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Anxiety, depression, and 1-year incident cognitive impairment in community-dwelling older adults.

https://arctichealth.org/en/permalink/ahliterature132631
Source
J Am Geriatr Soc. 2011 Aug;59(8):1421-8
Publication Type
Article
Date
Aug-2011
Author
Olivier Potvin
Hélène Forget
Sébastien Grenier
Michel Préville
Carol Hudon
Author Affiliation
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada. Olivier.Potvin@crulrg.ulaval.ca
Source
J Am Geriatr Soc. 2011 Aug;59(8):1421-8
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anxiety Disorders - diagnosis - epidemiology - psychology
Cognition Disorders - diagnosis - epidemiology - psychology
Comorbidity
Cross-Sectional Studies
Depressive Disorder - diagnosis - epidemiology - psychology
Diagnostic and Statistical Manual of Mental Disorders
Female
Geriatric Assessment - statistics & numerical data
Health Surveys
Humans
Incidence
Independent Living - psychology
Male
Mental Status Schedule - statistics & numerical data
Psychometrics
Quebec
Abstract
To examine in men and women the independent associations between anxiety and depression and 1-year incident cognitive impairment and to examine the association of cognitive impairment, no dementia (CIND) and incident cognitive impairment with 1-year incident anxiety or depression.
Prospective cohort study.
General community.
Population-based sample of 1,942 individuals aged 65 to 96.
Two structured interviews 12 months apart evaluated anxiety and mood symptoms and disorders according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. Incident cognitive impairment was defined as no CIND at baseline and a follow-up Mini-Mental State Examination score at least 2 points below baseline and below the 15th percentile according to normative data. The associations between cognitive impairment and anxiety or depression were assessed using logistic regression adjusted for potential confounders.
Incident cognitive impairment was, independently of depression, associated with baseline anxiety disorders in men (odds ratio (OR)=6.27, 95% confidence interval (CI)=1.39-28.29) and anxiety symptoms in women (OR=2.14, 95%=1.06-4.34). Moreover, the results indicated that depression disorders in men (OR=8.87, 95%=2.13-36.96) and anxiety symptoms in women (OR=4.31, 95%=1.74-10.67) were particularly linked to incident amnestic cognitive impairment, whereas anxiety disorders in men (OR=12.01, 95%=1.73-83.26) were especially associated with incident nonamnestic cognitive impairment. CIND at baseline and incident cognitive impairment were not associated with incident anxiety or depression.
Anxiety and depression appear to have different relationships with incident cognitive impairment according to sex and the nature of cognitive impairment. Clinicians should pay particular attention to anxiety in older adults because it may shortly be followed by incident cognitive treatment.
PubMed ID
21797836 View in PubMed
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Clinical characteristics and mortality risk in relation to obstructive and central sleep apnoea in community-dwelling elderly individuals: a 7-year follow-up.

https://arctichealth.org/en/permalink/ahliterature125918
Source
Age Ageing. 2012 Jul;41(4):468-74
Publication Type
Article
Date
Jul-2012
Author
Peter Johansson
Urban Alehagen
Eva Svanborg
Ulf Dahlström
Anders Broström
Author Affiliation
Department of Cardiology, Linkoping University Hospital, Linkoping, Sweden. peter.johansson@aries.vokby.se
Source
Age Ageing. 2012 Jul;41(4):468-74
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Aging
Cardiovascular Diseases - mortality - physiopathology
Cause of Death
Comorbidity
Female
Follow-Up Studies
Humans
Independent living
Kaplan-Meier Estimate
Male
Proportional Hazards Models
Risk assessment
Risk factors
Sleep
Sleep Apnea, Central - mortality - physiopathology
Sleep Apnea, Obstructive - mortality - physiopathology
Stroke Volume
Sweden - epidemiology
Systole
Time Factors
Ventricular Function, Left
Abstract
little is known about demographic and clinical characteristics associated with sleep-disordered breathing (SDB) and obstructive sleep apnoea (OSA) or central sleep apnoea (CSA) in community-dwelling elderly. We also examined these (OSA and CSA) associations to all-cause and cardiovascular (CV) mortality.
a total of 331 community-dwelling elderly aged 71-87 years underwent a clinical examination and one-night polygraphic recordings in their homes. Mortality data were collected after seven years.
a total of 55% had SDB, 38% had OSA and 17% had CSA. Compared with those with no SDB and OSA, more participants with CSA had a left ventricular ejection fraction 75 years does not appear to be associated with cardiovascular disease (CVD) disease or mortality, whereas CSA might be a pathological marker of CVD and impaired systolic function associated with higher mortality.
PubMed ID
22440587 View in PubMed
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Comparison of predictors of hip fracture and mortality after hip fracture in community-dwellers with and without Alzheimer's disease - exposure-matched cohort study.

