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Apolipoprotein E, cognitive function, and dementia in a general population aged 85 years and over.

https://arctichealth.org/en/permalink/ahliterature196597
Source
Int Psychogeriatr. 2000 Sep;12(3):379-87
Publication Type
Article
Date
Sep-2000
Author
K. Juva
A. Verkkoniemi
P. Viramo
T. Polvikoski
K. Kainulainen
K. Kontula
R. Sulkava
Author Affiliation
Department of Clinical Neurosciences, Helsinki University Central Hospital, University of Helsinki, Finland. katijuva@katto.kaapeli.fi
Source
Int Psychogeriatr. 2000 Sep;12(3):379-87
Date
Sep-2000
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Alleles
Apolipoproteins E - metabolism
Catchment Area (Health)
Cognition Disorders - diagnosis
Dementia - diagnosis - epidemiology - metabolism
Female
Finland - epidemiology
Genotype
Humans
Male
Neuropsychological Tests
Population Surveillance
Severity of Illness Index
Sex Distribution
Abstract
We examined 510 subjects representing 83.2% of all citizens of a Finnish city aged 85 years or over. Mini-Mental State Examination (MMSE) scores, diagnosis of dementia by DSM-III-R criteria, and Apo-E genotype were determined. The prevalence of dementia was 38.6%. The odds ratio (OR) of the Apo-E epsilon4 carriers (with the reference population of people with the genotype epsilon3/epsilon3) for dementia was 2.36 (95% CI 1.58 - 3.53). There was a significant sex difference: The OR in women was 3.23 (95% CI 2.02 - 5.17) whereas among men it was insignificant. The mean MMSE score (+/- SD) among the Apo-E epsilon4 carriers (15.0 +/- 10.0) and noncarriers (18.7 8.6) (p
PubMed ID
11081958 View in PubMed
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Apolipoprotein E polymorphism, Alzheimer's disease and vascular dementia among elderly Finnish men.

https://arctichealth.org/en/permalink/ahliterature214135
Source
Acta Neurol Scand. 1995 Oct;92(4):297-8
Publication Type
Article
Date
Oct-1995
Author
J H Stengård
J. Pekkanen
R. Sulkava
C. Ehnholm
T. Erkinjuntti
A. Nissinen
Author Affiliation
National Public Health Institute, Helsinki, Finland.
Source
Acta Neurol Scand. 1995 Oct;92(4):297-8
Date
Oct-1995
Language
English
Publication Type
Article
Keywords
Aged
Alleles
Alzheimer Disease - genetics
Apolipoproteins E - genetics
Dementia, Vascular - genetics
Finland
Humans
Male
Phenotype
Polymorphism, Genetic - genetics
Abstract
An association between late-onset Alzheimer's disease, vascular dementia and the common polymorphic alleles of the gene coding for apolipoprotein E, epsilon 2, epsilon 3, and epsilon 4, was assessed in a population sample of 393 elderly Finnish men aged 70 to 89 years. Of them, 7% suffered Alzheimer's disease and 3% had vascular dementia. Among those who suffered Alzheimer's disease, there was a statistically significant excess of the epsilon 4 allele. No such an association was observed between the apolipoprotein E alleles and vascular dementia. We conclude that the apolipoprotein E polymorphism confers information about a risk of Alzheimer's disease in this population sample of elderly Finnish men.
PubMed ID
8848934 View in PubMed
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Cardiovascular risk factors and Alzheimer's disease: a genetic association study in a population aged 85 or over.

