Pingo Kåreholt
Jönköping University, Institute of Gerontology, Faculty Member
Introduction: Mechanisms underlying the positive association between occupational mental demands and late-life cognition are poorly understood. The objective of this study was to assess whether the association between occupational... more
Introduction: Mechanisms underlying the positive association between occupational mental demands and late-life cognition are poorly understood. The objective of this study was to assess whether the association between occupational complexity and cognition is related to and moderated by brain integrity in individuals at risk for dementia. Brain integrity was appraised throughout structural measures (magnetic resonance imaging, MRI) and amyloid accumulation (Pittsburgh compound B (PiB)-positron emission tomography, PiB-PET). Methods: Participants from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) neuroimaging sample – MRI (N = 126), PiB-PET (N = 41) – were included in a post hoc cross-sectional analysis. Neuroimaging parameters comprised the Alzheimer’s disease signature (ADS) cortical thickness (FreeSurfer 5.3), medial temporal atrophy (MTA), and amyloid accumulation (PiB-PET). Cognition was assessed using the neuropsychological test...
Research Interests:
There is substantial evidence that work plays a significant role in post-retirement health. Yet little is known about its role in when late-life dependency may occur. We examined associations between job strain and the risk of entering... more
There is substantial evidence that work plays a significant role in post-retirement health. Yet little is known about its role in when late-life dependency may occur. We examined associations between job strain and the risk of entering late-life dependency. Individually linked nationwide Swedish registers were used to identify people 70+ alive in January 2014, and who did not experience the outcome (late-life dependency) during two months prior to the start of the follow-up. Late-life dependency was operationalized as use of long-term care. Information about job strain was obtained via a job exposure matrice and matched with job titles. Cox regression models with age as time-scale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios (HR) for entering late-life dependency during the 24 months of follow-up (n=993,595). Having an initial high starting point of job strain followed by an increasing trajectory througho...
Research Interests:
Background: Patient dissatisfaction with stroke care is associated with poor self-rated health and unmet care needs. Dementia patients’ satisfaction with stroke care is understudied. Objective: To compare satisfaction with stroke care in... more
Background: Patient dissatisfaction with stroke care is associated with poor self-rated health and unmet care needs. Dementia patients’ satisfaction with stroke care is understudied. Objective: To compare satisfaction with stroke care in patients with and without dementia. Methods: This longitudinal cohort study included 5,932 dementia patients (2007–2017) who suffered a first stroke after dementia diagnosis and 39,457 non-dementia stroke patients (2007–2017). Data were retrieved by linking the Swedish Stroke Register, the Swedish Dementia Register, the Swedish National Patient Register, and the Swedish Prescribed Drug Register. The association between dementia and satisfaction was analyzed with ordinal logistic regression. Results: When dementia patients answered themselves, they reported significantly lower odds of satisfaction with acute stroke care (OR: 0.71; 95% CI: 0.60–0.85), healthcare staff’s attitude (OR: 0.79; 95% CI: 0.66–0.96), communication with doctors (OR: 0.78; 95% ...
Research Interests:
In response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if... more
In response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if so, how) retirement after age 65 – the eligibility age for basic pension – compared to retiring earlier affects older adults’ (between ages 70 and 85) cognitive functioning. Using a propensity score matching (PSM) approach, we addressed the selection bias potentially introduced by non-random selection into either early or late retirement. We also examined average and heterogeneous treatment effects (HTEs). HTEs were evaluated for different levels of cognitive stimulation from occupational activities before retirement and from leisure activities after retirement. We drew from a rich longitudinal data-set linking two nationally representative Swedish surveys with a register data-set and found that, on average, individuals who retire after age 65 do n...
