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A 24-year follow-up of body mass index and cerebral atrophy.

https://arctichealth.org/en/permalink/ahliterature9325
Source
Neurology. 2004 Nov 23;63(10):1876-81
Publication Type
Article
Date
Nov-23-2004
Author
D. Gustafson
L. Lissner
C. Bengtsson
C. Björkelund
I. Skoog
Author Affiliation
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. deb.gustafson@neuro.gu.se
Source
Neurology. 2004 Nov 23;63(10):1876-81
Date
Nov-23-2004
Language
English
Publication Type
Article
Keywords
Adult
Alcohol drinking - epidemiology
Atrophy
Body mass index
Cardiovascular Diseases - epidemiology
Cerebral Cortex - pathology - radiography
Comorbidity
Dementia - epidemiology
Diabetes Mellitus - epidemiology
Educational Status
Female
Follow-Up Studies
Health Surveys
Hormone Replacement Therapy
Humans
Hyperlipidemia - epidemiology
Middle Aged
Obesity - epidemiology - pathology
Research Support, Non-U.S. Gov't
Risk factors
Smoking - epidemiology
Sweden - epidemiology
Tomography, X-Ray Computed
Waist-Hip Ratio
Abstract
OBJECTIVE: To investigate the longitudinal relationship between body mass index (BMI), a major vascular risk factor, and cerebral atrophy, a marker of neurodegeneration, in a population-based sample of middle-aged women. METHODS: A representative sample of 290 women born in 1908, 1914, 1918, and 1922 was examined in 1968 to 1969, 1974 to 1975, 1980 to 1981, and 1992 to 1993 as part of the Population Study of Women in Göteborg, Sweden. At each examination, women completed a survey on a variety of health and lifestyle factors and underwent anthropometric, clinical, and neuropsychiatric assessments and blood collection. Atrophy of the temporal, frontal, occipital, and parietal lobes was measured on CT in 1992 when participants were age 70 to 84. Univariate and multivariate regression analyses were used to assess the relationship between BMI and brain measures. RESULTS: Women with atrophy of the temporal lobe were, on average, 1.1 to 1.5 kg/m2 higher in BMI at all examinations than women without temporal atrophy (p
Notes
Comment In: Neurology. 2005 Jun 14;64(11):1990-1; author reply 1990-115955971
SummaryForPatientsIn: Neurology. 2004 Nov 23;63(10):E19-2015557485
PubMed ID
15557505 View in PubMed
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Evaluation of quality improvement programmes.

https://arctichealth.org/en/permalink/ahliterature187346
Source
Qual Saf Health Care. 2002 Sep;11(3):270-5
Publication Type
Article
Date
Sep-2002
Author
J. Øvretveit
D. Gustafson
Author Affiliation
Nordic School of Public Health, Karolinska Institute, Sweden. jovret@aol.com
Source
Qual Saf Health Care. 2002 Sep;11(3):270-5
Date
Sep-2002
Language
English
Publication Type
Article
Keywords
Evidence-Based Medicine
Health Services Research - methods
Hospital Administration - methods - standards
Humans
Management Audit
Program Evaluation - methods
Research Design - standards
Sweden
Total Quality Management
Abstract
In response to increasing concerns about quality, many countries are carrying out large scale programmes which include national quality strategies, hospital programmes, and quality accreditation, assessment and review processes. Increasing amounts of resources are being devoted to these interventions, but do they ensure or improve quality of care? There is little research evidence as to their effectiveness or the conditions for maximum effectiveness. Reasons for the lack of evaluation research include the methodological challenges of measuring outcomes and attributing causality to these complex, changing, long term social interventions to organisations or health systems, which themselves are complex and changing. However, methods are available which can be used to evaluate these programmes and which can provide decision makers with research based guidance on how to plan and implement them. This paper describes the research challenges, the methods which can be used, and gives examples and guidance for future research. It emphasises the important contribution which such research can make to improving the effectiveness of these programmes and to developing the science of quality improvement.
Notes
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PubMed ID
12486994 View in PubMed
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High total cholesterol levels in late life associated with a reduced risk of dementia.