https://arctichealth.org/en/permalink/ahliterature283663
Source
BMC Geriatr. 2016 Dec 01;16(1):204
Publication Type
Article
Date
Dec-01-2016
Author
Anna-Maija Tolppanen
Heidi Taipale
Antti Tanskanen
Jari Tiihonen
Sirpa Hartikainen
Source
BMC Geriatr. 2016 Dec 01;16(1):204
Date
Dec-01-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - epidemiology
Causality
Cohort Studies
Comorbidity
Demography
Female
Finland - epidemiology
Hip Fractures - epidemiology - mortality
Humans
Incidence
Independent Living - statistics & numerical data
Male
Proportional Hazards Models
Risk factors
Socioeconomic Factors
Abstract
Dementia, with Alzheimer's disease (AD) being the most common form, is a major hip fracture risk factor, but currently it is not known whether the same factors predict hip fracture among persons with and without dementia/AD. We compared the predictors of hip fracture and mortality after hip fracture in persons with and without AD.
An exposure-matched cohort of all community-dwellers of Finland who received a new clinically verified AD diagnosis in 2005-2011 and had no history of previous hip fracture (N = 67,072) and an age, sex, and region-matched cohort of persons without AD (N = 67,072). Associations between sociodemographic characteristics, comorbidities and medications and risk of hip fracture and mortality after hip fracture were assessed with Cox regression.
As expected, the incidence of hip fractures in 2005-2012 (2.19/100 person-years vs 0.90/100 person-years in the non-AD cohort), as well as mortality after hip fracture (29/100 person-years vs 23/100 person-years in the non-AD cohort) were higher in the AD cohort. This difference was evident regardless of the risk factors. Mental and behavioural disorders (adjusted hazard ratio; HR 95% confidence interval CI: 1.16, 1.09-1.24 and 1.71, 1.52-1.92 in the AD and non-AD-cohorts), antipsychotics (1.12, 1.04-1.20 and 1.56, 1.38-1.76 for AD and non-AD-cohorts) and antidepressants (1.06, 1.00-1.12 and 1.34 1.22-1.47 for AD and non-AD-cohorts) were related to higher, and estrogen/combination hormone therapy (0.87, 0.77-0.9 and 0.79, 0.64-0.98 for AD and non-AD-cohorts) to lower hip fracture risk in both cohorts. Stroke (1.42, 1.26-1.62), diabetes (1.13, 0.99-1.28), active cancer treatment (1.67, 1.22-2.30), proton pump inhibitors (1.14, 1.05-1.25), antiepileptics (1.27, 1.11-1.46) and opioids (1.10, 1.01-1.19) were associated with higher hip fracture risk in the non-AD cohort. Similarly, the associations between mortality risk factors (age, sex, several comorbidities and medications) were stronger in the non-AD cohort.
AD itself appears to be such a significant risk factor for hip fracture, and mortality after hip fracture, that it overrules or diminishes the effect of other risk factors. Thus, it is important to develop and implement preventive interventions that are suitable and effective in this population.
Notes
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PubMed ID
27908278 View in PubMed
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Dementia and road traffic accidents among non-institutionalized older people in Denmark: A Danish register-based nested case-control study.

https://arctichealth.org/en/permalink/ahliterature299164
Source
Scand J Public Health. 2019 Mar; 47(2):221-228
Publication Type
Journal Article
Date
Mar-2019
Author
Jindong Ding Petersen
Volkert Dirk Siersma
René Depont Christensen
Maria Munch Storsveen
Connie Thurøe Nielsen
Mikkel Vass
Frans Boch Waldorff
Author Affiliation
1 Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Source
Scand J Public Health. 2019 Mar; 47(2):221-228
Date
Mar-2019
Language
English
Publication Type
Journal Article
Keywords
Accidents, Traffic - statistics & numerical data
Aged
Aged, 80 and over
Case-Control Studies
Comorbidity
Dementia - drug therapy - epidemiology
Denmark - epidemiology
Female
Humans
Hypnotics and Sedatives - therapeutic use
Independent living
Male
Registries
Risk factors
Abstract
We used register-based data to estimate the effect of all-type dementia on road traffic accidents (RTAs) risk, combined with comorbidities or sedative medicines, among non-institutionalized older people in Denmark.
The source population was all residents in Denmark aged 65 years and older, alive as of January 1, 2008 ( n = 853,228). Cases were those who had any type of RTA in 2009-2014. Each case was matched for age, sex and geographic location to 4-6 controls. All-type dementia was ascertained using the International Classification of Diseases version 10 (ICD-10) diagnosis supplemented with prescribed medicine records. Eight chronic diseases were selected to assess comorbidities. Four types of medicines were categorized as sedative medicines for analysis. Conditional logistic regression with adjustment for education and marital status as well as either the number of comorbidities or sedative medications use was performed using STATA software.
Older people with dementia had lower RTAs risk compared to their controls (odds ratio = 0.43, 95% confidence interval (0.32-0.60), p
PubMed ID
29914317 View in PubMed
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Effect of Chronic Diseases and Multimorbidity on Survival and Functioning in Elderly Adults.

