Gymnastik- och idrottshögskolan, GIH

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  • 1.
    Gallo, Federico
    et al.
    Karolinska Institutet and Stockholm University, Stockholm, Sweden. National Research University Higher School of Economics, Moscow, Russia. Vita-Salute San Raffaele University, Milan, Italy..
    Kalpouzos, Grégoria
    Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Laukka, Erika J
    Karolinska Institutet and Stockholm University, Stockholm, Sweden. Stockholm Gerontology Research Center, Stockholm, Sweden.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet and Stockholm University, Stockholm, Sweden. University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
    Qiu, Chengxuan
    Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Bäckman, Lars
    Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Marseglia, Anna
    Karolinska Institutet, Stockholm, Sweden..
    Fratiglioni, Laura
    Karolinska Institutet and Stockholm University, Stockholm, Sweden. Stockholm Gerontology Research Center, Stockholm, Sweden.
    Dekhtyar, Serhiy
    Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Cognitive Trajectories and Dementia Risk: A Comparison of Two Cognitive Reserve Measures.2021In: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 13, article id 737736Article in journal (Refereed)
    Abstract [en]

    Background and Objectives: Cognitive reserve (CR) is meant to account for the mismatch between brain damage and cognitive decline or dementia. Generally, CR has been operationalized using proxy variables indicating exposure to enriching activities (activity-based CR). An alternative approach defines CR as residual variance in cognition, not explained by the brain status (residual-based CR). The aim of this study is to compare activity-based and residual-based CR measures in their association with cognitive trajectories and dementia. Furthermore, we seek to examine if the two measures modify the impact of brain integrity on cognitive trajectories and if they predict dementia incidence independent of brain status.

    Methods: We used data on 430 older adults aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, followed for 12 years. Residual-based reserve was computed from a regression predicting episodic memory with a brain-integrity index incorporating six structural neuroimaging markers (white-matter hyperintensities volume, whole-brain gray matter volume, hippocampal volume, lateral ventricular volume, lacunes, and perivascular spaces), age, and sex. Activity-based reserve incorporated education, work complexity, social network, and leisure activities. Cognition was assessed with a composite of perceptual speed, semantic memory, letter-, and category fluency. Dementia was clinically diagnosed in accordance with DSM-IV criteria. Linear mixed models were used for cognitive change analyses. Interactions tested if reserve measures modified the association between brain-integrity and cognitive change. Cox proportional hazard models, adjusted for brain-integrity index, assessed dementia risk.

    Results: Both reserve measures were associated with cognitive trajectories [β × time (top tertile, ref.: bottom tertile) = 0.013; 95% CI: -0.126, -0.004 (residual-based) and 0.011; 95% CI: -0.001, 0.024, (activity-based)]. Residual-based, but not activity-based reserve mitigated the impact of brain integrity on cognitive decline [β (top tertile × time × brain integrity) = -0.021; 95% CI: -0.043, 0.001] and predicted 12-year dementia incidence, after accounting for the brain-integrity status [HR (top tertile) = 0.23; 95% CI: 0.09, 0.58].

    Interpretation: The operationalization of reserve based on residual cognitive performance may represent a more direct measure of CR than an activity-based approach. Ultimately, the two models of CR serve largely different aims. Accounting for brain integrity is essential in any model of reserve.

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  • 2.
    Heiland, Emerald G
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Uppsala University, Sweden; Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Welmer, Anna-Karin
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden; Stockholm Gerontology Research Center, Sweden; Karolinska University Hospital, Stockholm, Sweden; Karolinska Institutet, Huddinge, Sweden.
    Kalpouzos, Grégoria
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Laveskog, Anna
    Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Qiu, Chengxuan
    Aging Research Center, Karolinska Institutet-Stockholm University, Sweden.
    Cerebral small vessel disease, cardiovascular risk factors, and future walking speed in old age: a population-based cohort study.2021In: BMC Neurology, E-ISSN 1471-2377, Vol. 21, no 1, article id 496Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this study was to examine the associations between combined and individual cerebral small vessel disease (cSVD) markers on future walking speed over 9 years; and to explore whether these associations varied by the presence of cardiovascular risk factors (CRFs).