Research Interests:
Research Interests:
Objectives: Perceived financial strain is associated with various health conditions, but it is unknown whether it is associated with an increased risk for dementia. The goal is to examine the associations between midlife perceptions of... more
Objectives: Perceived financial strain is associated with various health conditions, but it is unknown whether it is associated with an increased risk for dementia. The goal is to examine the associations between midlife perceptions of financial situation and dementia risk later in life. Methods: Participants were derived from the Cardiovascular Risk Factors, Aging, and Dementia population-based cohort study (n = 2000) (between 1972 and 1987, baseline mean age 50 years) in Finland. Participants returned for two re-examinations in late life (in 1998 and 2005–2008, mean age 71 and 78 years). In this study, 1442 subjects that participated in at least one re-examination (mean total follow-up 25 years) were included in analyses. Financial strain was measured using two questions in midlife on perceptions of financial situation and perceptions of changes in financial situation. For each question, participants were categorized into three groups reporting improvement, worsening, or stability...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Diet is an important modifiable lifestyle factor related to dementia risk. Yet, the role of midlife dietary changes is unclear. The goal is to investigate whether midlife healthy dietary changes are associated with late-life dementia... more
Diet is an important modifiable lifestyle factor related to dementia risk. Yet, the role of midlife dietary changes is unclear. The goal is to investigate whether midlife healthy dietary changes are associated with late-life dementia risk. Data were collected within the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) population-based cohort study (n = 2000) (mean baseline age = 56 years). Participants returned for two late-life re-examinations (mean age = 70 and 78 years). Self-reported midlife diet was measured in a sub-sample (n = 341) (mean total follow-up = 16.8 years). Changes in specific dietary components (fats, vegetables, sugar, salt) were measured in midlife. Dementia diagnoses were ascertained with detailed examinations. Analyses adjusted for potential confounders. Total midlife healthy dietary changes (improving quality of fats, increasing vegetables, decreasing sugar and salt) were associated with a reduced risk of dementia (fully adjusted odds ratio (OR) 0.41,...
Research Interests:
The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal... more
The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at ...
Research Interests:
Research Interests:
The causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses. Cohort study. Swedish Dementia... more
The causes of death in dementia are not established, particularly in rarer dementias. The aim of this study is to calculate risk of death from specific causes for a broader spectrum of dementia diagnoses. Cohort study. Swedish Dementia Registry (SveDem), 2007-2012. Individuals with incident dementia registered in SveDem (N = 28,609); median follow-up 741 days. Observed deaths were 5,368 (19%). Information on number of deaths and causes of mortality was obtained from death certificates. Odds ratios for the presence of dementia on death certificates were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox hazards regression for cause-specific mortality, using Alzheimer's dementia (AD) as reference. Hazard ratios for death for each specific cause of death were compared with hazard ratios of death from all causes (P-values from t-tests). The most frequent underlying cause of death in this cohort was cardiovascular (37%), followed by dementia ...
Research Interests:
Research Interests:
Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and... more
Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old. Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n=863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5-30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed. Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional proble...
Research Interests:
The aim of this study was to explore cross-sectional associations between Cardiovascular Risk Factors, Aging and Dementia Study (CAIDE) Dementia Risk Score and dementia-related cerebrospinal fluid and neuroimaging biomarkers in 724... more
The aim of this study was to explore cross-sectional associations between Cardiovascular Risk Factors, Aging and Dementia Study (CAIDE) Dementia Risk Score and dementia-related cerebrospinal fluid and neuroimaging biomarkers in 724 patients without dementia from the Memory Clinic at Karolinska University Hospital, Huddinge, Sweden. We additionally evaluated the score's capacity to predict dementia. Two risk score versions were calculated: one including age, gender, obesity, hyperlipidemia, and hypertension; and one additionally including apolipoprotein E (APOE) ε4 carrier status. Cerebrospinal fluid was analyzed for amyloid β (Aβ), total tau, and phosphorylated tau. Visual assessments of medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale, and Fazekas scale for white matter changes (WMC) were performed. Higher CAIDE Dementia Risk Score (version without APOE) was significantly associated with higher total tau, more severe MTA, WMC, and global cortical atr...
