Anita Karp

Mental, Physical and Social Components in Leisure Activities Equally Contribute to Decrease Dementia Risk

Background: There is accumulating evidence in the literature that leisure engagement has a beneficial effect on dementia. Most studies have grouped activities according to whether they were predominantly mental, physical or social. Since many activities contain more than one component, we aimed to verify the effect of all three major components on the dementia risk, as well as their combined effect. Methods: A mental, social and physical component score was estimated for each activity by the researchers and a sample of elderly persons. The correlation between the ratings of the authors and the means of the elderly subjects’ ratings was 0.86. The study population consisted of 776 nondemented subjects, aged 75 years and above, living in Stockholm, Sweden, who were still nondemented after 3 years and were followed for 3 more years to detect incident dementia cases. Results: Multi-adjusted relative risks (RRs) of dementia for subjects with higher mental, physical and social component score sums were 0.71 (95% CI: 0.49–1.03), 0.61 (95% CI: 0.42–0.87) and 0.68 (95% CI: 0.47–0.99), respectively. The most beneficial effect was present for subjects with high scores in all or in two of the components (RR of dementia = 0.53; 95% CI: 0.36–0.78). Conclusions: These findings suggest that a broad spectrum of activities containing more than one of the components seems to be more beneficial than to be engaged in only one type of activity.

Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden.

We 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.

Personality and lifestyle in relation to dementia incidence

Objective: High neuroticism has been associated with a greater risk of dementia, and an active/socially integrated lifestyle with a lower risk of dementia. The aim of the current study was to explore the separate and combined effects of neuroticism and extraversion on the risk of dementia, and to examine whether lifestyle factors may modify this association. Methods: A population-based cohort of 506 older people with no dementia from the Kungsholmen Project, Stockholm, Sweden, was followed up for an average of 6 years. Personality traits were assessed using the Eysenck Personality Inventory. Dementia was diagnosed by specialists according to DSM-III-R criteria. Results: Neither high neuroticism nor low extraversion alone was related to significantly higher incidence of dementia. However, among people with an inactive or socially isolated lifestyle, low neuroticism was associated with a decreased dementia risk (hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.27–0.96). When compared to persons with high neuroticism and high extraversion, a decreased risk of dementia was detected in individuals with low neuroticism and high extraversion (HR = 0.51, 95% CI = 0.28–0.94), but not among persons with low neuroticism and low extraversion (HR = 0.95, 95% CI = 0.57–1.60), nor high neuroticism and low extraversion (HR = 0.97 95% CI = 0.57–1.65). Stratified analysis by lifestyle showed that the inverse association of low neuroticism and high extraversion in combination was present only among the inactive or socially isolated persons. Conclusion: Low neuroticism in combination with high extraversion is the personality trait associated with the lowest dementia risk; however, among socially isolated individuals even low neuroticism alone seems to decrease dementia risk.

Mentally Stimulating Activities at Work During Midlife and Dementia Risk After Age 75: Follow-Up Study From the Kungsholmen Project

OBJECTIVES Previous research has suggested that mental stimulation in different life periods may protect against dementia or delay disease onset. This study aimed to explore the association between work complexity factors at midlife and dementia risk in late life under the hypothesis that high work complexity may modulate the increased dementia risk due to low education. DESIGN Population-based follow-up study. SETTING Urban. PARTICIPANTS A cohort of 931 nondemented subjects, aged 75+ years from the Kungsholmen Project, Stockholm, examined twice over 6 years. MEASUREMENTS Incident dementia cases were identified using Diagnostic and Statistical Manual of Mental Disorders, 3rd-Edition Revised criteria. Primary occupations were assigned into categories according to the Nordic Occupational Classification and matched to the 1970 U.S. Census to score the level of work complexity with data, people, and things by using a preformed matrix. RESULTS Lower dementia risk was associated with complexity of work with both data (age and gender adjusted relative risk [aRR]: 0.85, 95% confidence interval [CI]: 0.75-0.95) and with people (aRR: 0.88, 95% CI: 0.80-0.97). Adjusting for education led to similar results, although no longer statistically significant. Further, the highest degrees of complexity of work with data that involves analyzing, coordinating, and synthesizing data were associated with lower dementia risk even among lower educated subjects (relative risk: 0.52, 95% CI: 0.29-0.95). No gender differences were detected. CONCLUSIONS This study suggests that work complexity with data and people is related to lower risk of dementia and that the highest levels of work complexity may modulate the higher dementia risk due to low education.

