1,722,265 research outputs found
The impact of chronic multimorbidity and disability on functioning and survival. A community-based, longitudinal study
No full textAbstract. Marengoni A, von Strauss E, Rizzuto D,
Winblad B, Fratiglioni L (Aging Research Center,
Gerontology Research Center and Karolinska Institutet,
Stockholm, Sweden, and University of Brescia
and Civili Hospital, Brescia, Italy). The impact of
chronic multimorbidity and disability on functional
decline and survival in elderly persons. A communitybased,
longitudinal study. J Intern Med 2009;
265: 288–295.
Objective. We aimed to disentangle the effect of
chronic multimorbidity and disability on 3-year functional
decline and survival in the elderly.
Design. Prospective cohort study with a mean of follow-
up of 2.8 years.
Setting. Swedish elderly persons from the Kungsholmen
Project (1987–2000).
Subjects. A total of 1099 subjects, 77–100 years old,
living in the community and institutions.
Main outcome measurements. Medical diagnoses (based
on clinical examination, drug use, medical records
and blood tests), and functional assessment (according
to Katz Index) at baseline were investigated in relation
to functional decline and death occurring during
follow-up.
Results. At baseline, 12.1% of participants had disability,
and 52.3% were affected by multimorbidity. During
follow-up, 363 persons died and 85 worsened in
functioning. The number of chronic conditions incrementally
increased the risk of functional decline [hazard
ratio (HR) increased from 1.5 in subjects with one
disease to 6.2 in persons with 4+ diseases]. However,
this was not the case for mortality, as the HR of death
was the same for people with one disease as well as 4+
diseases (HR = 2.3). Baseline disability had the highest
impact on survival, independently of number of diseases
[HR = 8.1; 95% confidence interval (CI) = 4.8–
13.7 in subjects with one disease and HR = 7.7; 95%
CI = 4.7–12.6 in those with 2+ diseases].
Conclusions. In the elderly subjects, chronic disability
rather than multimorbidity emerged as the strongest
negative prognostic factor for functionality and
survival
Colocalization of interleukin-1 receptor type I and interleukin-1 receptor antagonist with vasopressin in the paraventricular and supraoptic nuclei of the rat hypothalamus
No full text
Heart failure and the risk of Alzheimer’s disease and dementia: population based cohort study
No full textPrevalence of Chronic Diseases and Multimorbidity Amongthe Elderly Population in Sweden.
No full textWe explored the role of age, gender, and socioeconomic status in the occurrence of chronic diseases and
multimorbidity in 1099 elderly participants in the Kungsholmen Project. Cardiovascular and mental
diseases were the most common chronic disorders. Of the participants, 55% had multimorbidity. Advanced
age, female gender, and lower education were independently associated with a more than 50% increased
risk for multimorbidity. Multimorbidity is the most common
clinical picture of the elderly and may be increased by unhealthy behaviors linked to education
Alzheimer's disease: clinical trials and drug development.
No full textAlzheimer’s disease is the most common cause of dementia in elderly people. Research into Alzheimer’s disease
therapy has been at least partly successful in terms of developing symptomatic treatments, but has also had several
failures in terms of developing disease-modifying therapies. These successes and failures have led to debate about the
potential defi ciencies in our understanding of the pathogenesis of Alzheimer’s disease and potential pitfalls in
diagnosis, choice of therapeutic targets, development of drug candidates, and design of clinical trials. Many clinical
and experimental studies are ongoing, but we need to acknowledge that a single cure for Alzheimer’s disease is
unlikely to be found and that the approach to drug development for this disorder needs to be reconsidered. Preclinical
research is constantly providing us with new information on pieces of the complex Alzheimer’s disease puzzle, and
an analysis of this information might reveal patterns of pharmacological interactions instead of single potential drug
targets. Several promising randomised controlled trials are ongoing, and the increased collaboration between
pharmaceutical companies, basic researchers, and clinical researchers has the potential to bring us closer to developing
an optimum pharmaceutical approach for the treatment of Alzheimer’s diseas
HETEROGENEITY IN RISK FACTORS FOR COGNITIVE IMPAIRMENT, NO DEMENTIA: Population-Based Longitudinal Study From the Kungsholmen Project.
Full text linkOBJECTIVES:
The objectives of this study were to investigate the relation of vascular, neuropsychiatric, social, and frailty-related factors with "Cognitive impairment, no dementia" (CIND) and to verify their effect independently of future progression to Alzheimer disease (AD).
METHODS:
Seven hundred eighteen subjects aged 75+ years who attended baseline, 3- and 6-year follow-up examinations of the Kungsholmen Project, a Swedish prospective cohort study, were studied. CIND was defined according to the performance on the Mini-Mental State Examination. Potential risk factors were collected at baseline and clustered according to four research hypotheses (frailty, vascular, neuropsychiatric, and social hypothesis), each representing a possible pathophysiological mechanism of CIND independently of subsequent development of AD.
RESULTS:
Over a mean 3.4 years of follow up, 82 participants (11.4%) developed CIND. When the population was subsequently followed for a mean of 2.7 years, subjects with CIND had a threefold increased risk to progress to AD. After multiple adjustments, including adjustment for the development of AD at the 6-year follow up, risk factors for CIND were hip fracture, polypharmacy, and psychoses.
CONCLUSIONS:
The results suggest that not only the AD-type neurodegenerative process, but also neuropsychiatric- and frailty-related factors may induce cognitive impairment in nondemented elderly. These findings may have relevant preventive and therapeutic implications
- …