Research Interests: Geriatrics, Dementia, Biomarkers, Mild Cognitive Impairment, Neurodegeneration, and 15 moreMedicine, Humans, Internal Medicine, Hypertension, Female, Male, Amyloid Beta, Clinical Sciences, Middle Aged, Atrophy, Memory Clinic, Neurobiology of Aging, Cross Sectional Studies, Geriatrik, and Hyperlipidemias
Vitamin B12, folate, and sulfur amino acids may be modifiable risk factors for structural brain changes that precede clinical dementia. To investigate the association of circulating levels of vitamin B12, red blood cell folate, and sulfur... more
Vitamin B12, folate, and sulfur amino acids may be modifiable risk factors for structural brain changes that precede clinical dementia. To investigate the association of circulating levels of vitamin B12, red blood cell folate, and sulfur amino acids with the rate of total brain volume loss and the change in white matter hyperintensity volume as measured by fluid-attenuated inversion recovery in older adults. The magnetic resonance imaging subsample of the Swedish National Study on Aging and Care in Kungsholmen, a population-based longitudinal study in Stockholm, Sweden, was conducted in 501 participants aged 60 years or older who were free of dementia at baseline. A total of 299 participants underwent repeated structural brain magnetic resonance imaging scans from September 17, 2001, to December 17, 2009. The rate of brain tissue volume loss and the progression of total white matter hyperintensity volume. In the multi-adjusted linear mixed models, among 501 participants (300 women ...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Although there is evident association between alcohol-related hospitalization and alcohol use, the relationship has not been well examined. This study analyzed the extent of alcohol abstinence, non-hazardous use and hazardous use among... more
Although there is evident association between alcohol-related hospitalization and alcohol use, the relationship has not been well examined. This study analyzed the extent of alcohol abstinence, non-hazardous use and hazardous use among people who had experienced alcohol-related hospitalization during the preceding decade. Registry data concerning alcohol-related hospitalizations between 1996 and 2007 were linked to two representative surveys, in 2006 and 2007, of residents of Stockholm County. Relevant contrasts were modeled, using logistic regression, in the pooled sample (n = 54 955). Ages were 23-84 years at follow-up. Among persons previously hospitalized (n = 576), half reported non-hazardous use. Non-hazardous use was less prevalent than in the general population--and the extent of non-hazardous use did not change over time following hospitalization. There were no significant age differences, but non-hazardous use was less frequent among people with repeated episodes of care. ...
Research Interests:
Background: The aim of this study was to explore the relationship between cerebrospinal fluid Alzheimer’s disease (AD) markers and depression in elderly people. Method: We included subjects with AD as well as persons with subjective... more
Background: The aim of this study was to explore the relationship between cerebrospinal fluid Alzheimer’s disease (AD) markers and depression in elderly people. Method: We included subjects with AD as well as persons with subjective cognitive impairment and normal cognition. Depression was assessed with the Cornell Scale for Depression in Dementia, and a cut-off score of >6 was used to define depression. Cerebrospinal fluid was analyzed using commercially available assays for β-amyloid 1–42, total tau, and phosphorylated tau 181. Results: A total of 183 participants (66.7% female) were included (92 with AD and 91 with subjective cognitive impairment), with a mean age (±SD) of 67.6 ± 7.4 years, a Mini-Mental State Examination score of 26.0 ± 4.0, and a median Cornell Scale for Depression in Dementia score of 5 (range 0–19). Depression scores were not associated with higher phosphorylated tau 181 and total tau or reduced β-amyloid 1–42 in AD or non-demented subjects. Conclusions: T...
Research Interests:
Exposure to violence may cause long-lasting consequences. The study addresses long-term economic consequences among women experiencing violence. It summarizes two registry studies examining the economic developments of 6 085 women aged... more
Exposure to violence may cause long-lasting consequences. The study addresses long-term economic consequences among women experiencing violence. It summarizes two registry studies examining the economic developments of 6 085 women aged 18-64 who are victims of violence requiring hospitalization. This group is compared with 55 016 women in the population. Data are analyzed with logistic regressions. Exposure to violence increases the risk of long-term negative economic consequences for both women with and without children. Less educated women are at highest risk of violence, but all victims are at a significantly increased risk of having social assistance up to ten years after the treatment episode.
