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Håkansson, K. (2018). Cons and Pros of Epidemiological Versus Experimental Approaches to Answer Questions About Risk and Protective Factors for Alzheimer’s Disease: A Personal Journey. In: SAGE Research Methods Cases: (pp. 1-17). London: Sage Publications
Open this publication in new window or tab >>Cons and Pros of Epidemiological Versus Experimental Approaches to Answer Questions About Risk and Protective Factors for Alzheimer’s Disease: A Personal Journey
2018 (English)In: SAGE Research Methods Cases, London: Sage Publications, 2018, p. 1-17Chapter in book (Refereed)
Abstract [en]

This text is a personal account of the research process that led to a dissertation about the long-term relevance of social and emotional factors for cognitive health. It describes how research ideas and methodological concerns developed out of the first results where people who had lived alone, especially after being widowed already in midlife, had a high risk increase for Alzheimer’s disease over two decades later. A second study investigated the associations between feelings of hopelessness in midlife and cognitive health in later life. Both of these studies used an epidemiological association approach with logistic regression as the main statistical method, including adjustments for several relevant variables. To address the methodological concerns in the epidemiological association approach, primarily the risk of reverse causation and confounding variables, a subsequent study applied a randomized control experimental design. In this study, the effects on brain-derived neurotrophic factor levels from different types of activities were measured in healthy elderly persons through a within-subject cross-over design. The case study illustrates the compromises that had to be made through this methodological shift in relation to the original research question—compromises in terms of real-life outcomes and exposures in exchange for experimental control and establishment of causality. The relative merits and limitations of three main approaches are finally summarized in light of these experiences: experimental studies on animals and on humans and epidemiological associations in humans. The examples are from research on dementia, but should be relevant for many other research questions.

Place, publisher, year, edition, pages
London: Sage Publications, 2018
Keywords
Methodology, Dementia, Alzheimer's disease
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Sciences, Psychology; Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-71726 (URN)10.4135/9781526430649 (DOI)9781526430649 (ISBN)
Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2018-03-29Bibliographically approved
Simon, S. S., Tusch, E. S., Feng, N. C., Håkansson, K., Mohammed, A. K. H. & Daffner, K. R. (2018). Is Computerized Working Memory Training Effective in Healthy Older Adults?: Evidence from a Multi-Site, Randomized Controlled Trial. Journal of Alzheimer's Disease, 65(3), 931-949
Open this publication in new window or tab >>Is Computerized Working Memory Training Effective in Healthy Older Adults?: Evidence from a Multi-Site, Randomized Controlled Trial
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2018 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 65, no 3, p. 931-949Article in journal (Refereed) Published
Abstract [en]

Background: Developing effective interventions to attenuate age-related cognitive decline and prevent or delay the onset of dementia are major public health goals. Computerized cognitive training (CCT) has been marketed increasingly to older adults, but its efficacy remains unclear. Working memory (WM), a key determinant of higher order cognitive abilities, is susceptible to age-related decline and a relevant target for CCT in elders. Objective: To evaluate the efficacy of CCT focused on WM compared to an active control condition in healthy older adults. Methods: Eighty-two cognitively normal adults from two sites (USA and Sweden) were randomly assigned to Cogmed Adaptive or Non-Adaptive (active control) CCT groups. Training was performed in participants' homes, five days per week over five weeks. Changes in the performance of the Cogmed trained tasks, and in five neuropsychological tests (Trail Making Test Part A and Part B, Digit Symbol, Controlled Oral Word Association Test and Semantic Fluency) were used as outcome measures. Results: The groups were comparable at baseline. The Adaptive group showed robust gains in the trained tasks, and there was a time-by-group interaction for the Digit Symbol test, with significant improvement only after Adaptive training. In addition, the magnitude of the intervention effect was similar at both sites. Conclusion: Home-based CCT Adaptive WM training appears more effective than Non-Adaptive training in older adults from different cultural backgrounds. We present evidence of improvement in trained tasks and on a demanding untrained task dependent upon WM and processing speed. The benefits over the active control group suggest that the Adaptive CCT gains were linked to providing a continuously challenging level of WM difficulty.

