A Population-Based Study of Dementia in 85-Year-Olds

Skoog, Ingmar; Nilsson, Lars; Palmertz, Bo; Andreasson, Lars-Arne; Svanborg, Alvar

doi:10.1056/nejm199301213280301

Cited by 641 publications

(465 citation statements)

References 32 publications

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“…Ratings of common signs and symptoms of dementia were also carried out (eg, assessments of memory, orientation, general knowledge, apraxia, visuospatial function, understanding proverbs, following commands, naming ability, and language) and have been described in detail (Guo et al, 2007;Skoog et al, 1993). Cognitive function was also measured with the MMSE (Folstein et al, 1975).…”

Section: Neuropsychiatric Examinations and Interviewsmentioning

confidence: 99%

“…Dementia was diagnosed by geriatric psychiatrists according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition, revised (American Psychiatric Association, 1987) on the basis of symptoms rated by the examiners during detailed neuropsychiatric examinations and close informant interviews, as described (Skoog et al, 1993). Diagnoses of major and minor depression according to DSM-IV (American Psychiatric Association, 1994) were determined from algorithms based on symptoms rated by the examiners during the psychiatric examinations.…”

Section: Diagnosis Of Dementia and Depressionmentioning

confidence: 99%

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Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression over 5 years in the Elderly

Olesen

Gustafson

Simoni

et al. 2010

Neuropsychopharmacol

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The influence of organic brain changes on the development of depression in the elderly is uncertain. Cross-sectional studies, most often from clinical samples, report associations with brain atrophy and cerebrovascular disease, while longitudinal population studies have given mixed results. Our aim was to investigate whether cortical atrophy and white matter lesions (WMLs) on computed tomography (CT) predict occurrence of depression in the elderly. This is a prospective population-based study with 5-year follow-up. The baseline sample included 525 elderly subjects, aged 70-86 years, without dementia or major depression, with a score on the Mini-Mental State Examination above 25, and without dementia at follow-up. Cortical atrophy and WMLs were evaluated at baseline using CT. The main outcome measure was development of major or minor depression at follow-up according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition, as evaluated using neuropsychiatric examinations and hospital discharge registers. Logistic regression was used to estimate risk. Over the period of 5 years, 20 individuals developed major and 63 minor depression. Presence of temporal lobe atrophy (odds ratio (OR) ¼ 2.81, 95% confidence interval (CI) 1.04-7.62) and moderate-to-severe WMLs (OR ¼ 3.21, 95% CI 1.00-10.26) independently predicted major, but not minor, depression after controlling for various confounders. Other brain changes did not predict occurrence of depression. Our findings suggest that temporal lobe atrophy and WMLs represent relatively independent and complementary pathways to major depression in the elderly. This may have implications for prevention, as both neurodegeneration and cerebrovascular disease have been related to preventable factors.

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Section: Neuropsychiatric Examinations and Interviewsmentioning

confidence: 99%

Section: Diagnosis Of Dementia and Depressionmentioning

confidence: 99%

Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression over 5 years in the Elderly

Olesen

Gustafson

Simoni

et al. 2010

Neuropsychopharmacol

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“…Second, although weights and volumes of thousands of brains have been recorded over the years, the number of very elderly brains examined has been relatively low until recently [2,3]. Third, it is known that diseases that cause a reduction in brain weight and volume, particularly Alzheimer's disease (AD), increase in prevalence exponentially with age [4] and many studies of brain weight and volume in old age have not taken steps to exclude brains with the pathology of this disease from their studies. Fourth, it is only recently, with the advent of non-invasive brain imaging, that longitudinal measures on the same brains over time have been possible and studies of this type have followed changes over relatively short periods of time [5].…”

Section: Ageing Of the Human Brainmentioning

confidence: 99%

Ageing and the brain

2007

The Journal of Pathology

175

118

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In this review, the evidence for changes in the human brain with ageing at both the macroscopic and microscopic levels is summarized. Loss of neurons is now recognized to be more modest than initial studies suggested and only affects some neuron populations. Accompanying loss of neurons is some reduction in the size of remaining neurons. This reflects a reduced size of dendritic and axonal arborizations. Some of the likely causes of these changes, including free radical damage resulting from a high rate of oxidative metabolism in neurons, glycation and dysregulation of intracellular calcium homeostasis, are discussed. The roles of genes and environmental factors in causing and responding to ageing changes are explored.

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“…For additional details on the sampling strategy, see Skoog et al 1619 Our study sample consists of those who did not meet criteria for dementia out a larger sample of 494. The majority of the sample was female (70.3%).…”

Section: Methodsmentioning

confidence: 99%

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

Orden

Simning

Conwell

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective To determine whether death ideation in late life is associated with markers of elevated risk for suicide, or reflects normal psychological processes in later life. Design/Setting Population based cross sectional study in Gothenburg, Sweden. Participants The sample consists of 345 men and women aged 85 (born 1901-02) and living in Gothenburg, Sweden. Main Outcome Measures The Paykel Scale measured the most severe level of suicidality over an individual’s lifetime. Other key measures were severity of depression and anxiety and frequency of death/suicidal ideation over the previous month. Results Latent class analysis revealed distinct groups of older adults who reported recent death ideation. Recent death ideation did not occur apart from other risk factors for suicide; instead individuals reporting recent death ideation also reported either 1) recent high levels of depression and anxiety, or 2) more distant histories of serious suicidal ideation (indicative of worst point severity of suicidal ideation)—both of which elevate risk for eventual suicide. Conclusions Our results indicate a heterogeneous presentation of older adults who report death ideation, with some presenting with acute distress and suicidal thoughts, and others presenting with low distress but histories of serious suicidal ideation. The presence of death ideation is associated with markers of increased risk for suicide, including “worst point” active suicidal ideation.

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A Population-Based Study of Dementia in 85-Year-Olds

Abstract: Dementia was present in nearly a third of unselected 85-year-olds in Sweden. Almost half these subjects appeared to have vascular dementia, which may currently be more amenable to prevention or treatment than Alzheimer's disease.

Cited by 641 publications

References 32 publications

Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression over 5 years in the Elderly

Temporal Lobe Atrophy and White Matter Lesions are Related to Major Depression over 5 years in the Elderly

Ageing and the brain

Characteristics and Comorbid Symptoms of Older Adults Reporting Death Ideation

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