economic Variables Associated with Depression Among Older People in Low and Middle Income Countries : World Health Organization Study on Global AGEing and Adult Health
- 2016
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Ingår i: American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1064-7481. ; 24:12, s. 1196-1208
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Tidskriftsartikel (refereegranskat)abstract
- Objective Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs. Methods The authors accessed the World Health Organization Study on Global AGEing and Adult Health Wave 1 data that studied nationally representative samples from six large LMICs (N = 14,877). A computerized algorithm derived depression diagnoses. The authors assessed hypothesized associations using survey multivariate logistic regression models for each LMIC and pooled their risk estimates by meta-analyses and investigated related socioeconomic inequalities using concentration indices. Results Cross-national prevalence of geriatric depression was 4.7% (95% CI: 1.9%–11.9%). Female gender, illiteracy, poverty, indebtedness, past informal-sector occupation, bereavement, angina, and stroke had significant positive associations, whereas pension support and health insurance showed significant negative associations with geriatric depression. Pro-poor inequality of geriatric depression were documented in five LMICs. Conclusions Socioeconomic factors and related inequalities may predispose, precipitate, or perpetuate depression amongolder people in LMICs. Relative absence of health safety net places socioeconomically disadvantaged older people in LMICs at risk. The need for population-based public health interventions and policies to prevent and to manage geriatric depression effectively in LMICs cannot be overemphasized.
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| 46. |
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| 47. |
- Brunnström, Hans, et al.
(författare)
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Clinicopathological concordance in dementia diagnostics.
- 2009
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Ingår i: The American Journal of Geriatric Psychiatry. - 1545-7214. ; 17:8, s. 664-670
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Accurate distinction between dementia subtypes is important for patient care and pharmacological treatment. Continuing systematic comparisons of clinical and neuropathological dementia diagnoses may provide a basis for further improvement of the diagnostic procedure. The purpose of this study was to investigate concordance between clinical dementia diagnosis and neuropathological findings in the specialized dementia care. METHODS: Inclusion required 1) a clinical dementia disorder diagnosed at a hospital-based memory clinic and 2) a neuropathological examination within the Department of Pathology at the University Hospital in Lund, Sweden, during the years 1996-2006. A total of 176 consecutive patients fulfilled the criteria and were thus included. Clinical dementia diagnoses were obtained from the medical records and compared with the neuropathological findings. RESULTS: The clinical and pathological dementia diagnoses were in full accordance in 86 (49%) of the patients (kappa 0.37). In an additional 24 (14%) cases, the clinical diagnosis corresponded with some but not all pathological components judged to contribute to the dementia disorder. Of the patients with clinical Alzheimer disease, 84% (46/55) had a significant Alzheimer component with or without other significant pathology at neuropathological examination. The corresponding figure for vascular dementia (VaD) was 59% (24/41), for frontotemporal dementia 74% (20/27), for combined Alzheimer and VaD 25% (4/16), and for dementia with Lewy bodies 67% (6/9). CONCLUSIONS: This study shows that clinical dementia diagnoses do not always correspond with neuropathological changes. It stresses the importance of neuropathological examination in research and in daily clinical practice.
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| 48. |
- Brunnström, Hans, et al.
(författare)
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Response to letter to the editor.
- 2010
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Ingår i: The American Journal of Geriatric Psychiatry. - 1545-7214. ; 18:1, s. 92-93
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Tidskriftsartikel (refereegranskat)
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| 49. |
- Börjesson-Hanson, Anne, 1959, et al.
(författare)
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One-Month Prevalence of Mental Disorders in a Population Sample of 95-Year Olds.
- 2011
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - 1545-7214. ; 19:3, s. 284-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: To determine the 1-month prevalence of mental disorders among 95-year olds. DESIGN:: Cross-sectional population sample of 95-year olds. SETTING:: All 95-year olds born in the period 1901-1903 living in Gothenburg, Sweden, were invited. Elderly living in both community settings and nursing homes were included. PARTICIPANTS:: In total, 338 95-year olds (response rate: 65%) were examined (263 women, 75 men). MEASUREMENTS:: All participants were examined by psychiatrists using the Comprehensive Psychopathological Rating Scale and cognitive tests. Mental disorders were classified according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria. RESULTS:: Two-third of all 95-year olds had a mental disorder. In the total sample of 95-year olds, the 1-month prevalence was 52% for dementia, 8% for depression, 4% for anxiety, and 3% for psychotic disorders. Almost one-third (29%) of the nondemented 95-year olds fulfilled criteria for a psychiatric disorder: 17% had depression, 9% anxiety, and 7% psychotic disorder. CONCLUSIONS:: The combined prevalence of mental disorders was high among 95-year olds, even after excluding dementia. These findings emphasize the importance of research, care, and detection of psychiatric problems in this age group.
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| 50. |
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