    METHODS: This population-based cohort study included 331 adults, aged ≥60 years, without limitation in walking speed (≥0.8 m/s). At baseline, cSVD markers, including white matter hyperintensities (WMH), lacunes, and perivascular spaces (PVS), were assessed on magnetic resonance imaging. The modifiable CRFs (physical inactivity, heavy alcohol consumption, smoking, hypertension, high total cholesterol, diabetes, and overweight/obese) were combined into a score. The association between baseline cSVD markers and the decline in walking speed was examined using linear mixed-effects models, whereas Cox proportional hazards models were used to estimate the association with walking speed limitation (defined as < 0.8 m/s) over the follow-up.

    RESULTS: Over the follow-up period, 76 (23.0%) persons developed walking speed limitation. Participants in the highest tertile of the combined cSVD marker score had a hazard ratio (HR) of 3.78 (95% confidence interval [CI] 1.70-8.45) for walking speed limitation compared with people in the lowest score tertile, even after adjusting for socio-demographics, CRFs, cognitive function, and chronic conditions. When investigating the cSVD markers individually, having the highest burden of WMH was associated with a significantly faster decline in walking speed (β coefficient - 0.020; 95% CI -0.035-0.004) and a greater HR of walking speed limitation (HR 2.78; 95% CI 1.31-5.89) compared with having the lowest WMH burden. Similar results were obtained for the highest tertile of PVS (HR 2.13; 95% CI 1.04-4.36). Lacunes were associated with walking speed limitation, but only in men. Having ≥4 CRFs and high WMH volume simultaneously, showed a greater risk of walking speed limitation compared with having ≥4 CRFs and low WMH burden. CRFs did not modify the associations between lacunes or PVS and walking speed.

    CONCLUSIONS: Combined cSVD markers strongly predict walking speed limitation in healthy older adults, independent of cognitive function, with WMH and PVS being the strongest contributors. Improving cardiovascular health may help to mitigate the negative effects of WMH on future walking speed.

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  • 3.
    Helgadóttir, Björg
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Laflamme, Lucie
    Monárrez-Espino, Joel
    Möller, Jette
    Medication and fall injury in the elderly population; do individual demographics, health status and lifestyle matter?2014In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, article id 92Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The simultaneous use of several medications is an important risk factor for injurious falls in older people. The aim of this study is to investigate the effect of the number of medications dispensed to elderly persons on fall injuries and to assess whether this relationship is explained by individual demographics, health habits and health status.

    METHODS: A population-based, nested, case-control study on people 65 years and older (N = 20.906) was conducted using data from the Stockholm Public Health Cohort (SPHC) derived from self-administered surveys and linked at the individual level with various Swedish health registers. Fall injuries leading to hospitalization recorded in the Swedish National Patient Register (NPR) were considered as the outcome. The main exposure, obtained from the Swedish Prescribed Drug Register (SPDR), was the number of medications dispensed within 90 days prior to the injurious fall. The injury risk was estimated using adjusted odds ratios (ORs) from logistic regression. Results were adjusted by selected demographic, social circumstances, lifestyle and health status data extracted from the SPHC.

    RESULTS: After adjusting for common risk factors within demographics, lifestyle, social circumstances and health status, using more than one medication increased the risk of fall injury but no clear dose-response relationship was observed, with point estimates ranging from 1.5-1.7 for the use of two, three, four or five or more medications as compared to using none. An increased risk remained, and was even elevated, after adjusting for the use of fall-risk-increasing drugs (FRIDs).

    CONCLUSIONS: Using more than one medication affects the risk of injurious falls among older people. The effect of any given number of medications studied remains and is even strengthened after adjusting for individual demographics, health habits, health conditions and the use of FRIDs.