Place, publisher, year, edition, pages
IOS Press, 2018
Keywords
Aging, computerized cognitive training, randomized controlled trial, working memory
National Category
Psychology
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-78427 (URN)10.3233/JAD-180455 (DOI)000444339800018 ()30103334 (PubMedID)
Available from: 2018-10-22 Created: 2018-10-22 Last updated: 2018-10-22Bibliographically approved
Håkansson, K., Ngandu, T. & Kivipelto, M. (2018). The Patient with Cognitive Impairment. In: Hachinsky, Vladimir (Ed.), Treatable and Potentially Preventable Dementias: (pp. 52-80). New York: Cambridge University Press
Open this publication in new window or tab >>The Patient with Cognitive Impairment
2018 (English)In: Treatable and Potentially Preventable Dementias / [ed] Hachinsky, Vladimir, New York: Cambridge University Press, 2018, p. 52-80Chapter in book (Refereed)
Place, publisher, year, edition, pages
New York: Cambridge University Press, 2018
National Category
Geriatrics Gerontology, specialising in Medical and Health Sciences
Research subject
Social Sciences, Psychology; Medicine, Gerontology
Identifiers
urn:nbn:se:lnu:diva-76660 (URN)9781107157460 (ISBN)
Available from: 2018-07-04 Created: 2018-07-04 Last updated: 2019-02-22Bibliographically approved
Kivipelto, M. & Håkansson, K. (2017). A Rare Success against Alzheimer's. Scientific American, 316(4), 32-37
Open this publication in new window or tab >>A Rare Success against Alzheimer's
2017 (English)In: Scientific American, ISSN 0036-8733, E-ISSN 1946-7087, Vol. 316, no 4, p. 32-37Article in journal (Other academic) Published
Abstract [en]
  • Two hundred experimental drugs intended to treat Alzheimer's disease have failed in the past 30 years. Without new therapies, the number of patients worldwide will increase dramatically by 2050.
  • A ray of hope has come recently from a clinical trial that showed that dementia's cognitive impairment might be prevented by paying close attention to various health factors.
  • Participants in the study who followed a regimen of health-related steps registered improvements on cognitive measures such as memory and mental-processing speed.
  • Results of this research suffice for health care professionals to begin making a series of recommendations to patients on diet, exercise and levels of social engagement that may help prevent dementia.
Place, publisher, year, edition, pages
Nature Publishing Group, 2017
National Category
Geriatrics
Research subject
Natural Science, Medicine; Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-61665 (URN)10.1038/scientificamerican0417-32 (DOI)000399229700023 ()28296841 (PubMedID)
Available from: 2017-03-23 Created: 2017-03-23 Last updated: 2018-05-31Bibliographically approved
Håkansson, K., Ledreux, A., Daffner, K., Terjestam, Y., Bergman, P., Carlsson, R., . . . Mohammed, A. K. H. (2017). BDNF Responses in Healthy Older Persons to 35 Minutes of Physical Exercise, Cognitive Training, and Mindfulness: Associations with Working Memory Function. Journal of Alzheimer's Disease, 55(2), 645-657
Open this publication in new window or tab >>BDNF Responses in Healthy Older Persons to 35 Minutes of Physical Exercise, Cognitive Training, and Mindfulness: Associations with Working Memory Function
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2017 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 55, no 2, p. 645-657Article in journal (Refereed) Published
Abstract [en]

Brain-derived neurotrophic factor (BDNF) has a central role in brain plasticity by mediating changes in cortical thickness and synaptic density in response to physical activity and environmental enrichment. Previous studies suggest that physical exercise can augment BDNF levels, both in serum and the brain, but no other study has examined how different types of activities compare with physical exercise in their ability to affect BDNF levels. By using a balanced cross over experimental design, we exposed nineteen healthy older adults to 35-minute sessions of physical exercise, cognitive training, and mindfulness practice, and compared the resulting changes in mature BDNF levels between the three activities. We show that a single bout of physical exercise has significantly larger impact on serum BDNF levels than either cognitive training or mindfulness practice in the same persons. This is the first study on immediate BDNF effects of physical activity in older healthy humans and also the first study to demonstrate an association between serum BDNF responsivity to acute physical exercise and working memory function. We conclude that the BDNF increase we found after physical exercise more probably has a peripheral than a central origin, but that the association between post-intervention BDNF levels and cognitive function could have implications for BDNF responsivity in serum as a potential marker of cognitive health.