https://arctichealth.org/en/permalink/ahliterature197031
Source
Neurosci Lett. 2000 Oct 13;292(3):195-8
Publication Type
Article
Date
Oct-13-2000
Author
L. Myllykangas
T. Polvikoski
R. Sulkava
A. Verkkoniemi
P. Tienari
L. Niinistö
K. Kontula
J. Hardy
M. Haltia
J. Pérez-Tur
Author Affiliation
Neurogenetics Laboratory, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224, USA. liisa.myllykangas@helsinki.fi
Source
Neurosci Lett. 2000 Oct 13;292(3):195-8
Date
Oct-13-2000
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alleles
Alzheimer Disease - epidemiology - genetics
Apolipoproteins E - genetics
Cardiovascular Diseases - epidemiology - genetics
Cohort Studies
Comorbidity
Female
Finland - epidemiology
Genetic Linkage
Genetic Testing
Genotype
Humans
Lipoprotein Lipase - genetics
Low Density Lipoprotein Receptor-Related Protein-1
Male
Peptidyl-Dipeptidase A - genetics
Polymorphism, Genetic - genetics
Receptors, Immunologic - genetics
Risk factors
Abstract
Increasing evidence suggests a relation between vascular disorders and late-onset Alzheimer's disease (AD). We performed an association analysis of low-density lipoprotein receptor-related protein (LRP), lipoprotein lipase (LPL), and angiotensin converting enzyme (ACE) genes, known to be involved in vascular disorders, and AD. Genotyping was carried out in 113 patients with clinically defined Alzheimer's disease (NINCDS-ADRDA criteria) and 203 non-demented controls in a prospective, population-based study of people aged 85 years or over (Vantaa 85+ Study). Corresponding analysis was performed on 121 neuropathologically verified AD patients (CERAD criteria) and 75 controls derived from the same study population. We did not find significant associations between the polymorphisms studied and AD. However, analysis of the LPL polymorphism showed a weak trend (uncorrected P-value 0.095) towards protection against neuropathologically defined AD. Our study is based on very elderly Finns. Therefore, further studies are warranted in other populations.
PubMed ID
11018310 View in PubMed
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The changing picture of hip fractures: dramatic change in age distribution and no change in age-adjusted incidence within 10 years in Central Finland.

https://arctichealth.org/en/permalink/ahliterature202923
Source
Bone. 1999 Mar;24(3):257-9
Publication Type
Article
Date
Mar-1999
Author
T M Huusko
P. Karppi
V. Avikainen
H. Kautiainen
R. Sulkava
Author Affiliation
Department of Geriatrics, Jyväskylä Central Hospital, Finland.
Source
Bone. 1999 Mar;24(3):257-9
Date
Mar-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Female
Finland - epidemiology
Hip Fractures - epidemiology - etiology
Humans
Incidence
Male
Middle Aged
Abstract
The objective of this study was to find out if the age-standardized incidence of hip fractures has changed in 10 years in Central Finland. Patients with acute hip fracture admitted to Jyväskylä Central Hospital in 1982-1983 (n = 317) and in 1992-1993 (n = 351) were selected from the hospital discharge register and from contemporaneous records of the Department of Anesthesiology and the ward of traumatology. Earlier studies in Finland have indicated that there has been an increase in incidence rates. The results of this study show no change in the age-standardized incidence of hip fractures of men and women during the last 10 years. However, because of the change in the age distribution of the population, the number of hip fractures has increased by 11%. The mean age of the hip fracture patients increased from 75.4 years in 1982-1983 to 78.4 years in 1992-1993. In 1982-1983, 18.0% of the patients were > or =85 years. The corresponding figure in 1992-1993 was 30.2%. Therefore, we summarize that there has been a dramatic change in age distribution and no change in age-adjusted incidence within the last 10 years in central Finland.
PubMed ID
10071919 View in PubMed
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Cognitive impairment among elderly coronary heart disease patients.

