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  • 1.
    Bojsen-Møller, Emil
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Heiland, Emerald
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Nilsson, Jonna
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Boraxbekk, Carl-Johan
    Umeå universitet.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Effects of two multicomponent behavior change interventions on cognitive functionsManuskript (preprint) (Övrigt vetenskapligt)
  • 2.
    Bojsen-Møller, Emil
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
    Nilsson, Jonna
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Heiland, Emerald G
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Department of Surgical Sciences, Medical Epidemiology, University of Uppsala, Uppsala, Sweden..
    Boraxbekk, Carl-Johan
    Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.; Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.; Institute of Sports Medicine Copenhagen (ISMC) and Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark..
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    The effect of two multi-component behavior change interventions on cognitive functions.2022Ingår i: BMC Public Health, E-ISSN 1471-2458, Vol. 22, nr 1, artikel-id 1082Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: We previously reported the effects of two cluster-randomized 6-month multi-component workplace interventions, targeting reducing sedentary behavior or increasing physical activity among office workers, on movement behaviors and cardiorespiratory fitness. The primary aim of this study was to investigate the effects of these interventions on cognitive functions compared to a wait-list control group. The secondary aims were to examine if changes in cognition were related to change in cardiorespiratory fitness or movement behaviors and if age, sex, or cardiorespiratory fitness moderated these associations.

    METHODS: Both interventions encompassed multi-components acting on the individual, environmental, and organizational levels and aimed to change physical activity patterns to improve mental health and cognitive function. Out of 263 included participants, 139 (mean age 43 years, 76% females) completed a neuropsychological test battery and wore accelerometers at baseline and 6-month follow-up. The intervention effect (aim 1) on cognitive composite scores (i.e., Executive Functions, Episodic Memory, Processing Speed, and Global Cognition) was investigated. Additionally, associations between changes in movement behaviors and cardiorespiratory fitness, and changes in cognition were examined (aim 2). Moreover, age, sex, and cardiorespiratory fitness level were investigated as possible moderators of change associations (aim 3).

    RESULTS: Overall, cognitive performance improved from baseline to follow-up, but the change did not differ between the intervention groups and the control group. Changes in cardiorespiratory fitness or any movement behavior category did not predict changes in cognitive functions. The association between changes in time in bed and changes in both Executive Function and Global Cognition were moderated by age, such that a more positive relation was seen with increasing age. A less positive association was seen between changes in sedentary behavior and Processing Speed for men vs. women, whereas higher cardiorespiratory fitness was related to a more positive association between changes in moderate-intensity physical activity and Global Cognition.

    CONCLUSION: The lack of an intervention effect on cognitive functions was expected since the intervention did not change movement behavior or fitness. Age, sex, and cardiorespiratory fitness level might moderate the relationships between movement behaviors and cognitive functions changes.

    TRIAL REGISTRATION: ISRCTN92968402 . Registered 09/04/2018.

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  • 3.
    Chen, Shuyun
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Persson, Margareta
    Umeå University, Umeå, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden..
    Dalman, Christina
    Karolinska Institutet, Stockholm, Sweden.
    Lee, Brian K
    Karolinska Institutet, Stockholm, Sweden; Drexel University School of Public Health, Philadelphia, PA, USA.; A.J. Drexel Autism Institute, Philadelphia, PA, USA.
    Karlsson, Håkan
    Karolinska Institutet, Stockholm, Sweden.
    Gardner, Renee M
    Karolinska Institutet, Stockholm, Sweden.
    Random capillary glucose levels throughout pregnancy, obstetric and neonatal outcomes, and long-term neurodevelopmental conditions in children: a group-based trajectory analysis.2023Ingår i: BMC Medicine, E-ISSN 1741-7015, Vol. 21, nr 1, artikel-id 260Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term risks, although it is unknown if risks vary by severity, timing, and duration of gestational hyperglycemia. We aimed to identify trajectories of random capillary glucose (RCG) levels throughout pregnancy and assess their associations with both obstetric/neonatal outcomes and children's risk of neurodevelopmental conditions (NDCs) (i.e., autism, intellectual disability, and attention-deficit/hyperactivity disorders [ADHD]).

    METHODS: A population-based cohort study was conducted involving 76,228 children born to 68,768 mothers without pregestational diabetes. Group-based trajectory modeling was utilized to identify distinct glucose trajectories across RCG values throughout the course of pregnancy. The associations between these trajectory groups and obstetric/neonatal outcomes as well as children's NDCs were then assessed using generalized estimating equation models with a logit link. The Benjamini-Hochberg (BH) procedure was employed to adjust P-values for multiple comparisons, controlling the false discovery rate (FDR).

    RESULTS: Five distinct glucose trajectory groups were identified, each with varying percentages diagnosed with GDM. Their associations with obstetric/neonatal outcomes as well as children's NDCs varied. For example, when compared to the "Persistently Low" group, other groups exhibited varying degrees of increased risk for large-for-gestational-age babies, with the exception of the "High in Early Pregnancy" group. Compared to the "Persistently Low" group, all other trajectory groups were associated with NDC outcomes, except the "High in Mid-Pregnancy" group. However, none of the associations with offspring NDCs remained significant after accounting for the FDR correction.

    CONCLUSIONS: Persistent high glucose levels or moderately elevated glucose levels throughout pregnancy, as well as transient states of hyperglycemia in early or mid-pregnancy, were found to be associated with increased risks of specific obstetric and neonatal complications, and potentially offspring NDCs. These risks varied depending on the severity, timing, duration, and management of hyperglycemia. The findings underscore the need for continuous surveillance and individualized management strategies for women displaying different glucose trajectories during pregnancy. Limitations such as potential residual confounding, the role of mediators, and small sample size should be addressed in future studies.