https://arctichealth.org/en/permalink/ahliterature286615
Source
J Am Geriatr Soc. 2017 May;65(5):1056-1060
Publication Type
Article
Date
May-2017
Author
Debora Rizzuto
René J F Melis
Sara Angleman
Chengxuan Qiu
Alessandra Marengoni
Source
J Am Geriatr Soc. 2017 May;65(5):1056-1060
Date
May-2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Chronic Disease - epidemiology
Cohort Studies
Comorbidity
Female
Geriatric Assessment - methods
Humans
Independent living
Longitudinal Studies
Male
Mortality
Prevalence
Sweden - epidemiology
Abstract
To determine the effect of chronic disorders and their co-occurrence on survival and functioning in community-dwelling older adults.
Population-based cohort study.
Kungsholmen, Stockholm, Sweden.
Individuals aged 78 and older examined by physicians four times over 11 years (N = 1,099).
Chronic diseases (grouped according to 10 organ systems according to the International Classification of Diseases, Tenth Revision, code) and multimorbidity (=2 coexisting chronic diseases) were evaluated in terms of mortality, population attributable risk of death, median years of life lost, and median survival time with and without disability (need of assistance in =1 activities of daily living).
Approximately one in four deaths were attributable to cardiovascular and one in six to neuropsychiatric diseases. Malignancy was the condition with the shortest survival time (2.5 years). Malignancies and cardiovascular disorders each accounted for approximately 5 years of life lost. In contrast, neurosensorial and neuropsychiatric conditions had the longest median survival time (>6 years), and affected people were disabled for more than half of this time. The most-prevalent and -burdensome condition was multimorbidity, affecting 70.4% of the population, accounting for 69.3% of total deaths, and causing 7.5 years of life lost. Finally, people with multimorbidity lived 81% of their remaining years of life with disability (median 5.2 years).
Survival in older adults differs in length and quality depending on specific conditions. The greatest negative effect at the individual (shorter life, greater dependence) and societal (number of attributable deaths, years spent with disability) level was from multimorbidity, which has made multimorbidity a clinical and public health priority.
PubMed ID
28306158 View in PubMed
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Frequent pain in older people with and without diabetes - Finnish community based study.

https://arctichealth.org/en/permalink/ahliterature294408
Source
BMC Geriatr. 2018 03 15; 18(1):73
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
03-15-2018
Author
M Karjalainen
J Saltevo
M Tiihonen
M Haanpää
H Kautiainen
P Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Kuopio, Finland.
Source
BMC Geriatr. 2018 03 15; 18(1):73
Date
03-15-2018
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Comorbidity
Cross-Sectional Studies
Depression - diagnosis - epidemiology - psychology
Diabetes Mellitus - diagnosis - epidemiology - psychology
Female
Finland - epidemiology
Humans
Independent Living - psychology
Male
Pain - diagnosis - epidemiology - psychology
Pain Measurement - methods - psychology
Primary Health Care - methods
Surveys and Questionnaires
Abstract
The association between pain and diabetes in older people has been largely unexplored. The aim of this survey was to analyze the prevalence and characteristics of pain among Finnish men and women 65 or older with and without diabetes in primary care.
All home-dwelling persons 65 years or older with diabetes (N?=?527) and age and gender matched controls (N?=?890) were identified from electronic patient records. Frequent pain was regarded as any pain experienced more often than once a week, and it was divided into pain experienced several times a week but not daily and pain experienced daily or continuously. The Numeric Rating Scale (0-10) (NRS) was used to assess the intensity and interference of the pain.
The number of subjects who returned the questionnaire was 1084 (76.5%). The prevalence of frequent pain in the preceding week was 50% among women without diabetes and 63% among women with diabetes (adjusted, p?=?0.22). In men, the corresponding proportions were 42% without diabetes and 47% with diabetes (adjusted, p?=?0.58). In both genders, depressive symptoms and the number of comorbidities were associated with pain experienced more often than once a week and with daily pain. Diabetes was not associated with pain intensity or pain interference in either women or men.
Pain in older adults is associated with depressive symptoms and the number of comorbidities more than with diabetes itself.
Notes
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PubMed ID
29544464 View in PubMed
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Impact of seizures on morbidity and mortality after stroke: a Canadian multi-centre cohort study.