  • 4.
    Helgadóttir, Björg
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Moller, Jette
    Karolinska Institute, Stockholm, Sweden.
    Laflamme, Lucie
    Karolinska Institute, Stockholm, Sweden.
    Patterns in health-related behaviours and fall injuries among older people: a population-based study in Stockholm County, Sweden.2015In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, no 4, p. 604-10Article in journal (Refereed)
    Abstract [en]

    AIM: we identified clusters of older people with similar health-related behaviours and assessed the association between those clusters and the risk of injurious fall.

    METHODS: we linked self-reported and register-based data on the over-65s from the Stockholm public health cohort (N = 20,212). Groups of people with similar health-related behaviours were identified by cluster analysis using four measures of physical activity, two of smoking and alcohol habits and two individual attributes (age and type of housing). The association between clusters and falls leading to hospitalisation (422 cases) was studied using a nested case-control design. Odds ratios (ORs), crude and adjusted for health status, were compiled by cluster using the one with the most 'protective' health behaviour profile as the reference.

    RESULTS: five clusters were identified revealing a variety of combinations of health-related behaviours, all linked to specific age groups and types of housing and with a tendency towards higher levels of physical activity among the younger ones. The risk of injurious falls differed across clusters, and for three out of four, it was significantly higher than in the comparison cluster. Adjusting for health status only partially reduced the ORs for those clusters and this was observed both in men and women.

    CONCLUSION: health-related behaviours aggregate in different manners among older people. Some health-related profiles are associated with an excess risk of falls leading to hospitalisation. Although this is partly a reflection of age differences across clusters, health status alone cannot fully explain the association.

  • 5.
    Hill, Robert
    et al.
    School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
    Tinning, Richard
    School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
    McCuaig, Louise
    School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
    Quennerstedt, Mikael
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Physical Activity and Sense of Coherence in Older Australians2016In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 24, no Suppl., p. S111-S112Article in journal (Refereed)
    Abstract [en]

    Introduction: Aaron Antonovsky’s focus on the sources of health (‘salutogenesis’) and his related concept of ‘sense of coherence’ (SOC) have been studied and used widely in Scandinavia, North America, England, and some other countries, but not in Australia. Few papers on his ideas and their usefulness for studying older adult health have been published. Guided by Antonovsky’s theories, this study investigated the relationships between ‘sense of coherence’ (SOC), physical activity (PA), and health in 36 Australians 65 years of age and older.

    Methods: Participants were Brisbane residents, aged 65 to 93, who were free of severe memory problems and able to walk without the assistance of another person. They completed the SOC-13, an instrument created by Antonovsky, to measure levels of SOC, and participated in semi-structured interviews that were recorded and transcribed verbatim. Interview questions focused on how they had handled life difficulties during the most recent five-year period and then in their earlier lives. Participants also completed a survey asking for basic demographic information, diagnosis or treatment for chronic diseases, and their assessment of their overall health. Qualitative data were augmented by quantitative data from accelerometers that each participant wore for one week while keeping a diary of PA.

    Results: Participants with higher scores on the SOC-13 spoke more often and more enthusiastically about PA. They also engaged in more minutes of moderate-to-vigorous PA, averaged more steps per day, and reported fewer chronic disease problems than those with lower SOC scores. Several expectations that had been expressed by Antonovsky seemed to have been borne out by the results of this study.

    Conclusion: Antonovsky’s ideas and SOC-measurement tools can be useful for the study of health in Australians aged 65 years and over. Our finding that higher SOC levels seem to be related to engagement in positive health maintenance practices by older people supports conclusions of earlier studies. Since one such practice is PA, further research into the role of SOC may offer novel opportunities for interventions aimed at improving the health of this population.

  • 6.
    Hoy, Sara
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Östh, Josefine
    Karolinska Institutet, Stockholm, Sweden.
    Pascoe, Michaela
    Victoria University, Melbourne, Australia.
    Kandola, Aaron
    University College London, London, United Kingdom..
    Hallgren, Mats
    Karolinska Institutet, Stockholm, Sweden.
    Effects of yoga-based interventions on cognitive function in healthy older adults: A systematic review of randomized controlled trials.2021In: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 58, article id 102690Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The world's elderly population is growing. Physical activity has positive effects on health and cognition, but is decreasing among the elderly. Interest in yoga-based exercises has increased in this population, especially as an intervention targeting balance, flexibility, strength, and well-being. Recent interest has arisen regarding yoga's potential benefits for cognition.