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  • 4.
    Ding, Lijie
    et al.
    Shandong Sport University, China.
    Liang, Yajun
    Karolinska institutet, Sweden.
    Tan, Edwin C K
    School of Pharmacy, Sydney, New South Wales, Australia.
    Hu, Yin
    Södertälje Hospital, Sweden.
    Zhang, Chi
    Royal Institute of Technology, Stockholm, Sweden.
    Liu, Yanxun
    Shandong University, China.
    Xue, Fuzhong
    Shandong University, China.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap. Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Smoking, heavy drinking, physical inactivity, and obesity among middle-aged and older adults in China: cross-sectional findings from the baseline survey of CHARLS 2011-2012.2020Ingår i: BMC Public Health, E-ISSN 1471-2458, Vol. 20, nr 1, artikel-id 1062Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Prevention and control of cardiometabolic conditions and cardiovascular disease (CVD) in China may contribute to sustainable CVD reduction globally, given the fact that one-fifth of the worldwide population is in China. Knowing the distribution of behavioral risk factors (e.g., smoking and physical inactivity), especially at a national level in China, would be extremely relevant to the field of public health and CVD prevention. The objectives of this study were to investigate the nationwide prevalence of obesity, smoking, heavy drinking, and physical inactivity in Chinese adults, and further explore whether cardiometabolic conditions would modify the distribution of behavioral risk factors.

    METHODS: This population-based study is based on the China Health and Retirement Longitudinal Study (2011-2012), including 17,302 adults (≥45 years, mean age 59.67 years, female 51.66%) from 25 provinces in China. Data on demographics, lifestyle factors, health status and history of diseases were collected via structured interviews and laboratory tests. Smoking, heavy drinking, obesity, and physical inactivity were defined following standard guidelines. We performed descriptive analysis and logistic regressions in this study.

    RESULTS: The overall prevalence of heavy drinking, obesity, current smoking, and physical inactivity among middle-aged and older adults was 7.23% (95% confidence interval 6.53-7.29%), 11.53% (10.43-12.62%), 27.46% (26.30-28.62%), and 44.06% (41.19-46.92%), respectively. The prevalence varied between rural and urban areas as well as among geographic areas, with higher prevalence in the Northern and Northeastern regions. Heavy drinking and obesity were significantly associated with incident hypertension, diabetes, and high cholesterol; while current smoking was significantly associated with incident hypertension. Compared with healthy individuals, participants who self-reported a diagnosis of hypertension, high cholesterol, or diabetes were less likely to smoke currently and drink alcohol heavily, but more likely to be physically inactive and obese.

    CONCLUSIONS: Among Chinese middle-aged and older adults, the prevalence of behavioral risk factors varies by geographic region. Further effort is required to improve physical activity and fitness for Chinese adults, especially those with cardiometabolic conditions.

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  • 5.
    Ding, Mozhu
    et al.
    Karolinska Institutet, Stockholm University, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet, Stockholm University, Sweden.
    Kalpouzos, Grégoria
    Karolinska Institutet, Stockholm, Sweden..
    Laukka, Erika J
    Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontology Research Center, Sweden.
    Li, Yuanjing
    Karolinska Institutet, Stockholm University, Sweden.
    Johnell, Kristina
    Karolinska Institutet, Stockholm, Sweden.
    Fratiglioni, Laura
    Karolinska Institutet, Stockholm University, Sweden; Stockholm Gerontology Research Center, Sweden.
    Qiu, Chengxuan
    Karolinska Institutet, Stockholm University, Sweden.
    Cerebral Small Vessel Disease Associated With Atrial Fibrillation Among Older Adults: A Population-Based Study.2021Ingår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 52, nr 8, s. 2685-2689Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE: Cerebral small vessel disease, as a potential mechanism underlying the association between atrial fibrillation (AF) and dementia, remains poorly investigated. In this cohort study, we sought to examine the association between AF and cerebral small vessel disease markers among older adults.

    METHODS: Data on 336 participants (age ≥60 years, mean 70.2 years; 60.2% women) free of dementia, disability, and cerebral infarcts were derived from the population-based Swedish National Study on Aging and Care in Kungsholmen. Structural brain magnetic resonance imaging examinations were performed at baseline (2001-2004) and follow-ups (2004-2007 and 2007-2010). Magnetic resonance imaging markers of cerebral small vessel disease included perivascular spaces, lacunes, and volumes of white matter hyperintensities, lateral ventricles, and total brain tissue. AF was assessed at baseline and follow-ups through clinical examinations, electrocardiogram, and medical records. Data were analyzed using linear mixed-effects models.

    RESULTS: At baseline, 18 persons (5.4%) were identified to have prevalent AF and 17 (5.6%) developed incident AF over the 6-year follow-up. After multivariable adjustment, AF was significantly associated with a faster annual increase in white matter hyperintensities volume (β coefficient=0.45 [95% CI, 0.04-0.86]) and lateral ventricular volume (0.58 [0.13-1.02]). There was no significant association of AF with annual changes in perivascular spaces number (β coefficient=0.53 [95% CI, -0.27 to 1.34]) or lacune number (-0.01 [-0.07 to 0.05]).

    CONCLUSIONS: Independent of cerebral infarcts, AF is associated with accelerated progression of white matter lesions and ventricular enlargement among older adults.