https://arctichealth.org/en/permalink/ahliterature149085
Source
Eur J Neurol. 2010 Jan;17(1):52-8
Publication Type
Article
Date
Jan-2010
Author
J G Burneo
J. Fang
G. Saposnik
Author Affiliation
Epilepsy Programme, Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada. jburneo2@uwo.ca
Source
Eur J Neurol. 2010 Jan;17(1):52-8
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Canada - epidemiology
Cohort Studies
Comorbidity
Disability Evaluation
Female
Humans
Independent Living - statistics & numerical data
Length of Stay
Male
Mortality
Outcome Assessment (Health Care)
Quality of Life
Seizures - diagnosis - mortality - therapy
Severity of Illness Index
Stroke - diagnosis - mortality - therapy
Abstract
Limited information is available about the impact of seizures on stroke outcome, health care delivery and resource utilization.
To determine whether the presence of seizures after stroke increases disability, mortality and health care utilization (length of hospital stay, ICU admission, consults, discharge to a long-term care facility).
This cohort study included consecutive patients with acute stroke between July 2003 and June 2005 from the Registry of the Canadian Stroke Network (RCSN), the largest clinical database of patients in Canada with acute stroke seen at selected acute care hospitals. We compared clinical characteristics and outcomes amongst patients experiencing stroke without and with seizures occurring during inpatient stay. Main outcome measures included: case-fatality, disability at discharge, length-of-stay, and discharge disposition. A logistic regression analysis was used to determine whether the presence of seizures was associated with poor stroke outcomes.
Amongst 5027 patients included in the study; seizures occurred in 138 (2.7%) patients with stroke. Patients with seizures had a higher mortality at 30-day (36.2% vs. 16.8%, P
PubMed ID
19686350 View in PubMed
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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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Long-term use of benzodiazepines and related drugs among community-dwelling individuals with and without Alzheimer's disease.

https://arctichealth.org/en/permalink/ahliterature270647
Source
Int Clin Psychopharmacol. 2015 Jul;30(4):202-8
Publication Type
Article
Date
Jul-2015
Author
Heidi Taipale
Marjaana Koponen
Antti Tanskanen
Anna-Maija Tolppanen
Jari Tiihonen
Sirpa Hartikainen
Source
Int Clin Psychopharmacol. 2015 Jul;30(4):202-8
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis - epidemiology - psychology
Benzodiazepines - administration & dosage - adverse effects
Case-Control Studies
Cognition - drug effects
Comorbidity
Drug Administration Schedule
Drug Prescriptions
Drug Utilization Review
Female
Finland - epidemiology
Humans
Inappropriate Prescribing
Independent living
Male
Practice Patterns, Physicians'
Prevalence
Registries
Risk assessment
Risk factors
Sex Factors
Time Factors
Treatment Outcome
Abstract
The aim of this study was to investigate the prevalence of benzodiazepine and related drug (BZDR) use, especially long-term use, and associated factors among community-dwelling individuals with and without Alzheimer's disease (AD). We utilized data from the MEDALZ-2005 cohort, which includes all community-dwelling individuals diagnosed with AD in Finland at the end of 2005 and matched comparison individuals without AD. Register-based data included prescription drug purchases, comorbidities, and hospital discharge diagnoses. In this study, 24,966 individuals with AD and 24,985 individuals without AD were included. During the 4-year follow-up, we found that 45% (N = 11,312) of individuals with AD and 38% (N = 9534) of individuals without AD used BZDRs. The prevalence of long-term (= 180 days) BZDR use was more common among individuals with AD (30%) than individuals without AD (26%). The median durations of the first long-term use periods of BZDRs were 1.5 and 2 years for individuals with and without AD, respectively. Factors associated with long-term BZDR use included female sex, AD, schizophrenia, bipolar disorder, depression, coronary artery disease, and asthma/chronic obstructive pulmonary disease. The high prevalence of long-term BZDR use among individuals with AD is especially a cause for concern because long-term use may further impair cognition and may be associated with serious adverse events.
PubMed ID
26011780 View in PubMed
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