Cecilia Karlsson

Mid-life adiposity factors relate to blood-brain barrier integrity in late life.

Abstract.  Gustafson DR, Karlsson C, Skoog I, Rosengren L, Lissner L, Blennow K (Gothenburg University, Gothenburg, Sweden; and Medical College of Wisconsin, Milwaukee, WI, USA). Mid‐life adiposity factors relate to blood–brain barrier integrity in late life. J Intern Med 2007; 262: 643–650.

Baseline Anandamide Levels and Body Weight Impact the Weight Loss Effect of CB1 Receptor Antagonism in Male Rats

The individual weight loss response to obesity treatment is diverse. Here we test the hypothesis that the weight loss response to the CB1 receptor antagonist rimonabant is influenced by endogenous levels of receptor agonists. We show that baseline anandamide levels and body weight independently contribute to predict the treatment response to rimonabant in rodents, demonstrating that addition of biomarkers related to mode of action is relevant for a personalized health care approach to obesity treatment.

Long-term incidence of serious fall-related injuries after bariatric surgery in Swedish obese subjects

Obesity increases risk of falling, but the effect of bariatric surgery on fall-related injuries is unknown. The aim of this study was therefore to study the association between bariatric surgery and long-term incidence of fall-related injuries in the prospective, controlled Swedish Obese Subjects study. At inclusion, body mass index was ≥ 34 kg/m2 in men and ≥38 kg/m2 in women. The surgery per-protocol group (n = 2007) underwent gastric bypass (n = 266), banding (n = 376), or vertical banded gastroplasty (n = 1365), and controls (n = 2040) received usual care. At the time of analysis (31 December 2013), median follow-up was 19 years (maximal 26 years). Fall-related injuries requiring hospital treatment were captured using data from the Swedish National Patient Register. During follow-up, there were 617 first-time fall-related injuries in the surgery group and 513 in the control group (adjusted hazard ratio 1.21, 95% CI, 1.07–1.36; P = 0.002). The incidence differed between treatment groups (P < 0.001, log-rank test) and was higher after gastric bypass than after usual care, banding and vertical banded gastroplasty (adjusted hazard ratio 0.50–0.52, P < 0.001 for all three comparisons). In conclusion, gastric bypass surgery was associated with increased risk of serious fall-related injury requiring hospital treatment.

Leptin and dementia over 32 years in Sweden: The Prospective Population Study of Women

Background: The 2009 World Alzheimer Report reported prevalence of dementia and Alzheimer’s disease worldwide, and highlighted the need for low and middle income countries, actually undergoing epidemiological transition, to quantify the burden of these age-related affections. There is still a particular dearth in epidemiological studies in Africa, where prevalence of dementia seems to be lower compared to high income countries. This study aimed at estimating the prevalence of dementia and assessing risk factors in elderly living in Central Africa: Bangui (Central African Republic) and Brazzaville (Republic of Congo). Methods: Two population-based studies were carried out in districts of Bangui and Brazzaville during 2008 and 2009. Elderly aged over 65 years were recruited by a door-to-door approach. They were interviewed about socio-demographical data, medical history, psychosocial factors and depressive symptoms. The Community Screening Interview for Dementia tests were conducted. Subjects who had a poor performance (<25.5/30) at the cognitive section of the CSI-D or had less than ten at the Five-Word Test were clinically assessed by a neurologist. Further psychometrical tests were conducted as Free and Cued Selective Reminding Test, Isaacs Set Test, Zazzo’s cancellation test. The DSM-IV and NINCDS-ADRDA criteria were required for dementia and Alzheimer’s disease diagnoses. Results: Among the 496 individuals interviewed in Bangui, 188 subjects were suspected of dementia, 165 (32.9%) were re-examined by a neurologist. Forty were identified with dementia (including 7 vascular dementia) and 1 was unclassifiable. In Brazzaville, among the 520 interviewed elderly, 148 (28.5%) were suspected of dementia and 133 of them were clinically assessed by a neurologist. After neurological assessment, 35 were identified with dementia (including 11 vascular dementia). Prevalence of dementia was 8.1% (95%CI [5.8-10.8]) in Bangui and 6.7% (95%CI [4.7-9.2]) in Brazzaville. Absence of schooling was associated to cognitive impairment in both cities. Factors associated to dementia in Bangui and Brazzaville were determined. Conclusions: Prevalence of dementia in these cities is higher than the ones previously observed in West Africa and similar to the ones of high income countries. Epidemiological transition, growing prevalence of cardio-vascular disease risk factors and traumatic life events occurred in these cities could be involved.