https://arctichealth.org/en/permalink/ahliterature54288
Source
Gerontology. 1999;45(2):87-95
Publication Type
Article
Date
1999
Author
M. Ahto
R. Isoaho
H. Puolijoki
P. Laippala
R. Sulkava
S L Kivelä
Author Affiliation
Unit of General Practice, Oulu University Hospital and Department of Public Health Science and General Practice, University of Oulu, Finland.merja.ahto@utu.fi
Source
Gerontology. 1999;45(2):87-95
Date
1999
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Distribution
Aged
Aged, 80 and over
Aging - physiology
Chest Pain - epidemiology
Cognition Disorders - epidemiology - nursing - rehabilitation
Community Health Nursing - statistics & numerical data
Comorbidity
Coronary Disease - epidemiology - nursing - rehabilitation
Disability Evaluation
Dyspnea - epidemiology
Female
Finland - epidemiology
Home Care Services - statistics & numerical data
Humans
Male
Mental Status Schedule
Middle Aged
Research Support, Non-U.S. Gov't
Sex Distribution
Smoking
Abstract
BACKGROUND: Coronary heart disease (CHD) and decline in cognitive functioning and dementia are common problems in the elderly. Cardiovascular diseases (CVDs) are connected with vascular dementia, but less is known about cognitive functioning among elderly patients with CHD based on population studies. OBJECTIVE: To describe the associations between CHD and cognitive impairment among the elderly. POPULATION AND METHODS: Of the total population of the Lieto study (488 community-dwelling men and 708 women, >/=64 years old), the ambulatory patients with CHD (89 men and 73 women) and sex- and age-matched controls without any sign of CHD (178 men and 146 women) were selected to make up the study population. CHD was defined as the presence of angina pectoris or a past myocardial infarction. Cognitive assessment was based on the Mini-Mental State Examination (MMSE). RESULTS: The total MMSE scores, the MMSE subtest scores and the overall test-based cognitive functioning did not differ between patients and controls. Among men, higher MMSE subscores in orientation and language were related to more severe chest pain. According to logistic regression analyses, the cognitive impairment of men was associated with high age, the use of cardiac glycosides and physical disability. Among women, cognitive impairment was associated with high age and the use of antipsychotics. CONCLUSION: In general, CHD has no independent association with cognitive impairment among the non-institutionalized community-living elderly. Among men, however, a complicated CHD may negatively affect cognitive functioning.
PubMed ID
9933731 View in PubMed
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Correction for age, education and other demographic variables in the use of the Mini Mental State Examination in Finland.

https://arctichealth.org/en/permalink/ahliterature223614
Source
Acta Neurol Scand. 1992 Jun;85(6):391-6
Publication Type
Article
Date
Jun-1992
Author
R. Ylikoski
T. Erkinjuntti
R. Sulkava
K. Juva
R. Tilvis
J. Valvanne
Author Affiliation
Department of Neurology, University of Helsinki, Finland.
Source
Acta Neurol Scand. 1992 Jun;85(6):391-6
Date
Jun-1992
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Cross-Sectional Studies
Dementia - diagnosis - epidemiology - psychology
Educational Status
Female
Finland - epidemiology
Humans
Incidence
Male
Mass Screening
Mental Status Schedule - statistics & numerical data
Psychometrics
Abstract
The population-based Helsinki Aging Study was comprised of three age groups: 75-, 80- and 85-year-olds. A random sample of 511 subjects completed the Mini Mental State Examination (MMSE) and were assessed on the Clinical Dementia Rating-scale (CDR). According to the CDR results 446 subjects were screened as non-demented. Of these subjects 30% scored below or at 24 MMSE points. Age, education and social group had a significant effect on the MMSE scores, even after excluding the demented cases. Together they explained 10% of the total variance within the MMSE. Social group correlated with education. The MMSE scores were corrected according to age and education. Adjustment of the originally used cutpoint of 24 resulted in cutpoints of 25 and 26 among the 75-year-olds, in the low and high education groups respectively; 23 and 26 in the 80-year-olds; 22 and 23 in the 85-year-olds.
PubMed ID
1642109 View in PubMed
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Cost analysis of an exercise program for older women with respect to social welfare and healthcare costs: a pilot study.

