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  • 1.
    Aguero-Torres, H
    et al.
    Aging Research Center (ARC).
    Kivipelto, M
    Aging Research Center (ARC).
    von Strauss, Eva
    Aging Research Center (ARC).
    Rethinking the dementia diagnoses in a population-based study: What is Alzheimer's disease and what is vascular dementia? A study from the Kungsholmen Project2006In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 22, no 3, p. 244-249Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the hypothesis that older adults often are affected by more than one disease, making the differential diagnosis between Alzheimer’s disease (AD) and vascular dementia (VaD) difficult. Methods: Incident dementia cases (n = 308) from a population-based longitudinal study of people 75+ years were investigated. The DSM-III-R criteria were used for the clinical diagnosis of dementia. Data on vascular disorders (hypertension, cerebrovascular and ischemic heart diseases, heart failure, atrial fibrillation, diabetes) as well as type of onset/course of dementia were used retrospectively to reclassify dementias. Results: Only 47% of the AD cases were reclassified as pure AD without any vascular disorder. Among subjects with AD and with a vascular component, cerebrovascular disease was the most common (41%). Only 25% of VaD were reclassified as pure VaD. Further, 26% of the pure AD subjects developed a vascular disorder in the following 3 years. Conclusions: Both vascular and degenerative mechanisms may often contribute to the expression of dementia among the elderly. Most of the AD cases have vascular involvements, and pure dementia types in very old subjects constitute only a minority of dementia cases.

  • 2.
    Karp, A
    et al.
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Paillard-Borg, Stéphanie
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Wang, H
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Silverstein, M
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Winblad, B
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Fratiglioni, L
    Aging Research Center, Division of Geriatric Epidemiology, Department of Neurotec, Karolinska Institutet, and the Stockholm Gerontology Research Center, Stockholm.
    Mental, physical and social components in leisure activities equally contribute to decrease dementia risk2006In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, ISSN 1420-8008, Vol. 21, no 2, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Background: There is accumulating evidence in the literature that leisure engagement has a beneficial effect on dementia. Most studies have grouped activities according to whether they were predominantly mental, physical or social. Since many activities contain more than one component, we aimed to verify the effect of all three major components on the dementia risk, as well as their combined effect. Methods: A mental, social and physical component score was estimated for each activity by the researchers and a sample of elderly persons. The correlation between the ratings of the authors and the means of the elderly subjects' ratings was 0.86. The study population consisted of 776 nondemented subjects, aged 75 years and above, living in Stockholm, Sweden, who were still nondemented after 3 years and were followed for 3 more years to detect incident dementia cases. Results: Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component score sums were 0.71 (95% CI: 0.49-1.03), 0.61 (95% CI: 0.42-0.87) and 0.68 (95% CI: 0.47-0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia = 0.53; 95% CI: 0.36-0.78). Conclusions: These findings suggest that a broad spectrum of activities containing more than one of the components seems to be more beneficial than to be engaged in only one type of activity

  • 3.
    Mecocci, P
    et al.
    Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
    von Strauss, Eva
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Cherubini, A
    Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
    Ercolani, S
    Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
    Mariani, E
    Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
    Senin, U
    Institute of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
    Winblad, B
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Fratiglioni, L
    Aging Research Center, Division of Geriatric Epidemiology and Medicine, Neurotec, Karolinska Institutet, Stockholm.
    Cognitive Impairment Is the Major Risk Factor for Development of Geriatric Syndromes during Hospitalization: Results from the GIFA Study2005In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 20, no 4, p. 262-269Article in journal (Refereed)
    Abstract [en]

    Objective: To detect the main factors associated with the occurrence of specific geriatric syndromes (namely pressure sores, fecal incontinence, urinary incontinence and falls) in elderly patients during hospitalization. Design: Observational prospective study. Setting: Eighty-one community and university hospitals throughout Italy. Participants: 13,729 patients aged 65 years and more, consecutively admitted to medical or geriatric acute wards during 20 months in the period between 1991 and 1998. Measurements: Occurrence of pressure sores, fecal incontinence, urinary incontinence and falls during the stay in hospital. Results: Pressure sores were already present in 3% of hospitalized subjects, fecal incontinence in 7.3%, while urinary incontinence, evaluated on a subgroup of total population (4,268 subjects), had a prevalence of 22.3%. During hospitalization (mean stay of 15 days), 74 subjects developed new pressure sores, 55 became fecal and 35 urinary incontinent, and 279 subjects had at least one episode of fall. In multivariate analyses, cognitive impairment, advanced age (85+ years), length of stay (more than 3 weeks) and severe disability were the main independent predictors of development of the four geriatric syndromes, with cognitive impairment as the most significant risk factor for all the four outcomes (OR 4.9, 95% CI 2.4–9.9 for pressure sores; OR 6.3, 95% CI 3.0–13.0 for fecal incontinence; OR 5.3, 95% CI 2.3–12.0 for urinary incontinence; OR 1.6, 95% CI 1.2–2.3 for falls). Conclusion: Very old people have a significant increased risk of several geriatric syndromes during the stay in hospital, particularly if it is long and they are cognitively impaired. A standardized comprehensive geriatric evaluation at admission could be helpful in detecting all subjects at risk and preventing the development of hospital-acquired geriatric syndromes.

     

  • 4.
    Paillard-Borg, Stéphanie
    et al.
    Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Fratiglioni, L
    Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Winblad, B
    Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Wang, H-X
    Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Leisure activities in late life in relation to dementia risk: principal component analysis2009In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, ISSN 1420-8008, Vol. 28, no 2, p. 136-144Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore the underlying dimensions of a set of interrelated lifestyle factors and test the hypothesis that an active lifestyle may protect against dementia. METHODS: The study population consisted of 776 participants aged >or=75 years who were dementia-free at both baseline and the first follow-up examinations. Participation in leisure activities was assessed at baseline of the survey, and principal component analysis was used to identify their underlying factors. RESULTS: During the 9-year follow-up from exposure assessment, 212 subjects developed dementia. Higher factor scores of physical, mental, and social dimensions of an active lifestyle was each related to a lower dementia risk. A significant dose-response association between participation in the diverse dimensions and lower dementia risk was observed. CONCLUSION: An active lifestyle may protect older people against dementia, and the higher level of engagement the stronger protection.

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