Occupational Exposure to Electromagnetic Fields and Risk of Alzheimer's Disease

Background: Extremely-low-frequency magnetic field (ELF-MF) exposure is suspected to increase the risk of Alzheimers disease. Such fields are present in the vicinity of electrical motors and other electric appliances containing coils. Methods: We investigated lifetime occupational ELF-MF exposure in relation to Alzheimers disease and dementia among a community dementia-free cohort (n = 931) age 75 years and older in Stockholm, Sweden. This cohort was followed from 1987–1989 until 1994–1996 to detect dementia cases (Diagnostic and Statistical Manual of Mental Disorders, revised 3rd edition criteria). Information on lifetime job history was obtained by interview, usually of next of kin. ELF-MF exposure was assessed using a job-exposure matrix, measurement on historical equipment, and expert estimation. We analyzed the data with Cox models controlling for potential confounders. Results: Dementia was diagnosed in 265 subjects, including 202 with Alzheimers disease. Among men, ELF-MF exposure ≥0.2 μT in lifetime principal job was related to multivariate-adjusted relative risks of 2.3 (95% CI = 1.0–5.1) for Alzheimers disease and 2.0 (1.1–3.7) for dementia. We found no association among women. A similar sex-specific pattern was seen for the associations with average ELF-MF exposure throughout the work life. A dose-response relation was suggested in men, with multivariate-adjusted relative risks of 2.4 (0.8–6.8) for Alzheimers disease and 2.5 (1.1–5.6) for dementia for the upper tertile of lifetime average exposure. Conclusions: Long-term occupational exposure to a higher ELF-MF level may increase the risk of Alzheimers disease and dementia in men. Similar patterns were not seen in women, which may in part be the result of a greater exposure misclassification in women than in men.

Psychosocial stress at work is associated with increased dementia risk in late life

To test the hypothesis that high job stress during working life might lead to an increased risk of dementia and Alzheimers disease (AD) in late life.

Effects of preventive home visits by district nurses on self-reported health of 75-year-olds.

AIM The aim of this study was to analyse the effects of preventive home visits (PHVs) by district nurses (DNs) on the self-reported health of 75-year-olds, including changes in self-reported health after the visits. The study also investigated whether or not the participants believed the visit was useful. BACKGROUND There is a need for methods that promote health among older persons so that they can remain healthy as long as possible. One such method is PHVs. In Sweden, the Stockholm County Council decided to implement such visits to 75-year-olds. METHODS The study was a cluster-controlled trial carried out in Stockholm. Sixteen healthcare centres (HCCs) were randomly selected from five geographic medical areas in the county. Eight were assigned to the study group (SG) and eight to the control group (CG). The 75-year-olds registered at these centres (SG n=176, CG n=262) filled in a questionnaire before and after the intervention. Each SG member received a PHV from a DN, and the CG was treated as usual. FINDINGS At follow-up, both the groups reported decreased health and well-being. However, the SG reported a significant reduction in pain as an effect of the PHV. Participants in the SG reported increased knowledge of local community and county council services, more contacts with their HCCs and increased use of medication. The PHV had no effect on health behaviour. The CG reported significantly more problems in the categories of activities of daily living (ADL) and breathing/circulation. Eighty-four per cent of the participants reported that the PHV was somewhat useful, useful or very useful.

P2-284 Mental, physical, and social components in common leisure activities in old age in relation to dementia: findings from the kungsholmen project

Mental, physical, and social components in common leisure activities in old age in relation to dementia : Findings from the Kungsholmen Project