National Category
Psychology Neurosciences
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-59565 (URN)10.3233/JAD-160593 (DOI)000389695700018 ()27716670 (PubMedID)
Projects
SAGE
Funder
The Kamprad Family Foundation
Available from: 2017-01-02 Created: 2017-01-02 Last updated: 2018-01-13Bibliographically approved
Håkansson, K. (2016). The role of socio-emotional factors for cognitive health in later life. (Doctoral dissertation). Stockholm: Karolinska Institutet
Open this publication in new window or tab >>The role of socio-emotional factors for cognitive health in later life
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

With increasing life expectancies in most parts of the world, the prevalence of dementia and other age-related chronic diseases is growing. Several factors affect future projections and are discussed in this thesis, including possible limits to a continued growth of life expectancy. A related question is to what extent healthy ageing per se affects cognitive functions in old persons. Previous studies have generally exaggerated ageing effects on cognition, by applying study designs that did not account for common confounders, such as birth cohort differences, and the effects of terminal decline and subclinical dementia. In contrast to healthy ageing, dementia neuropathologies dramatically reduce cognitive performance, and proposed mechanisms behind dementia are briefly discussed with focus on Alzheimer’s disease (AD), on the role of genetic factors and on life course exposures. Three studies (study 1-3) investigated how cohabitant status and feelings of loneliness and hopelessness in midlife were associated with cognitive health in later life. Neurotrophic factors could potentially be involved in the biological mechanisms behind these and other associations between life-style factors and cognitive health. The fourth study aimed to explore how levels of brain-derived neurotrophic factor (BDNF), measured in serum, were affected by performing different activities; physical exercise, cognitive training, and mindfulness.

THE FOUR STUDIES

Study 1-3 were epidemiological association studies based on the Cardiovascular Risk Factor, Ageing and Dementia (CAIDE) Study, a population based cohort study on 1511 persons in eastern Finland, who at baseline were 50.4 years. Two re-examinations have been performed in the CAIDE Study, in 1998 when the participants were between 65 and 80 years, and between 2005-2008, averagely 25.3 years after the baseline examinations. The first two studies were based on the 1409 persons who fully participated in the first re-examination and the third study on the 1511 persons who participated in one or both re-examinations. In the first two studies logistic regression was the main statistical method with any cognitive impairment versus no cognitive impairment as outcome. In addition we performed analyses with mild cognitive impairment and Alzheimer’s disease as separate outcomes. In Study 1 and 2 we also analysed how apolipoprotein epsilon 4 (ApoE4) status affected the associations with Alzheimer’s disease. The statistical method in Study 3 was survival model analysis (Kaplan-Meyer and Cox regression) and the outcome variable was dementia, without subtyping. We compared the results from the analysis on the 1511 participants with the results when we used the total sample (by including register linked data on dementia diagnoses). We adjusted the associations for several potential confounding variables in all three studies.

In Study 4 we used 19 elderly healthy volunteers who were between 65 and 80 years (mean = 70.8 years). They performed three different activities during 35 minutes on separate occasions, i.e. a within-subject cross-over experimental design where we randomized the order of the three conditions between the participants. We sampled blood from a suitable

lower arm vein directly before and after each activity session and in addition at 20 and 60 minutes after the session had ended. After the serum had been analysed for BDNF levels, we used repeated measures ANOVA to calculate the differences in the effect of BDNF levels between the three conditions.

MAIN RESULTS

We found that living alone in midlife was associated with approximately a doubled risk of cognitive impairment during the re-examination. Among the non-cohabitants the risk increase was especially high for persons who were widowed in midlife and who had continued to live alone until the re-examination (odds ratio (OR) 7.67, 95% confidence interval (CI) 1.6 – 40.0). Feelings of loneliness were common both among cohabitants and non-cohabitants, but we found that such feelings were only associated with an increased dementia risk if these persons had also been living alone. Feelings of hopelessness in midlife, but not at follow-up, were associated with increased risk of cognitive impairment at the re-examination, especially of Alzheimer’s disease (OR 2.90, CI 1.4 – 5.9). When we adjusted the association from midlife also for depression and hopelessness at the re-examination, this association was still statistically significant. Participants with a diagnosis of cognitive impairment had higher feelings of hopelessness at the re-examination, compared to the cognitively healthy group, but this difference between the groups existed already when they were in midlife. When we stratified the participants with reference to ApoE4 status, we found that participants who were also ApoE4 carriers had a dramatically increased risk of Alzheimer’s disease compared to non-carriers without feelings of hopelessness, even after final adjustment for depression (OR 6.48, CI 2.4 –17.5). A similar stratification for ApoE4 status in Study 1 showed an even more dramatic increase in the association for persons who had lost their partner (widowed or divorced/separated) if they in addition were ApoE4 carriers.