    OBJECTIVE: To systematically review evidence from randomized controlled trials (RCTs) examining the effects of yoga-based interventions on cognitive functioning in healthy adults aged ≥60. A secondary aim was to describe intervention characteristics and, where possible, the extent to which these influenced study outcomes.

    METHOD: The review was conducted in accordance with PRISMA guidelines. Searches were performed from inception to June 2020 using the following electronic databases: (1) PubMed (NLM); (2) Embase (Elsevier); (3) Cochrane Central (Wiley); (4) PsycINFO (EBSCOhost); and (5) Cinahl (EbscoHost).

    INCLUSION CRITERIA: RCTs of yoga-based interventions assessing cognition in healthy adults ≥60 years. Risk of bias was assessed using the revised Cochrane risk of bias tool.

    RESULTS: A total of 1466 records were initially identified; six studies (5 unique trials) were included in the review. Four of the six articles reported significant positive effects of yoga-based interventions on cognition, including gross memory functioning and executive functions. Intervention characteristics and assessment methods varied between studies, with a high overall risk of bias in all studies.

    CONCLUSION: Yoga-based interventions are associated with improvements in cognition in healthy older adults. Adequately powered RCTs with robust study designs and long-term follow-ups are required. Future studies should explicitly report the intervention characteristics associated with changes in cognitive function.

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  • 7.
    Hägglund, Karin
    et al.
    Uppsala University, Sweden.
    Helsing, Christer
    Sandmark, Hélène
    Assistant nurses working in care of older people: associations with sustainable work ability.2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 325-32Article in journal (Refereed)
    Abstract [en]

    Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case-control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI <30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one's own life in the ≥50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse's sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.

  • 8.
    Larsson, Liss Elin
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA..
    Cederholm, Tommy
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.; Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden..
    Wiggenraad, Fleur
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.; Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
    Rydén, Marie
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden..
    Hagman, Göran
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.; Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
    Hellénius, Mai-Lis
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden..
    Kivipelto, Miia
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.; Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.: The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom..
    Thunborg, Charlotta
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.; Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.; Mälardalen University Department of Health and Welfare, Sweden.; Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Sweden..
    Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population.2023In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, no 2, p. 777-788Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sarcopenia and cognitive impairment are two leading causes of disabilities.

    OBJECTIVE: The objective was to examine the prevalence of sarcopenia and investigate the association between sarcopenia diagnostic components (muscle strength, muscle mass, and physical performance) and cognitive impairment in memory clinic patients.

    METHODS: 368 patients were included (age 59.0±7.25 years, women: 58.7%), displaying three clinical phenotypes of cognitive impairments, i.e., subjective cognitive impairment (SCI, 57%), mild cognitive impairment (MCI, 26%), and Alzheimer's disease (AD, 17%). Sarcopenia was defined according to diagnostic algorithm recommended by the European Working Group on Sarcopenia in Older People. Components of sarcopenia were grip strength, bioelectrical impedance analysis, and gait speed. They were further aggregated into a score (0-3 points) by counting the numbers of limited components. Multi-nominal logistic regression was applied.

    RESULTS: Probable sarcopenia (i.e., reduced grip strength) was observed in 9.6% of the patients, and 3.5% were diagnosed with sarcopenia. Patients with faster gait speed showed less likelihood of MCI (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.06-0.90) and AD (OR: 0.12, 95% CI: 0.03-0.60). One or more limited sarcopenia components was associated with worse cognitive function. After adjusting for potential confounders, the association remained significant only for AD (OR 4.29, 95% CI 1.45-11.92).

    CONCLUSION: The results indicate a connection between the sarcopenia components and cognitive impairments. Limitations in the sarcopenia measures, especially slow walking speed, were related to poorer cognitive outcomes. More investigationsare required to further verify the causal relationship between sarcopenia and cognitive outcomes.