https://arctichealth.org/en/permalink/ahliterature158992
Source
Scand J Med Sci Sports. 2008 Dec;18(6):783-9
Publication Type
Article
Date
Dec-2008
Author
L. Timonen
T. Rantanen
E. Mäkinen
T E Timonen
T. Törmäkangas
R. Sulkava
Author Affiliation
Health Center of the City of Joensuu, Joensuu, Finland. leena.timonen@fimnet.fi
Source
Scand J Med Sci Sports. 2008 Dec;18(6):783-9
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cost-Benefit Analysis
Costs and Cost Analysis
Exercise
Female
Finland
Health Expenditures - statistics & numerical data
Humans
Mobility Limitation
Pilot Projects
Program Evaluation - economics
Social Welfare - economics
Abstract
The aim of this study was to analyze social welfare and healthcare costs and fall-related healthcare costs after a group-based exercise program. The 10-week exercise program, which started after discharge from the hospital, was designed to improve physical fitness, mood, and functional abilities in frail elderly women. Sixty-eight acutely hospitalized and mobility-impaired women (mean age 83.0, SD 3.9 years) were randomized into either group-based (intervention) or home exercise (control) groups. Information on costs was collected during 1 year after hospital discharge. There were no differences between the intervention and control groups in the mean individual healthcare costs: 4381 euros (SD 3829 euros) vs 3539 euros (SD 3967 euros), P=0.477, in the social welfare costs: 3336 euros (SD 4418 euros) vs 4073 euros (SD 5973 euros), P=0.770, or in the fall-related healthcare costs: 996 euros (SD 2612 euros) vs 306 euros (SD 915), P=0.314, respectively. This exercise intervention, which has earlier proved to be effective in improving physical fitness and mood, did not result in any financial savings in municipal costs. These results serve as a pilot study and further studies are needed to establish the cost-effectiveness of this exercise intervention for elderly people.
PubMed ID
18248543 View in PubMed
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Delirium episode as a sign of undetected dementia among community dwelling elderly subjects: a 2 year follow up study.

https://arctichealth.org/en/permalink/ahliterature197244
Source
J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):519-21
Publication Type
Article
Date
Oct-2000
Author
T. Rahkonen
R. Luukkainen-Markkula
S. Paanila
J. Sivenius
R. Sulkava
Author Affiliation
Brain Research and Rehabilitation Center Neuron, Kuopio, Finland. Terhi.Rahkonen@uku.fi
Source
J Neurol Neurosurg Psychiatry. 2000 Oct;69(4):519-21
Date
Oct-2000
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - physiology
Delirium - physiopathology
Dementia - diagnosis - physiopathology
Finland
Follow-Up Studies
Humans
Male
Neuropsychological Tests
Abstract
Cognitive decline is commonly stated as one of the main risk factors for delirium. The aim was to assess the importance of a delirium episode as a symptom of an underlying dementia among community dwelling healthy elderly people in a prospective 2 year follow up study. The study patients consisted of 51 people living at home and older than 65 years of age, without severe underlying disorders including diagnosed dementia, admitted consecutively as emergency cases to hospital because of an acute delirious state and followed up for 2 years. The diagnosis of delirium and dementia were based on the DSM-III-R criteria. The community dwelling patients were evaluated and tested annually by a clinical investigator, a geriatric study nurse, and a neuropsychologist. The medical records of the institutionalised patients were also evaluated. Dementia was diagnosed immediately after the assurance that delirium symptoms had subsided in 14 out of 51 subjects (27%) and the additional 14 subjects were diagnosed as being demented during the 2 year follow up, 28 out of 51 patients (55%) altogether. Alzheimer's disease or mixed dementia was diagnosed in 14 out of 51 patients (27%), vascular dementia in 10 (20%), and dementia with Lewy bodies in two (4%). One case of alcoholic dementia and one case of a non-alcoholic hepatic encephalopathia were also found. A delirium episode is often the first sign of dementia requiring attention from medical and social professionals.
PubMed ID
10990515 View in PubMed
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Delirium in elderly people without severe predisposing disorders: etiology and 1-year prognosis after discharge.