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  • 6.
    Ekblom, Maria
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden..
    Bojsen-Møller, Emil
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Department of Psychology, Stockholm University, Stockholm, Sweden..
    Tarassova, Olga
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysiologi, nutrition och biomekanik.
    Moberg, Marcus
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysiologi, nutrition och biomekanik.
    Pontén, Marjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysiologi, nutrition och biomekanik.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Acute effects of physical activity patterns on plasma cortisol and brain-derived neurotrophic factor in relation to corticospinal excitability.2022Ingår i: Behavioural Brain Research, ISSN 0166-4328, E-ISSN 1872-7549, Vol. 430, artikel-id 113926Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Brain-derived neurotrophic factor (BDNF) and cortisol are both capable of modulating synaptic plasticity, but it is unknown how physical activity-induced changes in their plasma levels relate to corticospinal plasticity in humans. Sixteen inactive middle-aged men and women participated in three separate interventions consisting of 3hours prolonged sitting (SIT); 3hours sitting interrupted every 30minutes with frequent short physical activity breaks (FPA); and 2.5hours prolonged sitting followed by 25minutes of moderate intensity exercise (EXE). These 3hour sessions were each followed by a 30min period of paired associative stimulation over the primary motor cortex (PAS). Blood samples were taken and corticospinal excitability measured at baseline, pre PAS, 5min and 30min post PAS. Here we report levels of plasma BDNF and cortisol over three activity conditions and relate these levels to previously published changes in corticospinal excitability of a non-activated thumb muscle. There was no interaction between time and condition in BDNF, but cortisol levels were significantly higher after EXE compared to after SIT and FPA. Higher cortisol levels at pre PAS predicted larger increases in corticospinal excitability from baseline to all subsequent time points in the FPA condition only, while levels of BDNF at pre PAS did not predict such changes in any of the conditions. Neither BDNF nor cortisol modified changes from pre PAS to the subsequent time points, suggesting that the increased corticospinal excitability was not mediated though an augmented effect of the PAS protocol. The relationship between cortisol and plasticity has been suggested to be U-shaped. This is possibly why the moderately high levels of cortisol seen in the FPA condition were positively associated with changes AURC, while the higher cortisol levels seen after EXE were not. A better understanding of the mechanisms for how feasible physical activity breaks affect neuroplasticity can inform the theoretical framework for how work environments and schedules should be designed. DATA AVAILABILITY: Data are available from the corresponding author upon reasonable request.

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  • 7.
    Ekblom, Maria
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wiklund, Camilla
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Environmental and genetic contributions to device-based measures of physical activity in Swedish 9-year-olds.2023Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

     

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  • 8.
    Freak-Poli, Rosanne
    et al.
    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
    Wagemaker, Nina
    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Aging Research Center, Karolinska Institute, Stockholm, Sweden.
    Lysen, Thom S.
    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
    Ikram, M. Arfan
    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
    Vernooij, Meike W.
    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
    Dintica, Christina S.
    Aging Research Center, Karolinska Institute, Stockholm, Sweden.
    Vernooij-Dassen, Myrra
    Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands.
    Melis, Rene J.M.
    Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
    Laukka, Erica J.
    Aging Research Center, Karolinska Institute, Stockholm, Sweden.
    Fratiglioni, Laura
    Aging Research Center, Karolinska Institute, Stockholm, Sweden.
    Xu, Weili
    Aging Research Center, Karolinska Institute, Stockholm, Sweden.
    Tiemeier, Henning
    Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, MA, USA.
    Loneliness, Not Social Support, Is Associated with Cognitive Decline and Dementia Across Two Longitudinal Population-Based Cohorts2022Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 85, nr 1, s. 295-308Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Poor social health is likely associated with cognitive decline and risk of dementia; however, studies show inconsistent results. Additionally, few studies separate social health components or control for mental health.

    Objective: To investigate whether loneliness and social support are independently associated with cognitive decline and risk of dementia, and whether depressive symptoms confound the association.

    Methods: We included 4,514 participants from the population-based Rotterdam Study (RS; aged 71±7SD years) followed up to 14 years (median 10.8, interquartile range 7.4-11.6), and 2,112 participants from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; aged 72±10SD years) followed up to 10 years (mean 5.9±1.6SD). At baseline, participants were free of major depression and scored on the Mini-Mental State Examination (MMSE) ≥26 for RS and ≥25 for SNAC-K. We investigated loneliness, perceived social support, and structural social support (specifically marital status and number of children). In both cohorts, dementia was diagnosed and cognitive function was repeatedly assessed with MMSE and a global cognitive factor (g-factor).

    Results: Loneliness was prospectively associated with a decline in the MMSE in both cohorts. Consistently, persons who were lonely had an increased risk of developing dementia (RS: HR 1.34, 95%CI 1.08-1.67; SNAC-K: HR 2.16, 95%CI 1.12-4.17). Adjustment for depressive symptoms and exclusion of the first 5 years of follow-up did not alter results. Neither perceived or structural social support was associated with cognitive decline or dementia risk.

    Conclusion: Loneliness, not social support, predicted cognitive decline and incident dementia independently of depressive symptoms.