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  • 9.
    Liang, Yajun
    et al.
    Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden ; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Gao, Ya
    Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China..
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden..
    Grande, Giulia
    Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden..
    Monastero, Roberto
    Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy..
    Dong, Yanhong
    Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China..
    Jiang, Xin
    Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China..
    Lv, Peiyuan
    Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei, China..
    Qiu, Chengxuan
    Department of Neurobiology, Aging Research Center and Center for Alzheimer Research, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden..
    Migraine, Cognitive Decline, and Dementia in Older Adults: A Population-Based Study.2022In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 88, no 1, p. 263-271Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The potential impact of migraine on cognitive aging among older adults remains controversial.

    OBJECTIVE: To examine the relationship of migraine and subtypes with cognitive decline and dementia in an older Swedish population.

    METHODS: This population-based study included 3069 participants (age≥60) from the Swedish National study on Aging and Care in Kungsholmen, Stockholm. Baseline examination was conducted in 2001-2004, and participants were followed every 3 or 6 years until 2013-2016. Data were collected through face-to-face interviews, clinical examinations, laboratory tests, and linkage with registers. Global cognitive function was measured with the Mini-Mental State Examination (MMSE). Dementia was diagnosed according to the DSM-IV criteria. Migraine and subtypes were defined following the international classification system. Data were analyzed using logistic regression, Cox regression, and linear mixed-effects models.

    RESULTS: At baseline, 305 participants were defined with non-migraine headache and 352 with migraine. The cross-sectional analysis showed that the multivariable-adjusted odds ratio (95% confidence interval) of prevalent dementia was 0.49 (0.20-1.21) for migraine and 0.66 (0.26-1.66) for migraine without aura. The longitudinal analysis showed that the multivariable-adjusted hazard ratios of incident dementia associated with migraine and subtypes ranged 0.68-0.89 (p > 0.05). Furthermore, migraine and subtypes were not significantly associated with either baseline MMSE score or MMSE changes during follow-ups (p > 0.05). The nonsignificant associations did not vary substantially by age, APOEɛ4 allele, cerebrovascular disease, and antimigraine treatment (p for interactions > 0.05).

    CONCLUSION: This study shows no evidence supporting the associations of migraine and its subtypes with cognitive decline and dementia among older adults.

  • 10.
    Lindberg, P.
    et al.
    Karolinska Inst, Stockholm, Sweden..
    Kronhed, A. C. Grahn
    Linköping Univ, Linköping, Sweden..
    Alin, C. Kaijser
    Karolinska Inst, Stockholm, Sweden..
    Andersson, Eva
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.
    Toth-Pal, E.
    Karolinska Inst, Stockholm, Sweden..
    Lundin, H. Ranch
    Karolinska Inst, Stockholm, Sweden..
    Saaf, M.
    Karolinska Inst, Stockholm, Sweden..
    Nyren, S.
    Karolinska Inst, Stockholm, Sweden..
    Salminen, H.
    Karolinska Inst, Stockholm, Sweden..
    Effects Training With Osteostrong Compared To Physical Training In Individuals At High Fracture Risk: A Study Protocol For A Randomised Controlled Trial2023In: Aging Clinical and Experimental Research, vol. 35, Suppl. 1, Springer, 2023, Vol. 35, p. S289-S289Conference paper (Other academic)
  • 11.
    Nilsson, Jonna
    et al.
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Ekblom, Maria
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Lebedev, Alexander
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Tarassova, Olga
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Moberg, Marcus
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Lövdén, Martin
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Acute increases in brain-derived neurotrophic factor in plasma following physical exercise relates to subsequent learning in older adults.2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 4395Article in journal (Refereed)
    Abstract [en]