https://arctichealth.org/en/permalink/ahliterature195278
Source
Int Psychogeriatr. 2000 Dec;12(4):473-81
Publication Type
Article
Date
Dec-2000
Author
T. Rahkonen
H. Mäkelä
S. Paanila
P. Halonen
J. Sivenius
R. Sulkava
Author Affiliation
Brain Research and Rehabilitation Center of Finland, Neuron, Kuopio. Terhi.Rahkonen@uku.fi
Source
Int Psychogeriatr. 2000 Dec;12(4):473-81
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Acute Disease
Aged
Aged, 80 and over
Cause of Death
Cerebrovascular Disorders - complications
Delirium - diagnosis - etiology - mortality
Diagnosis, Differential
Female
Finland - epidemiology
Follow-Up Studies
Humans
Infection - complications
Institutionalization - statistics & numerical data
Male
Survival Analysis
Abstract
The etiologic factors of delirium have been frequently studied in hospitalized elderly patients who usually have an underlying disorder, i.e., hip fracture or dementia predisposing to delirium. The etiologic factors of delirium and prognosis in healthy elderly remain unstudied. The aim of our study was to detect the primary and additional etiologic factors contributing to delirium among community-dwelling healthy elderly people without predisposing disorders to delirium and to evaluate 1-year prognosis after discharge to home.
The study subjects consisted of 51 community-dwelling people over 65 years of age, without severe underlying disorders predisposing to delirium, admitted consecutively to the hospital because of a delirious state. The diagnosis of delirium was based on the DSM-III-R criteria. After discharge to home, the subjects were followed up for 1 year.
The most important primary causes of delirium were infections in 22 cases (43%) and cerebrovascular attacks in 13 cases (25%). After the 1-year follow-up period, 10 patients (20%) had been taken into long-term care and 5 patients (10%) had died.
The plausible etiologic factor of delirium was detected in all cases. Among healthy elderly people, infections and cerebrovascular attacks were the most important etiologic factors for delirium. After discharge to home, 30% of the patients had to be taken into long-term care or had died within 1 year of the delirium.
PubMed ID
11263714 View in PubMed
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Delirium in the non-demented oldest old in the general population: risk factors and prognosis.

https://arctichealth.org/en/permalink/ahliterature194833
Source
Int J Geriatr Psychiatry. 2001 Apr;16(4):415-21
Publication Type
Article
Date
Apr-2001
Author
T. Rahkonen
U. Eloniemi-Sulkava
P. Halonen
A. Verkkoniemi
L. Niinistö
I L Notkola
R. Sulkava
Author Affiliation
Division of Geriatrics, Department of Public Health and General Practice, University of Kuopio, PO Box 1627, 70211 Kuopio, Finland. terhi.rahkonen@uku.fi
Source
Int J Geriatr Psychiatry. 2001 Apr;16(4):415-21
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition Disorders
Delirium - diagnosis - epidemiology - etiology
Dementia - diagnosis - epidemiology
Female
Finland - epidemiology
Humans
Hypertension
Incidence
Male
Mental Status Schedule
Odds Ratio
Population Surveillance
Prognosis
Prospective Studies
Risk factors
Abstract
The oldest old are prone to develop delirium. Studies into risk factors for delirium have been carried out predominantly in younger age groups. The aim of this population-based follow-up study was to investigate the risk factors for delirium requiring medical attention and subsequent prognosis in the non-demented general population aged > or = 85 years.
The study included the non-demented subjects in the population-based Vantaa 85+ study. After the 3-year observation period, 199 subjects (91% of those surviving) were re-examined and their medical records were evaluated for episodes of delirium. The subjects were followed up with respect to mortality for another 2 years.
During the 3-year observational period, 20 subjects (10%) had been diagnosed as having had an episode of delirium. A Mini-Mental State Examination score of or = 85 years. The study also highlights the significant association between delirium and a new dementia diagnosis in this age group.
PubMed ID
11333430 View in PubMed
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46 records – page 1 of 5.