In Study 4 we found that physical exercise, but not cognitive training or mindfulness, led to a statistically significant increase in BDNF levels of around 25%, compared to baseline. We also found that the individual differences in BDNF levels after the physical exercise correlated with working memory performance, measured on a separate occasion.

CONCLUSIONS

Social and emotional factors can have long-term consequences for cognitive health in later life. The long follow-up time in Study 1-3 suggests that the associations we found with dementia could reflect a causal, rather than a prodromal, relation. As other studies have found a range of adverse ill health consequences from both living alone and from depressive feelings, a possible mechanism behind the associations we found could be related to a systemic biological impact, and that the specific ill health outcome could be a result of individual vulnerability where genetic dispositions could play an important role. This conclusion seems consistent with the dramatic risk increases we found for AD when ApoE4

status was combined with the social factor of living alone and with the emotional dimension of hopelessness. At the micro level, as synaptic dysfunction and loss is characteristic of Alzheimer’s disease, and as BDNF has a central role for synaptogenesis, impaired BDNF functionality could play a role in the development of Alzheimer’s disease. More research is needed to further explore the role of BDNF in Alzheimer’s disease and if the disease can be prevented, or the disease process halted, by activities that stimulate BDNF expression in the brain.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2016. p. 78
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-59566 (URN)978-91-7676-449-7 (ISBN)
Public defence
2016-10-28, Petren, Karolinska Institutet, Nobels väg 12B, Karolinska Institutet, Solna, Solna, 14:15 (English)
Opponent
Supervisors
Available from: 2017-01-10 Created: 2017-01-02 Last updated: 2017-01-10Bibliographically approved
Håkansson, K., Soininen, H., Winblad, B. & Kivipelto, M. (2015). Feelings of Hopelessness in Midlife and Cognitive Health in Later Life: A Prospective Population-Based Cohort Study.. PLoS ONE, 10(10), 1-16, Article ID e0140261.
Open this publication in new window or tab >>Feelings of Hopelessness in Midlife and Cognitive Health in Later Life: A Prospective Population-Based Cohort Study.
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 10, p. 1-16, article id e0140261Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Several studies have found depression and depressive feelings to be associated with subsequent dementia. As dementias typically have a long preclinical development phase, it has been difficult to determine whether depression and depressive feelings reflect a concurrent underlying dementia disease, rather than playing a causative role. Our aim was to investigate hopelessness, one dimension of depressive feelings, and evaluate the likelihood of a prodromal versus a causative role of hopelessness feelings in dementia development.

METHODS: We invited a random sample of 2000 survivors from a representative population in Eastern Finland, originally investigated in midlife between 1972 and 1987, for re-examination an average of 21 years later. The age of the 1449 persons who accepted the invitation was between 39 and 64 years (mean 50.4 years) in midlife and between 65 and 80 (mean 71.3) at follow-up. To measure feelings of hopelessness in midlife and at follow-up, the participants indicated their level of agreement to two statements about their own possible future. We used logistic regression to investigate the association between the combined scores from these two items and cognitive health at follow-up, while adjusting for several health and life-style variables from midlife and for apolipoprotein E4 (ApoE4) status, depression and hopelessness feelings at follow-up. We compared the associations with late-life cognitive health when feelings of hopelessness were either measured in midlife or at the follow-up. In addition we analyzed the changes in hopelessness scores from midlife to follow-up in participants who were either cognitively healthy or impaired at follow-up.

RESULTS: We found higher levels of hopelessness in midlife, but not at follow-up, to be associated with cognitive impairment at follow-up; the adjusted odds ratio for each step of the five-level hopelessness scale was 1.30 (95% confidence interval 1.11-1.51) for any cognitive impairment and 1.37 (1.05-1.78) for Alzheimer's disease. These associations remained significant also after the final adjustments for depressive feelings and for hopelessness at follow-up. The individual changes in hopelessness scores between midlife and follow-up were not systematically related to cognitive health at the follow-up.