    Multidomain lifestyle interventions represents a promising strategy to counteract cognitive decline in older age. Brain-derived neurotrophic factor (BDNF) is essential for experience-dependent plasticity and increases following physical exercise, suggesting that physical exercise may facilitate subsequent learning. In a randomized-controlled trial, healthy older adults (65-75 years) completed a 12-week behavioral intervention that involved either physical exercise immediately before cognitive training (n = 25; 13 females), physical exercise immediately after cognitive training (n = 24; 11 females), physical exercise only (n = 27; 15 females), or cognitive training only (n = 21; 12 females). We hypothesized that cognition would benefit more from cognitive training when preceded as opposed to followed by physical exercise and that the relationship between exercise-induced increases in peripheral BDNF and cognitive training outcome would be greater when cognitive training is preceded by physical exercise. Greater increases of plasma BDNF were associated with greater cognitive training gains on trained task paradigms, but only when such increases preceded cognitive training (ß = 0.14, 95% CI [0.04, 0.25]). Average cognitive training outcome did not differ depending on intervention order (ß = 0.05, 95% CI [-0.10, 0.20]). The study provides the first empirical support for a time-critical but advantageous role for post-exercise increases in peripheral BDNF for learning at an interindividual level in older adults, with implications for future multidomain lifestyle interventions.

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  • 12.
    Shang, Ying
    et al.
    Karolinska Institutet & Stockholm University, Stockholm, Sweden..
    Fratiglioni, Laura
    Karolinska Institutet & Stockholm University, Stockholm, Sweden..
    Marseglia, Anna
    Karolinska Institutet & Stockholm University, Stockholm, Sweden..
    Plym, Anna
    Karolinska Institutet, Stockholm, Sweden..
    Welmer, Anna-Karin
    Karolinska Institutet & Stockholm Universtity, Stockholm, Sweden..
    Wang, Hui-Xin
    Karolinska Institutet & Stockholm University Stockholm, Sweden..
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Karolinska Institutet & Stockholm University, Stockholm, Sweden.; Univ Wisconsin, Madison, WI USA.
    Xu, Weili
    Karolinska Institutet & Stockholm University, Stockholm, Sweden.;Tianjin Med Univ, Tianjin, Peoples R China..
    Association of diabetes with stroke and post-stroke dementia: A population-based cohort study2020In: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 16, no 7, p. 1003-1012Article in journal (Refereed)
    Abstract [en]

    Introduction: The impact of prediabetes and diabetes on stroke and the development of dementia after a stroke remain unclear. Methods: A total of 2655 dementia-free participants (including a stroke-free cohort and a prevalent stroke cohort) were followed-up for 12 years. Dementia and post-stroke dementia were determined by clinical examinations and national registry data. Diabetes was ascertained via medical examination, medication use, medical records, or glycated hemoglobin (HbA1c) >= 6.5%. Prediabetes was defined as H bA1c >= 5.7% in diabetes-free participants. Results: In the stroke-free cohort, 236 participants developed ischemic stroke, and 47 developed post-stroke dementia. Diabetes was associated with ischemic stroke (hazard ratio [HR] 1.76, 95% confidence interval [CI] 1.16 to 2.67) and post-stroke dementia (HR 2.56, 95% CI 1.04 to 6.25). In the prevalent stroke cohort, diabetes was also related to dementia risk. Prediabetes was not significantly related to stroke or post-stroke dementia. Discussion: Diabetes, but not prediabetes, is associated with an increased risk of ischemic stroke and post-stroke dementia.

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  • 13.
    Welford, Paul
    et al.
    Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
    Östh, Josefine
    Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
    Hoy, Sara
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Diwan, Vinod
    Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
    Hallgren, Mats
    Department of Global Public Health, Karolinska Institutet, Solna, Sweden.
    Effects of yoga and aerobic exercise on wellbeing in physically inactive older adults: Randomized controlled trial (FitForAge)2022In: Complementary Therapies in Medicine, ISSN 0965-2299, E-ISSN 1873-6963, Vol. 66, p. 102815-102815, article id 102815Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the effects of yoga and aerobic exercise (AE) on wellbeing in physically inactive, but otherwise healthy older adults. A secondary objective was to assess and compare the frequency of adverse events associated with yoga and AE.

