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Living Alone with Alzheimer's Disease: Data from SveDem, the Swedish Dementia Registry.

https://arctichealth.org/en/permalink/ahliterature292004
Source
J Alzheimers Dis. 2017; 58(4):1265-1272
Publication Type
Journal Article
Date
2017
Author
Pavla Cermakova
Maja Nelson
Juraj Secnik
Sara Garcia-Ptacek
Kristina Johnell
Johan Fastbom
Lena Kilander
Bengt Winblad
Maria Eriksdotter
Dorota Religa
Author Affiliation
Department of Neurobiology, Care Sciences andSociety, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Stockholm, Sweden.
Source
J Alzheimers Dis. 2017; 58(4):1265-1272
Date
2017
Language
English
Publication Type
Journal Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - drug therapy - epidemiology - psychology
Antidepressive Agents
Antipsychotic Agents - therapeutic use
Cohort Studies
Comorbidity
Dementia - epidemiology - psychology
Female
Humans
Independent living
Magnetic Resonance Imaging
Male
Registries
Social Conditions
Sweden - epidemiology
Abstract
Many people with Alzheimer's disease (AD) live alone in their own homes. There is a lack of knowledge about whether these individuals receive the same quality of diagnostics and treatment for AD as patients who are cohabiting.
To investigate the diagnostic work-up and treatment of community-dwelling AD patients who live alone.
We performed a cross-sectional cohort study based on data from the Swedish Dementia Registry (SveDem). We studied patients diagnosed with AD between 2007 and 2015 (n?=?26,163). Information about drugs and comorbidities was acquired from the Swedish Prescribed Drug Register and the Swedish Patient Register.
11,878 (46%) patients lived alone, primarily older women. After adjusting for confounders, living alone was inversely associated with receiving computed tomography (OR 0.90; 95% CI 0.82-0.99), magnetic resonance imaging (OR 0.91; 95% CI 0.83-0.99), and lumbar puncture (OR 0.86; 95% CI 0.80-0.92). Living alone was also negatively associated with the use of cholinesterase inhibitors (OR 0.81; 95% CI 0.76; 0.87), memantine (OR 0.77; 95% CI 0.72; 0.83), and cardiovascular medication (OR 0.92; 0.86; 0.99). On the other hand, living alone was positively associated with the use of antidepressants (OR 1.15; 95% CI 1.08; 1.22), antipsychotics (OR 1.41; 95% CI 1.25; 1.58), and hypnotics and sedatives (OR 1.09; 95% CI 1.02; 1.17).
Solitary living AD patients do not receive the same extent of care as those who are cohabiting.
Notes
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PubMed ID
28550260 View in PubMed
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Modifiable midlife risk factors, independent aging, and survival in older men: report on long-term follow-up of the Uppsala Longitudinal Study of Adult Men cohort.

https://arctichealth.org/en/permalink/ahliterature265380
Source
J Am Geriatr Soc. 2015 May;63(5):877-85
Publication Type
Article
Date
May-2015
Author
Kristin Franzon
Björn Zethelius
Tommy Cederholm
Lena Kilander
Source
J Am Geriatr Soc. 2015 May;63(5):877-85
Date
May-2015
Language
English
Publication Type
Article
Keywords
Aging
Follow-Up Studies
Humans
Independent living
Life Style
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Risk factors
Survival Rate
Sweden
Time Factors
Abstract
To examine relationships between modifiable midlife factors, aging, and physical and cognitive function (independent aging) and survival in very old age.
Prospective cohort.
Uppsala Longitudinal Study of Adult Men, Uppsala, Sweden.
Swedish men investigated in 1970-74 (aged 48.6-51.1) and followed up for four decades (N=2,293).
Conventional cardiovascular risk factors, body mass index (BMI), and dietary biomarkers were measured, and a questionnaire was used to gather information on lifestyle variables at age 50. Four hundred seventy-two men were reinvestigated in 2008-09 (aged 84.8-88.9). Independent aging was defined as survival to age 85, Mini-Mental State Examination score of 25 or greater, not living in an institution, independent in personal care and hygiene, able to walk outdoors without personal help, and no diagnosis of dementia. The National Swedish Death Registry provided survival data.
Thirty-eight percent of the cohort survived to age 85. Seventy-four percent of the participants in 2008-09 were aging independently. In univariable analyses, high leisure-time physical activity predicted survival but not independent aging. Low work-time physical activity was associated more strongly with independent aging (odds ratio (OR)=1.84, 95% confidence interval (CI)=1.18-2.88) than with survival (OR=1.27, 95% CI=1.05-1.52). In multivariable analyses, midlife BMI was negatively associated (OR=0.80/SD, 95% CI=0.65-0.99/SD), and never or former smoking was positively associated (OR=1.66, 95% CI=1.07-2.59), with independent aging. As expected, conventional cardiovascular and lifestyle risk factors were associated with mortality.
A normal midlife BMI and not smoking were associated with independent aging close to four decades later, indicating that normal weight at midlife has the potential not only to increase survival, but also to preserve independence with aging.
PubMed ID
25919442 View in PubMed
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Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men.

https://arctichealth.org/en/permalink/ahliterature286089
Source
J Am Geriatr Soc. 2017 Sep;65(9):1953-1960
Publication Type
Article
Date
Sep-2017
Author
Kristin Franzon
Liisa Byberg
Per Sjögren
Björn Zethelius
Tommy Cederholm
Lena Kilander
Source
J Am Geriatr Soc. 2017 Sep;65(9):1953-1960
Date
Sep-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - prevention & control
Diet, Mediterranean
Exercise
Follow-Up Studies
Health Behavior
Humans
Independent living
Longitudinal Studies
Male
Risk factors
Surveys and Questionnaires
Sweden
Abstract
To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors.
Cohort study.
Uppsala Longitudinal Study of Adult Men, Sweden.
Swedish men (n = 1,104) at a mean age of 71 (range 69.4-74.1) were investigated, 369 of whom were evaluated for independent aging 16 years later, at a mean age of 87 (range 84.8-88.9).
A questionnaire was used to obtain information on lifestyle, including education, living conditions, and physical activity. Adherence to a Mediterranean-like diet was assessed according to a modified Mediterranean Diet Score derived from 7-day food records. Cardiovascular risk factors were measured. Independent aging at a mean age of 87 was defined as lack of diagnosed dementia, a Mini-Mental State Examination score of 25 or greater, not institutionalized, independence in personal activities of daily living, and ability to walk outdoors alone. Complete survival data at age 85 were obtained from the Swedish Cause of Death Register.
Fifty-seven percent of the men survived to age 85, and 75% of the participants at a mean age of 87 displayed independent aging. Independent aging was associated with never smoking (vs current) (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.05-4.60) and high (vs low) adherence to a Mediterranean-like diet (OR = 2.69, 95% CI = 1.14-6.80). Normal weight or overweight and waist circumference of 102 cm or less were also associated with independent aging. Similar associations were observed with survival.
Lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese at age 71 were associated with survival and independent aging at age 85 and older in men.
PubMed ID
28685810 View in PubMed
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