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  • 1.
    Fratiglioni, L
    et al.
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    Viitanen, M
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    von Strauss, Eva
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    Tontodonati, V
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    Herlitz, A
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    Winblad, B
    Stockholm Gerontology Research Center and Department of Geriatric Medicine, Karolinska Institute, Stockholm .
    Very Old Women at Highest Risk of Dementia and Alzheimer's Disease: Incidence Data from the Kungsholmen Project, Stockholm1997Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 48, nr 1, s. 132-138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine the incidence of different types of dementia in the very old, and to explore the relation with age and gender. Design: A dementia-free cohort was followed for an average of three years in Stockholm, Sweden. At the end of the follow-up, the subjects were interviewed by nurses, clinically examined by physicians, and cognitively assessed by psychologists. Deceased cohort members were studied using death certificates, hospital clinical records, and discharge diagnoses. Dementia diagnoses were made according to the DSM-III-R criteria independently by two physicians. Participants: The cohort consisted of 1,473 subjects (75+ years old), of which 987 were clinically examined at follow-up, 314 died before the examination, and 172 refused to participate. Results: During the follow-up, 148 subjects developed dementia. In the age-group 75 to 79, the incidence rates for dementia were 19.6 for women and 12.4 for men per 1,000 person-years, whereas for 90+ year-old subjects the corresponding figures were 86.7 and 15.0 per 1,000 person-years. A similar pattern of distribution by age and gender was seen for Alzheimer's disease. In each age stratum, the incidence rates of dementia and Alzheimer's disease were higher for women than for men. The age-adjusted odds ratio for women was 1.9 for dementia and 3.1 for Alzheimer's disease. Conclusions: (1) The incidence of dementia increases with age, even in the oldest age groups; (2) women have a higher risk of developing dementia than men, especially at very old ages; (3) this pattern is mainly due to the age and gender distribution of Alzheimer's disease, rather than vascular dementia.

  • 2.
    Ngandu, T
    et al.
    Aging Research Center (ARC), Karolinska Institutet, Stockholm.
    von Strauss, Eva
    Aging Research Center (ARC), Karolinska Institutet, Stockholm.
    Helkala, E L
    Public Health and General Practice, University of Kuopio, Finland.
    Winblad, B
    Aging Research Center (ARC), Karolinska Institutet, Stockholm.
    Nissinen, A
    Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki.
    Tuomilehto, J
    Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki.
    Soininen, H
    Departments of Neuroscience and Neurology, University of Kuopio, Finland.
    Kivipelto, M
    Aging Research Center (ARC), Karolinska Institutet, Stockholm.
    Education and dementia: What lies behind the association?2007Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 69, nr 14, s. 1442-1450Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Low education seems to be associated with an increased risk of dementia and Alzheimer disease (AD). People with low education have unhealthier lifestyles and more cardiovascular risk factors, but it is unclear how this affects the association between education and dementia.

    Methods: Participants of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study were derived from random, population-based samples previously studied in a survey in 1972, 1977, 1982, or 1987. After an average follow-up of 21 years, 1,449 individuals (72%) aged 65 to 79 participated in a re-examination in 1998.

    Results: Compared to individuals with formal education of 5 years or less, those with 6 to 8 years of education had OR of 0.57 (95% CI 0.29 to 1.13), and those with 9 years of education or more had OR of 0.16 (95% CI 0.06 to 0.41) for dementia. The corresponding ORs for AD were 0.49 (0.24 to 1.00) and 0.15 (0.05 to 0.40). The associations remained unchanged after adjustments for several demographic, socioeconomic, vascular, and lifestyle characteristics. The results were similar among both men and women. ApoE4 did not modify the association, but the risk of dementia and AD was very low among ApoE4 noncarriers with high education.

    Conclusions: The association between low education and dementia is probably not explained by the unhealthy lifestyles of the less educated compared with higher educated persons. Higher educated persons may have a greater cognitive reserve that can postpone the clinical manifestation of dementia. Unhealthy lifestyles may independently contribute to the depletion of this reserve or directly influence the underlying pathologic processes.

    GLOSSARY: AD = Alzheimer disease; CAIDE = Cardiovascular Risk Factors, Aging and Dementia; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th edition; MMSE = Mini-Mental State Examination; NINCDS-ADRDA = National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association; SBP = systolic blood pressure.

                    

  • 3.
    Qiu, Chengxuan
    et al.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet–Stockholm University.
    von Strauss, Eva
    Röda Korsets Högskola. Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet–Stockholm University.
    Bäckman, Lars
    Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet–Stockholm University.
    Winblad, Bengt
    Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet–Stockholm University.
    Fratiglioni, Laura
    Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet–Stockholm University.
    Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden2013Inngår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 80, nr 20, s. 1888-1894Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore whether prevalence, survival, and incidence of dementia have changed from 1987–1994 to 2001–2008 in Stockholm, Sweden.

    Methods: This study is based on 2 cross-sectional surveys of people aged 75 years or over conducted in central Stockholm: the Kungsholmen Project (KP) (1987–1989, n = 1,700) and the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) (2001–2004, n = 1,575). In both surveys we diagnosed dementia according to DSM-III-R criteria, following the identical diagnostic procedure. Death certificates were used to determine survival status of KP participants as of December 1994 and SNAC-K participants as of June 2008. We used logistic and Cox models to compare prevalence and survival, controlling for major confounders. We inferred incidence of dementia according to its relationship with prevalence and survival.

    Results: At baseline, 225 subjects in KP and 298 in SNAC-K were diagnosed with dementia. The age- and sex-standardized prevalence of dementia was 17.5% (12.8% in men; 19.2% in women) in KP and 17.9% (10.8% in men; 20.5% in women) in SNAC-K. The adjusted odds ratio of dementia in SNAC-K vs KP was 1.17 (95% confidence interval 0.95–1.46). The multiadjusted hazard ratio of death in SNAC-K vs KP was 0.71 (0.57–0.88) in subjects with dementia, 0.68 (0.59–0.79) in those without dementia, and 0.66 (0.59–0.74) in all participants.

    Conclusions: Prevalence of dementia was stable from the late 1980s to the early 2000s in central Stockholm, Sweden, whereas survival of patients with dementia increased. These results suggest that incidence of dementia may have decreased during this period.

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