    Design: Twelve-week, three-group, parallel randomized controlled trial with blinded follow-up assessment.

    Interventions: Participants were supported to complete ≥ 3 Hatha yoga classes/week or ≥ 3 AE sessions/week. A wait-list control (WLC) group continued usual daily activities.

    Main outcome measure: Change in wellbeing, assessed using the Satisfaction with Life Scale (SWLS) and Life Satisfaction Index-Z (LSI),at baseline and at 12-week follow up.

    Results: In total, 82 adults (mean age 72.5 years, range 65-85, 77% female) were recruited. Of these, 27 were randomized to yoga, 29 to aerobic exercise and 26 to wait-list control. Medium-magnitude treatment effects (Hedges' g) were seen for yoga versus WLC and AE versus WLC(SWLS, g = 0.65 and 0.56; LSI, g = 0.54 and 0.54, respectively). In per-protocol analyses, larger effect sizes were found (SWLS, g = 0.72 and 0.66; LSI, g = 0.76 and 0.76, respectively). Adverse events were less frequent in the yoga group (6/27; 22%) compared to AE (10/27; 37%).

    Conclusions: Among physically inactive older adults, participation in yoga or AE was associated with beneficial effects on subjective wellbeing when compared to a non-active control group. Yoga was associated with fewer injuries and may be especially suitable for older adults (DRKS 00015093).

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  • 14.
    Welford, Paul
    et al.
    Karolinska Institutet, Solna, Sweden.
    Östh, Josefine
    Karolinska Institutet, Solna, Sweden.
    Hoy, Sara
    Swedish School of Sport and Health Sciences, GIH, Department of Movement, Culture and Society.
    Rossell, Susan L
    Swinburne University, Melbourne, Australia..
    Pascoe, Michaela
    Victoria University, Melbourne, Australia.
    Diwan, Vinod
    Karolinska Institutet, Solna, Sweden.
    Hallgren, Mats
    Karolinska Institutet, Solna, Sweden.
    Effects of Yoga and Aerobic Exercise on Verbal Fluency in Physically Inactive Older Adults: Randomized Controlled Trial (FitForAge).2023In: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 18, p. 533-545Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To compare the effects on verbal fluency of a supported yoga-based exercise intervention to an aerobic exercise intervention and a wait-list control group.

    PARTICIPANTS AND METHODS: Eighty-two physically-inactive but otherwise healthy adults (mean age 72.5 years, range 65-85, 77% female) were recruited into a 12-week, three-group, parallel randomized controlled trial. Participants were supported to complete ≥3 Hatha yoga classes per/week or ≥3 structured aerobic exercise sessions/week. A wait-list control group continued usual daily activities only. Verbal fluency, including total-FAS, animals, and verbs, was assessed before and after interventions. Group effects were assessed using analysis of covariance (ANCOVA).

    RESULTS: Twenty-seven participants were randomized to yoga, 29 to aerobic exercise and 26 to a waitlist. At 12-week follow-up, compared to baseline, there were increases in mean total-FAS in the yoga (+5.0 words, p=0.002) and aerobic exercise groups (+6.6 words, p=0.004). Mean total-FAS in the wait-list control group remained stable (-0.5 words, p=0.838). There were medium-magnitude estimated treatment effects on total-FAS for yoga versus wait-list control and aerobic exercise versus wait-list control: Hedges' g=0.51 (p=0.213) and 0.57 (p=0.098) respectively. In addition, small-to-medium magnitude estimated treatment effects were seen on animals and verbs for yoga versus wait-list control and aerobic exercise versus wait-list control: g=0.28 (p=0.155), 0.19 (p=0.766) and 0.50 (p=0.085), 0.59 (p=0.233) respectively.

    CONCLUSION: Participation in yoga or aerobic exercise was associated with estimated improvements in verbal fluency compared to a non-active control group. Yoga and aerobic exercise may be promising approaches by which to promote cognitive function among older adults.

    TRIAL REGISTRATION: DRKS00015093, U1111-1217-4248.