  • 9.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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.2021Ingår i: Frontiers in Aging Neuroscience, ISSN 1663-4365, E-ISSN 1663-4365, Vol. 13, artikel-id 737736Artikel i tidskrift (Refereegranskat)
    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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  • 10.
    Heiland, Emerald G
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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.2021Ingår i: BMC Neurology, E-ISSN 1471-2377, Vol. 21, nr 1, artikel-id 496Artikel i tidskrift (Refereegranskat)
    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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  • 11.
    Larisch, Lisa-Marie
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Bojsen-Møller, Emil
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Nooijen, Carla F J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska institutet, Stockholm, Sweden.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Arvidsson, Daniel
    University of Gothenburg, Sweden..
    Fridolfsson, Jonatan
    University of Gothenburg, Sweden..
    Hallman, David M
    University of Gävle, Sweden.
    Mathiassen, Svend Erik
    University of Gävle, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska institutet, Stockholm, Sweden ; University of Wisconsin School of Medicine and Public Health, Madison, USA..
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Effects of Two Randomized and Controlled Multi-Component Interventions Focusing On 24-Hour Movement Behavior among Office Workers: A Compositional Data Analysis.2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 8, artikel-id 4191Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been suggested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardiorespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, neither for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.

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  • 12.
    Larsson, Liss Elin
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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.2023Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, nr 2, s. 777-788Artikel i tidskrift (Refereegranskat)
    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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  • 13.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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.2022Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 88, nr 1, s. 263-271Artikel i tidskrift (Refereegranskat)
    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.

  • 14.
    Motovylyak, Alice
    et al.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Vogt, Nicholas M.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Adluru, Nagesh
    University of Wisconsin, Madison, USA.
    Ma, Yue
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Oh, Jennifer M.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Kecskemeti, Steven R.
    University of Wisconsin, Madison, USA.
    Alexander, Andrew L.
    University of Wisconsin, Madison, USA.
    Dean, Douglas C.
    University of Wisconsin, Madison, USA.
    Gallagher, Catherine L.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Sager, Mark A.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Hermann, Bruce P.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Rowley, Howard A.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Johnson, Sterling C.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Asthana, Sanjay
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Bendlin, Barbara B.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Okonkwo, Ozioma C.
    University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Age-related differences in white matter microstructure measured by advanced diffusion MRI in healthy older adults at risk for Alzheimer’s disease2022Ingår i: Aging Brain, ISSN 2589-9589, Vol. 2, artikel-id 100030Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Neurite orientation dispersion and density imaging (NODDI) is an advanced diffusion imaging technique, which can detect more distinct microstructural features compared to conventional Diffusion Tensor Imaging (DTI). NODDI allows the signal to be divided into multiple water compartments and derive measures for orientation dispersion index (ODI), neurite density index (NDI) and volume fraction of isotropic diffusion compartment (FISO). This study aimed to investigate which diffusion metric—fractional anisotropy (FA), mean diffusivity (MD), NDI, ODI, or FISO—is most influenced by aging and reflects cognitive function in a population of healthy older adults at risk for Alzheimer’s disease (AD). Age was significantly associated with all but one diffusion parameters and regions of interest. NDI and MD in the cingulate region adjacent to the cingulate cortex showed a significant association with a composite measure of Executive Function and was proven to partially mediate the relationship between aging and Executive Function decline. These results suggest that both DTI and NODDI parameters are sensitive to age-related differences in white matter regions vulnerable to aging, particularly among older adults at risk for AD.

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  • 15.
    Nyberg, Gisela
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet, Stockholm, Sweden.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Kjellenberg, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet, Stockholm, Sweden.
    Larsson, Håkan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för rörelse, kultur och samhälle.
    Thedin Jakobsson, Britta
    Gymnastik- och idrottshögskolan, GIH, Institutionen för rörelse, kultur och samhälle.
    Helgadóttir, Björg
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Associations between the School Environment and Physical Activity Pattern during School Time in Swedish Adolescents2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 19, artikel-id 10239Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Knowledge about associations between school-based initiatives and physical activity patterns is limited. The purpose of this paper was to examine associations between factors in the school environment, physical activity and sedentary time during school time. The cross-sectional study included 1139 adolescents aged 13–14 from 34 schools. Physical activity and sedentary time were measured using hip-worn accelerometers. Factors in the school environment included health policy, a mobile phone ban during breaks, organized physical activities during breaks and activity breaks during lessons reported by teachers. The frequency and duration of breaks and physical education (PE) lessons were collected from school schedules. The results showed significant associations between health policy (β = 3.87, 95% confidence interval (CI): 2.37, 5.23), the mobile phone ban (β = 2.51, 95% CI: 1.29, 3.94) and PE; total duration (β = 0.08, 95% CI: 0.05, 0.11), average duration (β = 0.08, 95% CI: 0.01, 0.13) and frequency (β = 1.73, 95% CI: 0.50, 3.04) and moderate-vigorous physical activity. There were negative associations between health policy (β = −6.41, 95% CI: −10.24, −2.67), the mobile phone ban (β = −3.75, 95% CI: −7.25, −0.77) and PE; total duration (β = −0.15, 95% CI: −0.23, −0.08) and average duration (β = −0.14, 95% CI: −0.27, −0.03) and time spent sedentary. Adolescents attending schools with health policies, mobile phone bans and more time for PE showed higher levels of physical activity and lower sedentary time.