Research Interests:
Research Interests:
Objective: To explore the role of working conditions in the association between socioeconomic position and health after retirement age using over 20 years follow-up. Method: Two Swedish nationally representative Level of Living Surveys... more
Objective: To explore the role of working conditions in the association between socioeconomic position and health after retirement age using over 20 years follow-up. Method: Two Swedish nationally representative Level of Living Surveys (total N = 1,131) were used. Ordered logistic regression was used to assess the association between socioeconomic position and health (self-rated health, psychological distress, musculoskeletal pain, circulatory problems, physical and cognitive impairment). The role of physical and psychological working conditions was also assessed. Results: Lower socioeconomic position was associated with more adverse physical, but not psychological, working conditions. Physical working conditions partially explained the differences in physical impairment and musculoskeletal pain in old age attributed to socioeconomic position, but not differences in self-rated health, circulatory problems, psychological distress, and cognitive impairment. Socioeconomic position was ...
Research Interests:
Research Interests: Cognitive Science, Dementia, Risk assessment, Medicine, Prospective studies, and 15 moreHumans, Internal Medicine, Female, Male, Homocysteine, Clinical Sciences, Aged, Risk Assessment, Alzheimer Disease, Community Health Planning, Neurosciences, Prospective Study, confounding, Quartile, and Prospective Cohort Study
Research Interests:
The risk of dementia and Alzheimer's disease (AD) probably results from an interaction between genetic and environmental factors. The aim of this study was to investigate the effects and putative interactions between the apoE ɛ4... more
The risk of dementia and Alzheimer's disease (AD) probably results from an interaction between genetic and environmental factors. The aim of this study was to investigate the effects and putative interactions between the apoE ɛ4 allele and lifestyle related risk factors for dementia and AD. Participants of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study were derived from random, population‐based samples previously studied in 1972, 1977, 1982 or 1987. After an average follow‐up of 21 years, 1449 individuals (72.5%) aged 65–79 years were re‐examined in 1998. The apoE ɛ4 allele was an independent risk factor for dementia/AD even after adjustments for sociodemographic, lifestyle and vascular factors (odds ratio [OR]= 2.83, 95% confidence interval [CI]ɛ1.61–4.97). Physical inactivity, alcohol drinking and smoking increased the risk of dementia/AD particularly among the apoE ɛ4 carriers. Furthermore, low–moderate intake of polyunsaturated, and moderate–high intake o...
Research Interests: Demography, Dementia, Life Style, Physical Activity, Medicine, and 15 moreCellular, Population, Humans, Female, Male, Population based study, Apoe, Apolipoprotein E, Clinical Sciences, Aged, Middle Aged, Odds ratio, Cellular and Molecular Medicine, Alzheimer Disease, and Biochemistry and cell biology
Background Shorter leukocyte telomere length (LTL) is associated with aging and dementia. Impact of lifestyle changes on LTL, and relation to cognition and genetic susceptibility for dementia, has not been investigated in randomized... more
Background Shorter leukocyte telomere length (LTL) is associated with aging and dementia. Impact of lifestyle changes on LTL, and relation to cognition and genetic susceptibility for dementia, has not been investigated in randomized controlled trials (RCTs). Methods Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability is a 2-year RCT enrolling 1260 participants at risk for dementia from the general population, aged 60–77 years, randomly assigned (1:1) to multidomain lifestyle intervention or control group. The primary outcome was cognitive change (Neuropsychological Test Battery z-score). Relative LTL was measured using quantitative real-time polymerase chain reaction (trial registration: NCT01041989). Results This exploratory LTL substudy included 756 participants (377 intervention, 379 control) with baseline and 24-month LTL measurements. The mean annual LTL change (SD) was −0.016 (0.19) in the intervention group and −0.023 (0.17) in the control grou...