CONCLUSION: Our results suggest that feelings of hopelessness already in midlife may have long-term implications for cognitive health and increase the risk of Alzheimer's disease in later life.

National Category
Gerontology, specialising in Medical and Health Sciences
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-51884 (URN)10.1371/journal.pone.0140261 (DOI)26460971 (PubMedID)
Note

Correction published in:Håkansson K, Soininen H, Winblad B, Kivipelto M (2015) Correction: Feelings of Hopelessness in Midlife and Cognitive Health in Later Life: A Prospective Population-Based Cohort Study. PLoS ONE 10(11): e0142465. doi:10.1371/journal.pone.0142465

Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2018-01-10Bibliographically approved
Feng, L., Ng, X.-T., Yap, P., Li, J., Lee, T.-S., Håkansson, K., . . . Ng, T.-P. (2014). Marital Status and Cognitive Impairment among Community-Dwelling Chinese Older Adults: The Role of Gender and Social Engagement. Dementia and geriatric cognitive disorders extra, 4(3), 375-384, Article ID 25473404.
Open this publication in new window or tab >>Marital Status and Cognitive Impairment among Community-Dwelling Chinese Older Adults: The Role of Gender and Social Engagement
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2014 (English)In: Dementia and geriatric cognitive disorders extra, E-ISSN 1664-5464, Vol. 4, no 3, p. 375-384, article id 25473404Article in journal (Refereed) Published
Abstract [en]

Aims: To examine the association between marital status and cognitive impairment among community-dwelling Chinese older adults. Methods: We analyzed data from 2,498 Chinese aged 55 and older from the Singapore Longitudinal Aging Study cohort. Cognitive impair- ment was defined as a Mini-Mental State Examination total score of 23 or below. Odds ratios of associations were reported and adjusted for potential confounders in logistic regression models. Results: The prevalence of cognitive impairment was 12.2% (n = 306). Being single was associated with about 2.5 times increased odds of cognitive impairment compared to be- ing married (adjusted OR = 2.53, 95% CI: 1.41–4.55). The association between marital status and cognitive impairment was much stronger in men compared to that in women, and was indeed statistically significant only for men. Among the single and widowed persons social engagement was associated with a lower risk of cognitive impairment. Compared with sub- jects in the lowest tertile of social engagement scores, the odds of having cognitive impair- ment was lowered by 50% for subjects in the second and the third tertile. Conclusion: Being single or widowed was associated with higher odds of cognitive impairment compared to be- ing married in a cohort of older Chinese men but not women.

Place, publisher, year, edition, pages
Basel: S. Karger, 2014
Keywords
Cognitive impairment, Chinese older adults, Mini-Mental State Examination, Marital status, Social engagement

National Category
Gerontology, specialising in Medical and Health Sciences
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-44167 (URN)10.1159/000358584 (DOI)25473404 (PubMedID)
Available from: 2015-06-13 Created: 2015-06-13 Last updated: 2018-01-11Bibliographically approved
Sindi, S., Håkansson, K., Hagman, G., Kulmala, J., Soininen, H., Kareholt, I., . . . Kivipelto, M. (2014). Mid-life work-related stress increases dementia risk in late-life: The CAIDE 30-year study. Paper presented at Alzheimer's Association International Conference 2014. Alzheimer's & Dementia, 10(4, Supplement), P746
Open this publication in new window or tab >>Mid-life work-related stress increases dementia risk in late-life: The CAIDE 30-year study
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2014 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 10, no 4, Supplement, p. P746-Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: The associations between work-related stress and various health outcomes in mid-life are well documented, yet less is known about the effects on late-life cognitive process and dementia. The current study investigated the associations between work-related stress in mid-life and the development of cognitive impairment and Alzheimer’s disease in late-life. Methods: The data was derived from the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) study; a prospective cohort study. Participants were randomly selected from four independent population-based samples that completed cardiovascular surveys. First baseline examinations occurred when participants were 50 years old on average, in 1972, 1977, 1982, or 1987. A random sample of 2,000 individ- uals was selected for re-examinations (carried out in 1998 and 2005-2008), where 1,511 subjects participated in at least one re-examination. The re- examinations included an extensive neuropsychological and cognitive assessment. Follow-up time was on average 28 (S.E.M. 1⁄4 0.17) years. Work-related stress comprised the total score of two questions adminis- tered in mid-life. The questions asked participants to rate their stress related to meeting demands at work, and constant hurry at work. Groups were categorized so that those with high or medium levels of stress were compared to those with low levels or no work-related stress. Results: High levels of work-related stress in mid-life were associated with higher