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  • 16.
    Nyberg, Gisela
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Kjellenberg, Karin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Larsson, Håkan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för rörelse, kultur och samhälle.
    Thedin Jakobsson, Britta
    Gymnastik- och idrottshögskolan, GIH, Institutionen för rörelse, kultur och samhälle.
    Helgadóttir, Björg
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Skolbaserade policyer för fysisk aktivitet samvarierar med fysisk aktivitet och minskat stillasittande hos skolungdomar2021Ingår i: Svensk idrottsmedicin 2021:3, 2021Konferensbidrag (Övrigt vetenskapligt)
  • 17.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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 study2020Ingår i: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 16, nr 7, s. 1003-1012Artikel i tidskrift (Refereegranskat)
    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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  • 18.
    Speh, Andreja
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institute, Stockholm, Sweden; Stockholm University, Sweden; University of Wisconsin, USA.
    Winblad, Bengt
    Karolinska Institute, Stockholm, Sweden.
    Kramberger, M G
    Univ Med Ctr Ljubljana, Slovenia.
    Backman, Lars
    Karolinska Institute, Stockholm, Sweden.
    Qiu, C X
    Karolinska Institute, Stockholm, Sweden.
    Laukka, E J
    Karolinska Institute, Stockholm, Sweden.
    The Relationship Between Cardiovascular Health and Rate of Cognitive Decline in Young-Old and Old-Old Adults: A Population-Based Study2021Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 84, nr 4, s. 1523-1537Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Modifiable vascular risk factors have been associated with late-life cognitive impairment. The Life Simple 7 (LS7) score comprises seven cardiovascular health metrics: smoking, diet, physical activity, body mass index, plasma glucose, total serum cholesterol, and blood pressure. Objective: To investigate the association between individual and composite LS7 metrics and rate of cognitive decline, and potential differences in these associations between young-old and old-old individuals. Methods: This cohort study included 1,950 participants aged >= 60 years (M= 70.7 years) from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), who underwent repeated neuropsychological testing (episodic and semantic memory, verbal fluency, processing speed, global cognition) across 12 years. The LS7 score was assessed at baseline and categorized as poor, intermediate, or optimal. Level and change in cognitive performance as a function of LS7 categories were estimated using linear mixed-effects models. Results: Having an optimal LS7 total score was associated with better performance (expressed in standard deviation units) at baseline for perceptual speed (beta=0.21, 95% CI 0.12-0.29), verbal fluency (beta=0.08, 0.00-0.16), and global cognition (beta = 0.06, 0.00-0.12) compared to the poor group. Age-stratified analyses revealed associations for cognitive level and change only in the young-old (< 78 years) group. For the specific metrics, diverging patterns were observed for young-old and old-old individuals. Conclusion: Meeting the LS7 criteria for ideal cardiovascular health in younger old age is associated with slower rate of cognitive decline. However, the LS7 criteria may have a different meaning for cognitive function in very old adults.

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  • 19.
    Vesperman, Clayton J.
    et al.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA; The Department of Neurobiology Care Sciences and Society Karolinska Institutet Stockholm Sweden.
    Schultz, Stephanie A.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Department of Radiology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Department of Radiology Washington University in St. Louis School of Medicine St. Louis Missouri USA.
    Law, Lena L.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Dougherty, Ryan J.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Department of Kinesiology University of Wisconsin School of Education Madison Wisconsin USA.
    Ma, Yue
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Oh, Jennifer M.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Edwards, Dorothy F.
    Department of Kinesiology University of Wisconsin School of Education Madison Wisconsin USA.
    Gallagher, Catherine L.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Department of Neurology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Chin, Nathaniel A.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Asthana, Sanjay
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Geriatric Research Education and Clinical Center William S. Middleton Memorial Veterans Hospital Madison Wisconsin USA.
    Hermann, Bruce P.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Department of Neurology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Sager, Mark A.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Johnson, Sterling C.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Geriatric Research Education and Clinical Center William S. Middleton Memorial Veterans Hospital Madison Wisconsin USA;Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Cook, Dane B.
    Department of Kinesiology University of Wisconsin School of Education Madison Wisconsin USA;Research Service William S. Middleton Memorial Veterans Hospital Madison Wisconsin USA.
    Okonkwo, Ozioma C.
    Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA;Geriatric Research Education and Clinical Center William S. Middleton Memorial Veterans Hospital Madison Wisconsin USA;Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
    Cardiorespiratory fitness and cognition in persons at risk for Alzheimer's disease2022Ingår i: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, ISSN 2352-8729, Vol. 14, nr 1, artikel-id e12330Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: This study examined the relationship between cardiorespiratory fitness (CRF) and longitudinal cognitive functioning in a cohort enriched with risk factors for Alzheimer's disease (AD).

    Methods: A total of 155 enrollees in the Wisconsin Registry for Alzheimer's Prevention completed repeat comprehensive neuropsychological evaluations that assessed six cognitive domains. Peak oxygen consumption (VO2peak) was the primary measure of CRF. Random effects regression was used to investigate the effect of CRF on cognitive trajectories.

    Results: Higher CRF was associated with slower decline in the cognitive domains of verbal learning and memory (P < .01) and visual learning and memory (P < .042). Secondary analyses indicated that these effects were stronger among men than women, and for noncarriers of the apolipoprotein E ε4 allele.

    Discussion: Higher CRF was associated with a slower rate of the decline in episodic memory that occurs as a natural consequence of aging in a cohort enriched with risk factors for AD.

