To improve health care for older persons, we need to learn more about ageing, e.g. identify protective factors and early markers for diseases. The Gothenburg H70 Birth Cohort Studies (the H70 studies) are multidisciplinary epidemiological studies examining representative birth cohorts of older populations in Gothenburg, Sweden. So far, six birth cohorts of 70-year-olds have been examined over time, and examinations have been virtually identical between studies. This paper describes the study procedures for the baseline examination of the Birth cohort 1944, conducted in 2014–16. In this study, all men and women born 1944 on specific dates, and registered as residents in Gothenburg, were eligible for participation (n = 1839). A total of 1203 (response rate 72.2%; 559 men and 644 women; mean age 70.5 years) agreed to participate in the study. The study comprised sampling of blood and cerebrospinal fluid, psychiatric, cognitive, and physical health examinations, examinations of genetics and family history, use of medications, social factors, functional ability and disability, physical fitness and activity, body composition, lung function, audiological and ophthalmological examinations, diet, brain imaging, as well as a close informant interview, and qualitative studies. As in previous examinations, data collection serves as a basis for future longitudinal follow-up examinations. The research gained from the H70 studies has clinical relevance in relation to prevention, early diagnosis, clinical course, experience of illness, understanding pathogenesis and prognosis. Results will increase our understanding of ageing and inform service development, which may lead to enhanced quality of care for older persons. Electronic supplementary material The online version of this article (10.1007/s10654-018-0459-8) contains supplementary material, which is available to authorized users.
Objective: This study examines whether overweight in midlife increases dementia risk later in life. Methods: In 1963 body mass index was assessed in 1152 participants of The Swedish Twin Registry, at the age of 45-65 years. These participants were later screened for dementia in a prospective study with up to 40 years follow-up. A total of 312 participants were diagnosed with dementia. Results: Logistic regression analyses adjusted for demographic factors, smoking and alcohol habits, indicated that men and women categorized as overweight in their midlife had an elevated risk of dementia (OR ¼ 1.59; 95% CI: 1.21-2.07, P ¼ 0.002), Alzheimer's disease (OR ¼ 1.71; 95% CI: 1.24-2.35, P ¼ 0.003), and vascular dementia (OR ¼ 1.55; 95% CI: 0.98-2.47, P ¼ 0.059). Further adjustments for diabetes and vascular diseases did not substantially affect the associations, except for vascular dementia (OR ¼ 1.36; 95% CI: 0.82-2.56, P ¼ 0.116), reflecting the significance of diabetes and vascular diseases in the etiology of vascular dementia. There was no significant interaction between overweight and APOE e4 status, indicating that having both risk factors does not have a multiplicative effect with regard to dementia risk. Conclusions: This study gives further support to the notion that overweight in midlife increases later risk of dementia. The risk is increased for both Alzheimer's disease and vascular dementia, and follows the same pattern for men and women.
There is substantial acceleration in cognitive decline many years prior to death among individuals without dementia. Time of onset and rate of terminal decline vary considerably across cognitive abilities.
A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.
From an aging research and life-course perspective, the transition to retirement marks a significant life-event and provides a unique opportunity to study psychological health and coping during a period of substantial change in everyday life. The aim of the present paper is to: (a) outline the rationale of the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) study, (b) describe the study sample, and (c) to present some initial results from the two first waves regarding the association between retirement status and psychological health. The HEARTS study is designed to annually study psychological health in the years before and following retirement, and to examine change and stability patterns related to the retirement event. Among a representative Swedish population-based sample of 14,990 individuals aged 60–66 years, 5,913 completed the baseline questionnaire in 2015. The majority of the participants (69%) completed a web-based survey, and the rest (31%) completed a paper version. The baseline HEARTS sample represents the general population well in terms of gender and age, but is more highly educated. Cross-sectional findings from the first wave showed that retired individuals demonstrated better psychological health compared to those who were still working. Longitudinal results from the first and second waves showed that individuals who retired between waves showed more positive changes in psychological health compared with those still working or previously retired.
Later-born cohorts of older adults tend to outperform earlier born on fluid cognition (i.e., Flynn effect) when measured at the same chronological ages. We investigated cohort differences in level of performance and rate of change across three population-based samples born in 1901, 1906, and 1930, drawn from the Gerontological and Geriatric Population Studies in Gothenburg, Sweden (H70), and measured on tests of logical reasoning and spatial ability at ages 70, 75, and 79 years. Estimates from multiple-group latent growth curve models (LGCM) revealed, in line with previous studies, substantial differences in level of performance where later-born cohorts outperformed earlier born cohorts. Somewhat surprisingly, later-born cohorts showed, on average, a steeper decline than the earlier-born cohort. Gender and education only partially accounted for observed cohort trends. Men outperformed women in the 1906 and 1930 cohorts but no difference was found in the 1901 cohort. More years of education was associated with improved performance in all three cohorts. Our findings confirm the presence of birth cohort effects also in old age but indicate a faster rate of decline in later-born samples. Potential explanations for these findings are discussed.
This study investigates life satisfaction in relation to impending death among the oldest-old using overall disease load, self-rated health, and personality as interacting covariates of level and change. We used data from a sample of 370 healthy individuals who completed the Life Satisfaction Index-Z at four measurement occasions during a 6-year period in the Swedish OCTO-Twin study of individuals aged 80 and older. Growth curve analyses showed a linear decrease in life satisfaction as individuals approached death. The decrease was not related to level or change in self-rated health and disease load. High disease load was, however, related to lower levels of life satisfaction, but, this association was moderated by locus of control, such that those with high disease load and high locus of control did not show lower life satisfaction. Poor self-rated health was also associated with lower life satisfaction, but, this association was moderated by neuroticism, such that those with poorrated health and low neuroticism did not show lower live satisfaction. Personality factors such as locus of control and neuroticism can influence the association between health and life satisfaction. The findings suggest further investigations of the role of personality characteristics in late life satisfaction and whether interventions aimed to increase personal control can improve life satisfaction in old age.The notion of lifelong stability of life satisfaction produced by a set-point equilibrium mechanism has been questioned in recent longitudinal studies of life satisfaction in the oldest-old. In a previous study we found a linear and largely homogenous decrease in life satisfaction across four measurement occasions during a 6-year period in individuals aged 80-98 (Berg et al.
These findings provide strong evidence for substantial birth cohort effects in cognition in older ages and emphasize the importance of life long environmental factors in shaping cognitive aging trajectories. Inferences from cognitive testing, and standardization of test scores, in elderly populations must take into account the substantial birth cohort differences.
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