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  • 15.
    Wu, Jing
    et al.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Xiong, Ying
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden..
    Xia, Xin
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Orsini, Nicola
    Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden..
    Qiu, Chengxuan
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Kivipelto, Miia
    Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland; Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, United Kingdom; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Theme Aging, Karolinska University Hospital, Sweden..
    Rizzuto, Debora
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden..
    Wang, Rui
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Can dementia risk be reduced by following the American Heart Association's Life's Simple 7?: A systematic review and dose-response meta-analysis.2023In: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 83, article id 101788Article in journal (Refereed)
    Abstract [en]

    This study aimed to quantify the relationships between the American Heart Association (AHA) Cardiovascular Health (CVH) metrics, namely AHA Life's Simple 7, and cognitive outcomes. We searched PubMed and Embase (January 1, 2010-August 24, 2022) and finally included 14 longitudinal studies (311654 participants with 8006 incident dementia cases). Random-effects meta-analysis and one-stage linear mixed-effects models were performed. Increased CVH score seemed to associate with decreased risk of incident dementia in a linear manner, but this relationship varied by the measurement age of CVH metrics. That is, midlife CVH tended to have a linear association with late-life dementia risk, whereas a J-shaped association was observed between the late-life CVH score and dementia. In addition, late-life dementia risk was reduced significantly if individuals maintained an ideal level of AHA's CVH guidelines of physical activity, fasting plasma glucose, total cholesterol, and smoking. However, our meta-analysis did not show a significant association between CVH score and global cognitive decline rate. Following AHA's CVH guidelines and maintaining CVH at an optimal level would substantially reduce the late-life dementia risk. More research is required to explore the link between a favorable CVH score and cognitive trajectories among cognitively asymptomatic older populations.

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  • 16.
    Östlund-Lagerström, Lina
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Blomberg, Karin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Algilani, Samal
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Schoultz, Magnus
    Nutrition and Physical Activity Research Centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Brummer, Robert J.
    Örebro universitet, Institutionen för läkarutbildning.
    Schoultz, Ida
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Senior orienteering athletes as a model of healthy aging: a mixed-method approach2015In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 15, article id 76Article in journal (Refereed)
    Abstract [en]

    Background: The proportion of individuals reaching an old age is increasing and will, in the near future consume a majority of health care resources. It is therefore essential to facilitate the maintenance of optimal functionality among older adults. By characterizing older individuals experiencing wellbeing, factors important to promote and maintain health through life can be identified. Orienteering is an endurance-running sport involving cross-country navigation, demanding both cognitive and physical skills of its practitioners. In this study we aim to explore a Swedish population of senior orienteering athletes as a potential model of healthy aging.

    Methods: We undertook a mixed-method approach using quantitative (i.e. questionnaires) and qualitative (i.e. focus group discussions) methodologies to explore a population of senior orienteering athletes (n = 136, median age = 69 (67-71) years). Quantitative data was collected to evaluate health status, assessing physical activity (Frandin-Grimby activity scale (FGAS)), functional wellbeing (EQ-5D-5 L), gut health (Gastrointestinal symptoms rating scale (GSRS)), anxiety and depression (Hospital Anxiety and Depression scale (HADS)) and overall health (Health index (HI)). The data was further compared to reference values obtained from a free-living Swedish population of older adults. Focus group discussions (FGD) were performed as a complement to the quantitative data to facilitate the individuals' own views on health and physical activity.

    Results: The orienteering athletes enrolled in the study reported a significantly better health compared to the free-living older adults (p < 0.0015) on all questionnaires except HADS. The high health status displayed in this population was further confirmed by the FGD findings, in which all participants declared their engagement in orienteering as a prerequisite for health.

    Conclusions: In conclusion our results show that senior orienteering may represent an ideal model in studies of healthy aging. Furthermore, our results show that even though the senior orienteering athletes are well aware of the long-term benefits of physical activity and have practiced the sport from a young age, they particularly point out that their engagement in orienteering is driven by short-term values such as enjoyment and passion. This may be important to consider when introducing public health interventions among the general older population.

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