risk of cognitive impairment (where participants with cognitive impair- ment and dementia were compared to the group with no cognitive impair- ment) [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.1-2.1], and Alzheimer’s disease [OR, 2.1; CI, 1.1-3.9], when assessed at the first or second follow-up. Results remained significant after adjusting for age, ed- ucation, marital status, chronic health conditions, apolipoprotein E ε 4 allele (APOE ε 4), measures of hopelessness and loneliness. Conclusions: High levels of mid-life work-related stress predict the risk of developing dementia in late-life. The evidence suggests that individuals experiencing high levels of work-related stress form an important at-risk population. Preventive interventions are needed for this population in order to post- pone or prevent the development of cognitive impairment and Alzheimer’s disease. 

National Category
Gerontology, specialising in Medical and Health Sciences
Research subject
Social Sciences, Psychology
Identifiers
urn:nbn:se:lnu:diva-51881 (URN)10.1016/j.jalz.2014.05.1408 (DOI)
Conference
Alzheimer's Association International Conference 2014
Available from: 2016-04-01 Created: 2016-04-01 Last updated: 2018-01-10Bibliographically approved
Kivipelto, M., Solomon, A., Ngandu, T., Håkansson, K. & Winblad, B. (2013). Fokus på tidig diagnos och förebyggande i Alzheimer forskning. Finska Läkaresällskapets Handlingar, 173(2), 11-19
Open this publication in new window or tab >>Fokus på tidig diagnos och förebyggande i Alzheimer forskning
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2013 (Swedish)In: Finska Läkaresällskapets Handlingar, ISSN 0015-2501, Vol. 173, no 2, p. 11-19Article, review/survey (Refereed) Published
Abstract [sv]

Alzheimers sjukdom identifieras traditionellt med demenssyndrom. De nya förslagen till diag- noskriterier öppnar ett nytt perspektiv där sjukdomen kan identifieras innan patienterna får demens. Tidig diagnos innebär bättre möjligheter till att hitta effektiva läkemedel och andra demensförebyggande interventioner. Epidemiologiska studier har visat att förutom hög ålder och genetiska faktorer finns det många påverkbara vaskulära, livsstilsrelaterade och psyko- sociala riskfaktorer för Alzheimers sjukdom. I Finland har steget redan tagits från observation till intervention, med fokus på stora multifaktoriella interventionsstudier där flera riskfaktorer och mekanismer påverkas samtidigt (t.ex. FINGER-studien). Tillsammans med två liknande studier i Frankrike och Nederländerna ingår FINGER i European Dementia Prevention Initiative. Resultaten av detta internationella samarbete kommer att leda fram till rekommendationer om en hälsosam livsstil för förebyggande av kognitiv svikt och demens hos äldre. Sådana rekommendationer behövs både för folkhälsan och inom sjukvården. 

Abstract [en]

Focus on early diagnosis and prevention in Alzheimer studies/research

Alzheimer’s disease has been identified with dementia. Recent diagnostic criteria help to identify it be- fore dementia development, which offers hope for finding efficient drugs and preventive interventions. In addition to age and genetics, epidemiological studies have revealed modifiable risks such as vascular, lifestyle, and psychosocial factors. . Steps have already taken place, moving from observation to inter- vention in large multifactorial studies in which risk factors and mechanisms are targeted simultane- ously. The Finnish geriatric programme FINGER is part of the European Dementia Prevention Initiative (EDPI), together with two studies in France and the Netherlands. These will all aid in formulating lifestyle recommendations for preventing/delaying cognitive decline and dementia. 

Place, publisher, year, edition, pages
Helsingfors: , 2013
Keywords
Alzheimer, Alzheimer
National Category
Medical and Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-32234 (URN)
Available from: 2014-02-11 Created: 2014-02-11 Last updated: 2014-03-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0057-0308

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