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  • 20.
    Wang, Rui
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska University Hospital at Huddinge, Sweden; University of Wisconsin School of Medicine and Public Health, Madison, USA.
    Blom, Victoria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Stockholm University, Sweden.
    Nooijen, Carla F J
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Kallings, Lena
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Uppsala University, Sweden.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Ekblom, Maria M.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet, Stockholm, Sweden.
    The Role of Executive Function in the Effectiveness of Multi-Component Interventions Targeting Physical Activity Behavior in Office Workers2022Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, nr 1, s. 266-266Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A knowledge gap remains in understanding how to improve the intervention effectiveness in office workers targeting physically active (PA) behavior. We aim to identify the modifying effect of executive function (EF) on the intervention effectiveness targeting PA-behaviors, and to verify whether the observed effect varies by Job Demand Control (JDC) categories. This workplace-based intervention study included 245 participants who were randomized into a control group and two intervention arms—promoting physical activity (iPA) group or reducing sedentary behavior (iSED) group. The interventions were conducted through counselling-based cognitive behavioral therapy and team activities over 6 months. PA-behaviors were measured by an accelerometer. EF was assessed by the Trail Making Test-B, Stroop, and n-back test. The JDC categories were measured by the demand control questionnaire. Higher EF level at baseline was significantly associated with the intervention effect on increased sleep time (β-coefficient: 3.33, p = 0.003) and decreased sedentary time (−2.76, p = 0.049) in the iSED-group. Participants with active jobs (high job demands, high control) presented significantly increased light-intensity PA in the iSED-group in comparison to the control group. Among participants with a high level of EF and active jobs, relative to the control group, the iPA-group showed a substantial increase in light-intensity PA (1.58, p = 0.036) and the iSED-group showed a tendency of reducing sedentary behavior (−5.35, p = 0.054). The findings suggest that office workers with a high EF and active jobs may benefit most from an intervention study targeting PA-behaviors.

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  • 21.
    Wang, Rui
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    Dekhtyar, Serhiy
    Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute and Stockholm University, Stockholm, Sweden.
    Wang, Hui-Xin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Cognitive Reserve: A Life-Course Perspective2023Ingår i: Neurobiological and Psychological Aspects of Brain Recovery / [ed] Petrosini, Laura, Springer Publishing Company, 2023, s. 121-135Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    The concept of reserve has been developed to account for the discontinuity between the extent of brain damage at its clinical manifestation in the form of cognitive decline or dementia. In this chapter, we discuss contributors to cognitive reserve from various stages of the life-course, including childhood, early adulthood, middle age, and late life. Evidence from observational studies as well as intervention trials is presented and assessed. We conclude by arguing that reserve formation in dementia risk is a life-course process whereby baseline cognitive abilities are subjected to modulation by subsequent experiences at diverse stages over the entire life-course. Variations among individuals in their ability to withstand age-related brain changes are ultimately dependent on their life-time accumulation of mental, physical, and lifestyle inputs into cognitive reserve.

  • 22.
    Wang, Rui
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
    Ekblom, Maria
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. The Department of Neuroscience, Karolinska Institute, Solna, Sweden.
    Arvidsson, Daniel
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Fridolfsson, Jonatan
    Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Börjesson, Mats
    Center for Health and Performance, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital/Östra, Gothenburg, Sweden..
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa.
    The interrelationship between physical activity intensity, cardiorespiratory fitness, and executive function in middle-aged adults: An observational study of office workers.2022Ingår i: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, artikel-id 1035521Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Previous evidence supports a beneficial effect of physical activity on executive function across the whole lifespan. Yet, the interrelationships of the intensities of physical activity, cardiorespiratory fitness, and executive function require further investigation in adults.

    AIM: Using unfiltered accelerometry data and high-resolution intensity classification, we sought to estimate the associations of physical activity with cardiorespiratory fitness and executive function in adult office workers.

    METHODS: We included 343 full-time office workers (mean age: 42.41 years, range of age: 36-49 years). Executive function was assessed using Stroop, Trail making tests (part-B), and 2-back tests, and a composite score was produced to reflect the general executive function performance. Physical activity was assessed using the Actigraph GT3X+-monitor, worn by each participant for seven days at the hip. Raw accelerometry data were processed by the 10 Hz frequency extended method and divided into 22 intensity bins and sleep time. Cardiorespiratory fitness was estimated using the submaximal Ekblom-Bak cycle ergometer test. Data were analyzed using partial least squares regressions.

    RESULTS: In adults, cardiorespiratory fitness was closely correlated with a wide range of absolute physical activity intensity patterns. A higher level of executive function in adults was associated with both higher absolute physical activity intensities and cardiorespiratory fitness, which was independent of age, sex, and education levels. A very weak association between intensities, fitness, and executive function was observed in high-fit adults. Among low-fit adults, although a positive association started already toward the upper end of moderate intensity, there still appeared to be an association between intensities, cardiorespiratory fitness, and executive function. That is, cardiorespiratory fitness may mediate the association between absolute physical activity intensities and executive function up to a certain level.

    CONCLUSION: The maintenance of executive function in adulthood was related to both physical activity intensities and cardiorespiratory fitness, while their interrelationship was not equal across fitness levels. It is highly recommended to consider the cardiorespiratory fitness level in future studies that focus on executive functions in aging as well when designing individualized physical activity training programs.

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  • 23.
    Wang, Rui
    et al.
    Karolinska Institutet and Stockholm University, Sweden.
    Laveskog, Anna
    Karolinska Institutet and Stockholm University, Sweden.
    Laukka, Erika J
    Karolinska Institutet and Stockholm University, Sweden.
    Kalpouzos, Grégoria
    Karolinska Institutet and Stockholm University, Sweden.
    Bäckman, Lars
    Karolinska Institutet and Stockholm University, Sweden.
    Fratiglioni, Laura
    Karolinska Institutet and Stockholm University, Sweden.
    Qiu, Chengxuan
    Karolinska Institutet and Stockholm University, Sweden.
    MRI load of cerebral microvascular lesions and neurodegeneration, cognitive decline, and dementia.2018Ingår i: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 91, nr 16, s. e1487-e1497Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore the differential associations of neurodegeneration and microvascular lesion load with cognitive decline and dementia in older people and the modifying effect of the APOE genotype on these associations.