https://arctichealth.org/en/permalink/ahliterature67171
Source
Neurology. 2005 May 24;64(10):1689-95
Publication Type
Article
Date
May-24-2005
Author
M M Mielke
P P Zandi
M. Sjögren
D. Gustafson
S. Ostling
B. Steen
I. Skoog
Author Affiliation
Center on Aging and Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA. mmielke@jhsph.edu
Source
Neurology. 2005 May 24;64(10):1689-95
Date
May-24-2005
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Aging - metabolism
Alzheimer Disease - blood - epidemiology
Brain - metabolism - pathology - physiopathology
Cholesterol - blood
Cohort Studies
Comorbidity
Dementia, Vascular - blood - epidemiology
Female
Humans
Hypercholesterolemia - blood - epidemiology
Hyperlipidemia - blood - epidemiology
Longitudinal Studies
Male
Predictive value of tests
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Risk factors
Sex Distribution
Smoking - adverse effects
Sweden - epidemiology
Triglycerides - blood
Abstract
OBJECTIVE: To examine the longitudinal association between plasma total cholesterol and triglyceride levels and incident dementia. METHODS: Neuropsychiatric, anthropometric, laboratory, and other assessments were conducted for 392 participants of a 1901 to 1902 birth cohort first examined at age 70. Follow-up examinations were at ages 75, 79, 81, 83, 85, and 88. Information on those lost to follow-up was collected from case records, hospital linkage system, and death certificates. Cox proportional hazards regression examined lipid levels at ages 70, 75, and 79 and incident dementia between ages 70 and 88. RESULTS: Increasing cholesterol levels (per mmol/L) at ages 70 (hazard ratio [HR] 0.77, 95% CI: 0.61 to 0.96, p = 0.02), 75 (HR 0.70, CI: 0.52 to 0.93, p = 0.01), and 79 (HR 0.73, CI: 0.55 to 0.98, p = 0.04) were associated with a reduced risk of dementia between ages 79 and 88. Examination of cholesterol levels in quartiles showed that the risk reduction was apparent only among the highest quartile at ages 70 (8.03 to 11.44 mmol/L [311 to 442 mg/dL]; HR 0.31, CI: 0.11 to 0.85, p = 0.03), 75 (7.03 to 9.29 mmol/L [272 to 359 mg/dL]; HR 0.20, CI: 0.05 to 0.75, p = 0.02), and 79 (6.82 to 9.10 mmol/L [264 to 352 mg/dL]; HR 0.45, CI: 0.17 to 1.23, p = 0.12). Triglyceride levels were not associated with dementia. CONCLUSIONS: High cholesterol in late life was associated with decreased dementia risk, which is in contrast to previous studies suggesting high cholesterol in mid-life is a risk factor for later dementia. The conflicting results may be explained by the timing of the cholesterol measurements in relationship to age and the clinical onset of dementia.
PubMed ID
15911792 View in PubMed
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Prodromal cognitive signs of dementia in 85-year-olds using four sources of information.

https://arctichealth.org/en/permalink/ahliterature171384
Source
Neurology. 2005 Dec 27;65(12):1894-900
Publication Type
Article
Date
Dec-27-2005
Author
S. Sacuiu
M. Sjögren
B. Johansson
D. Gustafson
I. Skoog
Author Affiliation
Psychiatry Section, Institute of Clinical Neuroscience, Sahlgrenska Academy, Göteborg University, Sweden. simona.sacuiu@neuro.gu.se
Source
Neurology. 2005 Dec 27;65(12):1894-900
Date
Dec-27-2005
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Alzheimer Disease - diagnosis - psychology
Cognition Disorders - diagnosis - psychology
Cohort Studies
Dementia - diagnosis - psychology
Dementia, Vascular - diagnosis - psychology
Disease Progression
Early Diagnosis
Female
Humans
Longitudinal Studies
Male
Memory Disorders - diagnosis - psychology
Neuropsychological Tests
Predictive value of tests
Prognosis
Reproducibility of Results
Sweden
Abstract
To evaluate the utility of assessing four cognitive domains obtained from four information sources to identify individuals at risk for developing dementia, Alzheimer disease (AD), and vascular dementia (VaD).
A representative population sample of nondemented 85-year-olds (n = 313) from Gothenburg, Sweden, was examined regarding memory, language, and visuospatial and executive functions, using self- and key informant reports and neuropsychiatric and psychometric examinations. The sample was followed 3 years for incident dementia, AD, or possible VaD.
All cases of dementia, AD, and VaD were preceded by low performance in most domains irrespective of information source. Isolated low memory performance or low cognitive performance with unimpaired memory did not predict dementia. Positive predictive values increased with number of domains affected. Self- and key informant reports were less useful for predicting dementia than neuropsychiatric and psychometric examinations. The best positive predictive value (88%) was for low cognitive performance in all domains using neuropsychiatric and psychometric examinations; however, sensitivity was only 18%.
Although memory impairment was necessary to predict dementia, it was not sufficient. Other cognitive domains needed to be affected. Relying on self-reports or key informants for early detection of dementia excluded a large group at risk. In addition, vascular dementia appeared to have a prodromal stage.
PubMed ID
16380609 View in PubMed
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The prognosis and incidence of social phobia in an elderly population. A 5-year follow-up.