Research Interests:
Research Interests:
Research Interests:
To compare access to intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) and its outcomes in patients with and without dementia. This was a longitudinal cohort study of the Swedish dementia and stroke registries. Patients with... more
To compare access to intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) and its outcomes in patients with and without dementia. This was a longitudinal cohort study of the Swedish dementia and stroke registries. Patients with preexisting dementia who had AIS from 2010 to 2014 (n = 1,356) were compared with matched patients without dementia (n = 6,755). We examined access to thrombolysis and its outcomes at 3 months (death, residency, and modified Rankin Scale [mRS] score). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with logistic and ordinal logistic regression. The median age at stroke onset was 83 years in both groups. IVT was administered to 94 (7.0%) patients with dementia and 639 (9.5%) patients without dementia. The OR of receiving IVT was 0.68 (95% CI 0.54-0.86) for patients with dementia. When the analysis was repeated exclusively among patients independent in everyday activities, dementia status was no longer significant (OR 0.79, 95% CI...
Research Interests:
Synaptic dysfunction is the best anatomical correlate of early cognitive impairment in Alzheimer's disease (AD). Electroencephalography (EEG) directly reflects brain electrical activity at the level of synapses. The aim of the present... more
Synaptic dysfunction is the best anatomical correlate of early cognitive impairment in Alzheimer's disease (AD). Electroencephalography (EEG) directly reflects brain electrical activity at the level of synapses. The aim of the present study was to investigate correlations of quantitative EEG measures, global field power (GFP) and global field synchronization (GFS), with conventional cerebrospinal fluid (CSF) biomarkers of neurodegeneration in patients diagnosed with subjective cognitive decline (n = 210), mild cognitive impairment (n = 230), and AD (n = 197). Decreased CSF amyloid β42 significantly correlated with increased theta and delta GFP, whereas increased p- and t-tau with decreased alpha and beta GFP. Decreased CSF amyloid β42 and increased p- and t-tau were significantly associated with decreased GFS alpha and beta. Subanalysis of the separate diagnostic groups demonstrated significant correlations between CSF biomarkers and generalized power and synchronization already...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Knowledge on survival in dementia is crucial for patients and public health planning. Most studies comparing mortality risk included few different dementia diagnoses. To compare mortality risk in the most frequent dementia disorders in a... more
Knowledge on survival in dementia is crucial for patients and public health planning. Most studies comparing mortality risk included few different dementia diagnoses. To compare mortality risk in the most frequent dementia disorders in a large cohort of patients with an incident diagnosis, adjusting for potential confounding factors. 15,209 patients with dementia from the national quality database, Swedish Dementia Registry (SveDem), diagnosed in memory clinics from 2008 to 2011, were included in this study. The impact of age, gender, dementia diagnosis, baseline Mini-Mental State Examination (MMSE), institutionalization, coresidency, and medication on survival after diagnosis were examined using adjusted hazard ratios (HR) with 95% confidence intervals (CI). During a mean follow-up of 2.5 years, 4,287 deaths occurred, with 114 (95% CI 111-117) deaths/1,000 person-years. Adjusted HR of death for men was 1.56 (95% CI 1.46-1.66) compared to women. Low MMSE, institutionalization, and h...
Research Interests:
Research Interests:
Most studies on health trends in the elderly population focus on specific conditions, studied one at a time. However, health problems are often interrelated and exist simultaneously in late life. Individuals with health problems in... more
Most studies on health trends in the elderly population focus on specific conditions, studied one at a time. However, health problems are often interrelated and exist simultaneously in late life. Individuals with health problems in several domains present special challenges to care services. To estimate future needs for care it may be relevant to study trends of complex health problems
Research Interests:
Research Interests:
This study examines the effect of point of reference on the predictive validity of self-rated health for mortality in a 5-year follow-up period. Two self-rated health measures are examined: an age group comparative question and a global... more
This study examines the effect of point of reference on the predictive validity of self-rated health for mortality in a 5-year follow-up period. Two self-rated health measures are examined: an age group comparative question and a global question with no explicit point of reference. The baseline data (SweOld) is a nationally representative interview survey among Swedish people aged 77+ in 1992. Mortality for the 1992-1996 period was analysed using Cox proportional hazards regression models. Age-referential self-rated health was found to be a better predictor of elderly men's mortality both in non-adjusted models and in models adjusting for age and both self-rated health measures. In separate analyses, both measures were found to be equally strong predictors of women's mortality. When adding both measures into the model simultaneously, the age-referential question lost much of its predictive power. The findings suggest that self-rated health measures are not insensitive to differences in question wording.
