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Journal of the American Geriatrics Society 05/2008; 56(4):771-2. · 3.74 Impact Factor
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ABSTRACT: To investigate the association between blood pressure and mortality in people aged 85 and older.
Population-based prospective study with 9-year follow-up.
Department of Neuroscience and Neurology and Department of Public Health and General Practice, University of Kuopio, and Department of Clinical Neurosciences, Helsinki University Hospital.
Of all 601 people living in the city of Vantaa born before April 1, 1906, whether living at home or in institutions and alive on April 1, 1991, 521 were clinically examined and underwent blood pressure measurement.
Blood pressure was measured using a standardized method in the right arm of the subject after resting for at least 5 minutes. Information on medical history for each participant was verified from a computerized database containing all primary care health records. Death certificates were obtained from the National Register; the collection of death certificates was complete.
After adjusting for age, sex, functional status, and coexisting diseases (earlier-diagnosed myocardial infarction, congestive heart failure, dementia, cancer, stroke, or hypertension), low systolic blood pressure (BP) was associated with risk of death.
Low systolic BP may be partially related to poor general health and poor vitality, but the very old may represent a select group of individuals, and the use of BP-lowering medications needs to be evaluated in this group.
Journal of the American Geriatrics Society 07/2006; 54(6):912-8. · 3.74 Impact Factor
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ABSTRACT: To evaluate the effect of medical record use on figures for the incidence of dementia and the effect of apolipoprotein E (APOE) polymorphism on this incidence and neuropathologically defined Alzheimer's disease (AD) in very elderly individuals.
Cognitive functions were examined in a cohort of 328 (92% of the very elderly people of a town participated in this study) nondemented Finnish elderly individuals 85 years of age or more in 1991. The examination was repeated in survivors in 1994, 1996, 1999 and 2001. Medical notes and social work records were evaluated. All these individuals were genotyped for APOE. Neuropathological analysis of AD-type pathology was performed on 159 of 303 subjects who died during the follow-up.
Age group, gender or APOE did not significantly affect the incidence of dementia, which was over 20% higher (85 vs. 69 per 1,000 person-years) if the cognitive status at death was ascertained by medical and social work records than without this evaluation. The APOE upsilon4 allele was highly significantly (p=0.002) and age almost significantly (p=0.06) associated with neuropathological AD in nondemented individuals.
Medical records should be analyzed in studies on the incidence of dementia in very elderly individuals. APOE polymorphism does not affect the incidence of dementia in this age group. However, clinical dementia diagnosis in very elderly individuals does not necessarily correlate well with the presence of neuropathological AD which, even in this age group, is significantly associated with the APOE upsilon4 allele.
Neuroepidemiology 02/2006; 26(2):76-82. · 2.31 Impact Factor
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Journal of the American Geriatrics Society 05/2003; 51(4):576-7. · 3.74 Impact Factor
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ABSTRACT: To investigate what kind of changes spouse caregivers of demented patients experience after the onset of dementia (a) in the general atmosphere, happiness, and relations of marriage and (b) in the sexual side of marriage.
Semistructured telephone interviews of spouse caregivers of demented patients.
Community-living demented patients and their spouse caregivers in eastern Finland.
The spouse caregivers of 42 demented patients recruited from a previous intervention study. Measures: The questionnaire covered different areas of marriage from the time before and after the onset of dementia.
A statistically significant decline had occurred in extent of happiness (p = .012), in equal relations (p = .001), and in patients' expressions of sexual needs (p < .001) when compared the time before and after dementia. Twenty-five (60%) of the caregivers reported that the demented patient had shown at least one negative sexual behavioral change during the course of dementia. Seven male patients (24%) had shown the behavioral symptom of constantly expressing need for making love. One in 10 caregivers had experienced positive sexual behavioral changes. In one third of the patients, the expressions of tenderness towards the caregiver had increased. Dementia did not affect significantly the general atmosphere of the marriage. Out of those still in home care, at 3 years from the onset of dementia, 19 couples (46%) continued to practice intercourse, at 5 years the number was 15 couples (41%), and at 7 years it had declined to 7 couples (28%).
Dementing illness has a major negative impact on many dimensions of marriage. However, there are also positive changes and preserved aspects of marriage. Dementia seems to have a surprisingly little impact on whether the couple continues to have intercourse when compared with the general aging population.
International Psychogeriatrics 03/2002; 14(1):47-58. · 2.24 Impact Factor
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ABSTRACT: Objectives: To investigate what kind of changes spouse caregivers of demented patients experience after the onset of dementia (a) in the general atmosphere, happiness, and relations of marriage and (b) in the sexual side of marriage. Design: Semistructured telephone interviews of spouse caregivers of demented patients. Setting: Community-living demented patients and their spouse caregivers in eastern Finland. Participants: The spouse caregivers of 42 demented patients recruited from a previous intervention study. Measures: The questionnaire covered different areas of marriage from the time before and after the onset of dementia. Results: A statistically significant decline had occured in extent of happiness (p = .012), in equal relations (p = .001), and in patients' expressions of sexual needs (p < .001) when compared the time before and after dementia. Twenty-five (60%) of the caregivers reported that the demented patient had shown at least one negative sexual behavioral change during the course of dementia. Seven male patients (24%) had shown the behavioral symptom of constantly expressing need for making love. One in 10 caregivers had experienced positive sexual behavioral changes. In one third of the patients, the expressions of tenderness towards the caregiver had increased. Dementia did not affect significantly the general atmosphere of the marriage. Out of those still in home care, at 3 years from the onset of dementia, 19 couples (46%) continued to practice intercourse, at 5 years the number was 15 couples (41%), and at 7 years it had declined to 7 couples (28%). Conclusions: Dementing illness has a major negative impact on many dimensions of marriage. However, there are also positive changes and preserved aspects of marriage. Dementia seems to have a surprisingly little impact on whether the couple continues to have intercourse when compared with the general aging population.
International Psychogeriatrics 02/2002; 14(01):47 - 58. · 2.24 Impact Factor
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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 [varepsilon]4 carriers (with the reference population of people with the genotype [varepsilon]3/[varepsilon]3) for dementia was 2.36 (95% CI 1.58–3.58). 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 [varepsilon]4 carriers (15.0 ± 10.0) and noncarriers (18.7 ± 8.6) (p < .001) differed among the whole population, but not within the demented or nondemented subjects analyzed separately. This study does not support the hypothesis that the Apo-E [varepsilon]4 allele impairs cognitive functions of nondemented elderly, at least in those surviving to very old age.
International Psychogeriatrics 08/2000; 12(03):379 - 387. · 2.24 Impact Factor
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ABSTRACT: The independent predictive roles of early losses, personality traits, acute losses and long-term stress situations for the occurrence of depression in elderly Finns were described using a longitudinal design. The persons non-depressed in an epidemiological study in 1984–85 were interviewed in 1989–90 (N=679) and the occurrence of depression was determined according to DSM III-criteria. Logistic regression models were used to assess the independent roles of the hypothesized factors as predictors. An early loss of the mother among men and an early loss of the father among women independently predicted the occurrence of depression in logistic regression models. Older age in men, and a higher number of symptoms, the occurrence of previous depression and not living alone in women were also independent predictors. In men, impaired functional abilities and poor self-perceived health tended to predict depression. In conclusion, the psychological trauma which develops upon the experience of an early parental loss contributes to the development of depression even in old age. The role of stressors in life as independent predictors of depression in old age was also ascertained. © 1998 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry 07/1998; 13(8):527 - 530. · 2.42 Impact Factor