    METHODS: A sample of 436 participants (age ≥ 60 years) was derived from the population-based Swedish National study on Aging and Care in Kungsholmen, Stockholm, and clinically examined at baseline (2001-2003) and 3 occasions during the 9-year follow-up. At baseline, we assessed microvascular lesion load using a summary score for MRI markers of lacunes, white matter hyperintensities (WMHs), and perivascular spaces and neurodegeneration load for markers of enlarged ventricles, smaller hippocampus, and smaller gray matter. We assessed cognitive function using the Mini-Mental State Examination (MMSE) test and diagnosed dementia following the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. We analyzed data using linear mixed-effects, mediation, and random-effects Cox models.

    RESULTS: During the follow-up, 46 participants were diagnosed with dementia. Per 1-point increase in microvascular lesion and neurodegeneration score (range 0-3) was associated with multiple adjusted β-coefficients of -0.35 (95% confidence interval, -0.51 to -0.20) and -0.44 (-0.56 to -0.32), respectively, for the MMSE score and multiple adjusted hazard ratios of 1.68 (1.12-2.51) and 2.35 (1.58-3.52), respectively, for dementia; carrying APOE ε4 reinforced the associations with MMSE decline. WMH volume changes during the follow-up mediated 66.9% and 12.7% of the total association of MMSE decline with the baseline microvascular score and neurodegeneration score, respectively.

    CONCLUSIONS: Both cerebral microvascular lesion and neurodegeneration loads are strongly associated with cognitive decline and dementia. The cognitive decline due to microvascular lesions is exacerbated by APOE ε4 and is largely attributed to progression and development of microvascular lesions.

  • 24.
    Wang, Rui
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Oh, Jennifer M
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.; Middleton Memorial Veterans Hospital, Madison, WI, USA..
    Motovylyak, Alice
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Ma, Yue
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Sager, Mark A
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Rowley, Howard A
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Johnson, Kevin M
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Gallagher, Catherine L
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Carlsson, Cynthia M
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Bendlin, Barbara B
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Johnson, Sterling C
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Asthana, Sanjay
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Eisenmenger, Laura
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Okonkwo, Ozioma C
    University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
    Impact of sex and APOE ε4 on age-related cerebral perfusion trajectories in cognitively asymptomatic middle-aged and older adults: A longitudinal study.2021Ingår i: Journal of Cerebral Blood Flow and Metabolism, ISSN 0271-678X, E-ISSN 1559-7016, Vol. 41, nr 11, s. 3016-3027Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Cerebral hypoperfusion is thought to contribute to cognitive decline in Alzheimer's disease, but the natural trajectory of cerebral perfusion in cognitively healthy adults has not been well-studied. This longitudinal study is consisted of 950 participants (40-89 years), who were cognitively unimpaired at their first visit. We investigated the age-related changes in cerebral perfusion, and their associations with APOE-genotype, biological sex, and cardiometabolic measurements. During the follow-up period (range 0.13-8.24 years), increasing age was significantly associated with decreasing cerebral perfusion, in total gray-matter (β=-1.43), hippocampus (-1.25), superior frontal gyrus (-1.70), middle frontal gyrus (-1.99), posterior cingulate (-2.46), and precuneus (-2.14), with all P-values < 0.01. Compared with male-ɛ4 carriers, female-ɛ4 carriers showed a faster decline in global and regional cerebral perfusion with increasing age, whereas the age-related decline in cerebral perfusion was similar between male- and female-ɛ4 non-carriers. Worse cardiometabolic profile (i.e., increased blood pressure, body mass index, total cholesterol, and blood glucose) was associated with lower cerebral perfusion at all the visits. When time-varying cardiometabolic measurements were adjusted in the model, the synergistic effect of sex and APOE-ɛ4 on age-related cerebral perfusion-trajectories became largely attenuated. Our findings demonstrate that APOE-genotype and sex interactively impact cerebral perfusion-trajectories in mid- to late-life. This effect may be partially explained by cardiometabolic alterations.

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  • 25.
    Wang, Rui
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden ; University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA..
    Qiu, Chengxuan
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Dintica, Christina S
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Shang, Ying
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Larrañaga, Amaia Calderón
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Wang, Hui-Xin
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden..
    Xu, Weili
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden ; Tianjin Medical University, Tianjin, P. R. China.
    Shared risk and protective factors between Alzheimer's disease and ischemic stroke: A population-based longitudinal study.2021Ingår i: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 17, nr 2, s. 191-204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Stroke, especially ischemic stroke's (IS) link with Alzheimer's disease (AD) remains unclear.

    METHODS: This prospective cohort study included 2459 AD- and cerebrovascular disease-free older adults at baseline (mean age 71.9 ± 10.3 years, Stockholm, Sweden). Using Cox regressions, shared risk factors (SRFs) and shared protective factors (SPFs) between AD and IS were recognized when their hazard ratios in both AD and IS models were significant and in the same direction.

    RESULTS: During the follow-up period of up to 15 years, 132 AD and 260 IS mutually exclusive cases were identified. SRFs were low education, sedentary lifestyle, and heart diseases. High levels of psychological well-being, actively engaging in leisure activities, and a rich social network were SPFs. Having ≥1 SPF reduced 47% of AD and 28% of IS risk among people with a low risk profile (<2 SRFs), and 38% of AD and 31% of IS risk with a high risk profile (≥2 SRFs). In total, 57.8% of AD/IS cases could be prevented if individuals have ≥1 SPF and no SRF.