Research Interests:
To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position. Baseline data from the Swedish Level of Living Survey and follow-up data... more
To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position. Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study of Living Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions. Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress. With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psych...
Research Interests:
Research Interests:
The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals’ needs. A further objective was... more
The objectives were to identify factors that predict the use of home help services and transition into institutional care and to study to what extent care services were targeted according to the individuals’ needs. A further objective was to study whether people who had moved into institutional care facilities had received home help prior to institutionalisation. A community-dwelling sample (n=502)
Research Interests:
The majority of older people experience progressive disability at the end of their lives and require long-term care as a result. This study analysed patterns of care utilisation during the 5 years prior to death, particularly the effects... more
The majority of older people experience progressive disability at the end of their lives and require long-term care as a result. This study analysed patterns of care utilisation during the 5 years prior to death, particularly the effects of age and time to death in relation to the use of public elder care (i.e. home help services and institutional care) and hospital care. A longitudinal study provided data on care utilisation among participants (aged 83+) who died between 1995 and 2004 (n = 567). Almost everyone received some kind of care in the last 5 years, 91% in the last year and 88% in the last 3 months preceding death. The number of days of elder care outnumbered the number of days in hospital by ten to one. Increasing chronological age was important for receipt of home help, whereas time to death was important for admission to hospital; there was a sharp increase in the proportion treated in hospital in the last 9 months before death. The proportion residing in institutional care facilities with around-the-clock care increased steadily with a sharper gradient 6 months before death. Both age and time to death had an effect on use of institutional care, but time to death had twice the effect of increasing age. In conclusion, age and time to death have different effects depending on the type of care studied, and individual-based longitudinal data gives a very different picture of care utilisation among the oldest old compared to cross-sectional data.
Research Interests:
To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age. We used 810 eligible participants from Longitudinal Study of Living... more
To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age. We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition. Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive...
Research Interests:
People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life... more
People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age. Data from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20-24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems). While not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among m...
Research Interests: Geriatrics, Occupational Health, Adolescent, Sweden, Humans, and 15 moreWork, Female, Male, Follow-up studies, Aged, Middle Aged, Longitudinal Studies, Adult, Public health systems and services research, Sex Factors, Educational Status, Psychological Stress, Logistic Models, Health services for the aged, and health status indicators
It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and... more
It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and balance), and particularly in terms of the role played by multimorbidity of chronic diseases. We aimed to detect the age-related differences across four components of physical performance and to explore to what extent chronic diseases and multimorbidity may explain such differences. We analyzed cross-sectional data from a population-based sample of 3323 people, aged 60 years and older from the SNAC-K study, Stockholm, Sweden. Physical performance was assessed by trained nurses using several tests (grip strength, walking speed, balance and chair stands). Clinical diagnoses were made by the examining physician based on clinical history and examination. Censored normal regression analyses showed that the 72-90+ year-old persons had 17-40% worse grip st...
Research Interests:
Inflammation has been associated with Alzheimer's disease (AD) and dementia. The association between rheumatoid arthritis (RA) or arthritis and dementia/AD has been investigated in several case-control or hospital- and register-based... more
Inflammation has been associated with Alzheimer's disease (AD) and dementia. The association between rheumatoid arthritis (RA) or arthritis and dementia/AD has been investigated in several case-control or hospital- and register-based studies with mixed results. This long-term population-based study investigates the association between presence of joint disorders (RA and other joint disorders) in midlife and cognitive status later in life. 1,449 participants were first evaluated in 1972, 1977, 1982, and 1987 and follow-up was performed after 21 years. A self-administered questionnaire including questions on joint disorders was used at both evaluations. Cognitive status (control, mild cognitive impairment, dementia/AD) was assessed at follow-up. The presence of any joint disorder in midlife was significantly associated with a worse cognitive status later in life: OR (95% CI) in an ordinal logistic regression analysis adjusted for age, gender, follow-up time, education, APOEε4, bod...