https://arctichealth.org/en/permalink/ahliterature144285
Source
Acta Psychiatr Scand. 2010 Jul;122(1):4-10
Publication Type
Article
Date
Jul-2010
Author
B. Karlsson
R. Sigström
M. Waern
S. Ostling
D. Gustafson
I. Skoog
Author Affiliation
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden. karlsson.bjorn@gmail.com
Source
Acta Psychiatr Scand. 2010 Jul;122(1):4-10
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Disease
Diagnostic and Statistical Manual of Mental Disorders
Female
Follow-Up Studies
Geriatric Assessment - statistics & numerical data
Humans
Incidence
Longitudinal Studies
Male
Phobic Disorders - diagnosis - epidemiology
Population Surveillance
Prognosis
Psychometrics
Quality of Life
Severity of Illness Index
Social Environment
Sweden - epidemiology
Abstract
To examine the prognosis and incidence of social fears and phobia in an elderly population sample followed for 5 years.
A general population sample (N = 612) of non-demented men (baseline age 70) and women (baseline age 70 and 78-86) was investigated in 2000-2001 and in 2005-2006 with semi-structured psychiatric examinations including the Comprehensive Psychopathological Rating Scale, and the Mini International Neuropsychiatric Interview. Social phobia was diagnosed according to the DSM-IV criteria.
Among nine individuals with DSM-IV social phobia in 2000, 5 (55.6%) had no social fears in 2005, and 1 (11.1%) still met the criteria for DSM-IV social phobia. Among individuals without DSM-IV social phobia in 2000 (N = 603), 12 (2.0%) had DSM-IV social phobia in 2005.
These findings challenge the notion that social phobia is a chronic disorder with rare occurrence in old age.
Notes
Comment In: Acta Psychiatr Scand. 2010 Jul;122(1):1-320597874
PubMed ID
20384601 View in PubMed
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Quality collaboratives: lessons from research.

https://arctichealth.org/en/permalink/ahliterature187479
Source
Qual Saf Health Care. 2002 Dec;11(4):345-51
Publication Type
Article
Date
Dec-2002
Author
J. ØVretveit
P. Bate
P. Cleary
S. Cretin
D. Gustafson
K. McInnes
H. McLeod
T. Molfenter
P. Plsek
G. Robert
S. Shortell
T. Wilson
Author Affiliation
The Nordic School of Public Health, Goteborg, Sweden The Health Services Management Centre, Birmingham University, UK. jovret@aol.com
Source
Qual Saf Health Care. 2002 Dec;11(4):345-51
Date
Dec-2002
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Diffusion of Innovation
Guidelines as Topic
Health Care Coalitions - organization & administration
Health Services Research
Humans
Management Quality Circles
Organizational Objectives
Quality Assurance, Health Care - methods - organization & administration
Sweden
Abstract
Quality improvement collaboratives are increasingly being used in many countries to achieve rapid improvements in health care. However, there is little independent evidence that they are more cost effective than other methods, and little knowledge about how they could be made more effective. A number of systematic evaluations are being performed by researchers in North America, the UK, and Sweden. This paper presents the shared ideas from two meetings of these researchers. The evidence to date is that some collaboratives have stimulated improvements in patient care and organisational performance, but there are significant differences between collaboratives and teams. The researchers agreed on the possible reasons why some were less successful than others, and identified 10 challenges which organisers and teams need to address to achieve improvement. In the absence of more conclusive evidence, these guidelines are likely to be useful for collaborative organisers, teams and their managers and may also contribute to further research into collaboratives and the spread of innovations in health care.
Notes
Comment In: Qual Saf Health Care. 2002 Dec;11(4):30712468688
PubMed ID
12468695 View in PubMed
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Secular changes in cognitive predictors of dementia and mortality in 70-year-olds.

https://arctichealth.org/en/permalink/ahliterature141149
Source
Neurology. 2010 Aug 31;75(9):779-85
Publication Type
Article
Date
Aug-31-2010
Author
S. Sacuiu
D. Gustafson
M. Sjögren
X. Guo
S. Ostling
B. Johansson
I. Skoog
Author Affiliation
Department of Psychiatry and Neurochemistry, Unit of Psychiatric Epidemiology, University of Gothenburg and Sahlgrenska University Hospital, Institute of Neuroscience and Physiology, Wallinsgatan 6, 431 41 Mölndal, Sweden. simona.sacuiu@neuro.gu.se
Source
Neurology. 2010 Aug 31;75(9):779-85
Date
Aug-31-2010
Language
English
Publication Type
Article
Keywords
Aged
Cognition
Cognition Disorders - diagnosis - mortality - psychology
Cohort Studies
Dementia - diagnosis - mortality - psychology
Disease Progression
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Neuropsychological Tests - standards
Predictive value of tests
Registries
Risk factors
Sweden - epidemiology
Abstract
Successive elderly birth cohorts improved in cognitive performance during the 20th century. It is not clear whether this influences cognitive predictors of dementia and mortality.
In 2 longitudinal population studies, representing 2 cohorts of 70-year-olds examined 30 years apart, we investigated the relation between baseline cognitive function and 5-year occurrence of dementia and mortality.
Two representative cohorts of 70-year-olds initially free from dementia born in 1901-1902 (cohort 1901-1902: n = 381) and 1930 (cohort 1930: n = 551) from Gothenburg, Sweden, were examined in 1971-1972 and 2000-2001 and after 5 years for the outcome of dementia and death. Recent memory was evaluated during psychiatric examinations, and nonmemory domains using psychometric tests.
At age 70, cohort 1930 performed better on psychometric tests, and had fewer recent memory problems compared to cohort 1901-1902. During 5-year follow-up, 5.0% in cohort 1901-1902 and 4.4% in cohort 1930 (p = 0.742) developed dementia, and 15.7% in cohort 1901-1902 and 4.4% in cohort 1930 died (p
Notes
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PubMed ID
20805523 View in PubMed
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7 records – page 1 of 1.