    DISCUSSION: AD and IS share risk/protective profiles, and SPFs seem to counteract the adverse effects of SRFs on both AD and IS.

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  • 26.
    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
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. 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.2023Ingår i: Ageing Research Reviews, ISSN 1568-1637, E-ISSN 1872-9649, Vol. 83, artikel-id 101788Artikel i tidskrift (Refereegranskat)
    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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  • 27.
    Xia, Xin
    et al.
    Karolinska Institutet & Stockholm University, Sweden .
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet & Stockholm University, Sweden ; University of Wisconsin School of Medicine and Public Health, Madison (R.W.) USA.
    Vetrano, Davide L
    Karolinska Institutet & Stockholm University, Sweden ; Catholic University of Rome, Italy ; Centro di Medicina dell'Invecchiamento, Fondazione Policlinico A. Gemelli, Rome, Italy.
    Grande, Giulia
    Karolinska Institutet & Stockholm University, Sweden .
    Laukka, Erika J
    Karolinska Institutet & Stockholm University, Sweden ; Stockholm Gerontology Research Center, Sweden.
    Ding, Mozhu
    Karolinska Institutet & Stockholm University, Sweden .
    Fratiglioni, Laura
    Karolinska Institutet & Stockholm University, Sweden ; Stockholm Gerontology Research Center, Sweden.
    Qiu, Chengxuan
    Karolinska Institutet & Stockholm University, Sweden .
    From Normal Cognition to Cognitive Impairment and Dementia: Impact of Orthostatic Hypotension.2021Ingår i: Hypertension, ISSN 0194-911X, E-ISSN 1524-4563, Vol. 78, nr 3, s. 769-778Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The role of orthostatic hypotension (OH) in the continuum of cognitive aging remains to be clarified. We sought to investigate the associations of OH with dementia, cognitive impairment, no dementia (CIND), and CIND progression to dementia in older adults while considering orthostatic symptoms. This population-based cohort study included 2532 baseline (2001–2004) dementia-free participants (age ≥60 years; 62.6% women) in the SNAC-K (Swedish National Study on Aging and Care in Kungsholmen) who were regularly examined over 12 years. We further divided the participants into a baseline CIND-free cohort and a CIND cohort. OH was defined as a decrease by ≥20/10 mmHg in systolic/diastolic blood pressure upon standing and further divided into asymptomatic and symptomatic OH. Dementia was diagnosed following the international criteria. CIND was defined as scoring ≥1.5 SDs below age group-specific means in ≥1 cognitive domain. Data were analyzed with flexible parametric survival models, controlling for confounding factors. Of the 2532 participants, 615 were defined with OH at baseline, and 322 were diagnosed with dementia during the entire follow-up period. OH was associated with an adjusted hazard ratio of 1.40 for dementia (95% CI, 1.10–1.76), 1.15 (0.94–1.40) for CIND, and 1.54 (1.05–2.25) for CIND progression to dementia. The associations of dementia and CIND progression to dementia with asymptomatic OH were similar to overall OH, whereas symptomatic OH was only associated with CIND progression to dementia. Our study suggests that OH, even asymptomatic OH, is associated with increased risk of dementia and accelerated progression from CIND to dementia in older adults.

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  • 28.
    Xu, Yongshi
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Möller, Jette
    Karolinska Institutet, Stockholm, Sweden.
    Wang, Rui
    Gymnastik- och idrottshögskolan, GIH, Institutionen för fysisk aktivitet och hälsa. Karolinska Institutet and Stockholm University, Stockholm, Sweden; University of Wisconsin School of Medicine and Public Health, Wisconsin, United States of America.
    Liang, Yajun
    Karolinska Institutet, Stockholm, Sweden.
    Life-course blood pressure trajectories and cardiovascular diseases: A population-based cohort study in China.2020Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 15, nr 10, artikel-id e0240804Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The patterns of blood pressure trajectory (i.e., change over time) over life-course remain to be explored. In this study, we aim to determine the trajectories of systolic blood pressure (SBP) from adulthood to late life and to assess its impact on the risk of cardiovascular diseases (CVDs).

    METHODS: Based on the China Health and Nutrition Survey, a total of 3566 participants aged 20-50 years at baseline (1989) with at least three SBP measurements during 1989-2011 were included. SBP was measured through physical examination, and socio-demographic factors, lifestyles, medications, and CVDs were based on self-reported questionnaire. Latent class growth modeling was performed to examine SBP trajectory. Odds ratio (OR) and 95% confidence interval (CI) from logistic regression was used to determine the association between SBP trajectory and CVDs.

    RESULTS: Five trajectory groups of SBP were identified: Class 1: rapid increase (n = 113, 3.2%); Class 2: slight increase (n = 1958, 54.9%); Class 3: stable (n = 614, 17.2%); Class 4: increase (n = 800, 22.4%); Class 5: fluctuant (n = 81, 2.3%). After adjustment of demographic factors, baseline SBP, and lifestyles, compared with the "slight increase" group, the OR (95% CI) of CVDs was 0.65 (0.32, 1.28) for "stable" group, 2.24 (1.40, 3.58) for "increase" group, 3.95 (1.81, 8.62) for "rapid increase" group, and 4.32 (1.76, 10.57) for "fluctuant" group. After stratified by use of antihypertensive drugs, the association was only significant for "rapid increase" group among those using antihypertensive drugs with OR (95% CI) of 2.81 (1.01, 7.77).

    CONCLUSIONS: Having a rapidly increasing SBP over life-course is associated with a higher risk of CVDs. This implies the importance of monitoring lifetime change of blood pressure for the prevention of CVDs.

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