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Objective: This study aims to explore whether low mood is related to an increased dementia risk in two cohorts of older adults of different generations, and whether marital status and living situation modify this association.Methods: Participants (≥70 years), free from dementia and living at home, were identified from two population-based studies: the Kungsholmen Project (KP; n = 1,197) and the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K; n = 1,402). Low mood was obtained by self-report (KP and SNAC-K) at baseline in 1987-89 (KP) and 2001-04 (SNAC-K). Incident dementia cases were ascertained over 9 years, using the same diagnostic procedures and comparable criteria for the two cohorts (DSM-III-R in KP and DSM-IV-TR in SNAC-K). Hazard ratios (HR) were derived from Cox proportional hazards models.Results: Those having low mood at baseline were at higher risk of dementia in both cohorts combined (HR: 1.2, 95% confidence interval (CI): 1.0-1.4) than those without low mood. However, an increased risk was detected only in those who did not have a partner (HR: 1.5, 95% CI: 1.2-1.9), or lived alone (HR: 1.5, 95% CI: 1.2-1.9), but not among those who had a partner or lived with someone (HR: 0.8, 95% CI: 0.5-1.2).Conclusion: Marital status and living situation have the potential to buffer the detrimental effects of low mood on dementia onset. Thus, specific attention from health care should target individuals having low mood and who do not have a partner or live alone. [ABSTRACT FROM AUTHOR]

Objective: We intended to assess the relationship between personality and survival in an older population and to explore the role of lifestyle behaviors and health status as potential mediators.Design: Population-based cohort study.Setting: Swedish National Study of Aging and Care in Kungsholmen, Sweden.Participants: 2,298 adults aged 60 or more years, without dementia or depression, followed for 11 years.Measurements: Personality (extraversion, neuroticism, and openness) was assessed with a shortened version of the NEO-Five Factor Inventory. We tested whether personality affected mortality and examined the potential mediating effect of health status (body mass index, number of chronic diseases, impairment in instrumental activities of daily living, and C-reactive protein) and lifestyle behaviors (leisure activities, social network, smoking, and alcohol consumption).Results: Over 11 years of follow-up, higher levels of extraversion were associated with a 14% reduction in mortality. Examination of different combinations of personality traits showed that independent of levels of neuroticism and openness, high extraversion were associated with up to 65% lower mortality. Decomposing the effect of extraversion on mortality, we found that the majority (44%) of the beneficial effect was mediated by healthy lifestyle behaviors. Health status accounted for 5% of the association.Conclusions: Extroverted people, who are characterized by higher optimism and high self-efficacy, are prone to healthier behaviors and better health, which may result in longer survival. These results highlight the importance of a healthy lifestyle in survival. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current study was to examine the effect of negative life events and widowhood on the incidence of dementia.Methods: Data were from four Swedish longitudinal cohort studies with a total of nearly 2,000 participants and 8-25 years of follow-up. Seven stressful events were examined for which data were available in all cohorts. Clinical dementia diagnoses were made through medical and psychological examinations. Cox proportional hazards models were used to estimate the association between life events and dementia, adjusting for lifestyle and cardiovascular risk factors.Results: The experience of one stressful life event was not associated with dementia incidence, but two or more negative life events at baseline predicted higher risk for dementia (pooled HR: 2.00). This was most apparent for the incidence of vascular dementia (pooled HR: 3.60) but not for Alzheimer disease (pooled HR: 1.29). Moreover, persons who were widowed and had experienced one or more negative life events were found to have a threefold risk for dementia.Conclusion: Widowhood augments the effect of negative life events on dementia incidence and negative life events specifically increase the risk for vascular dementia. [ABSTRACT FROM AUTHOR]

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

There is strong and consistent evidence across numerous studies that social isolation or lack of social support is an independent risk factor for incident coronary heart disease. However, the impact of social isolation or lack of social support on the progression of coronary atherosclerosis in women has not been well documented. Among 292 women, aged 30–65 years, consecutively hospitalized with acute myocardial infarction or unstable angina between 1991 and 1994 enrolled in the female coronary risk study, 102 women were available to study disease progression over an average of 3.2 years. Three aspects of social support were studied: emotional support, social integration, and interpersonal social relations. Quantitative coronary angiography was performed 3–6 months following index hospitalization and repeated 3 years later. Progression of coronary atherosclerosis was evaluated as the change in mean luminal diameter from first to second measurements of 10 pre-defined coronary segments. Mixed model ANOVA was used to analyze the impact of social support on progression of coronary atherosclerosis. Significantly greater coronary atherosclerosis progression was found among women who lacked emotional support (mean coronary artery luminal diameter narrowing by 0.15 mm), with social isolation (0.14 mm), and lack of interpersonal social relations (0.13 mm), whereas women with high levels of support progressed less. It was 0.05 mm in women with high levels of emotional support, 0.07 mm for socially integrated women, and 0.04 mm in women with adequate interpersonal social relations. These associations were independent of conventional clinical and lifestyle factors such as age, smoking history, body mass index, menopausal status, and diagnosis of index event of acute myocardial infarction. The results of our study suggest that lack of emotional support, social isolation, and lack of interpersonal social relations are important risk factors for accelerated progression of coronary atherosclerosis in middle-aged women. [Copyright &y& Elsevier]

A response from the authors of the article "A life-course study of cognitive reserve in dementia: From childhood to old age," which was published in a previous issue is presented.

A flexible and transparent hydrogen sensor using semiconducting single-wall carbon nanotube (s-SWCNT) networks synthesized by a floating catalyst vapor deposition method is fabricated, which shows excellent hydrogen sensing performance at room temperature, with a fast response time of several seconds and a fast recovery capability (within 1 minute) at a low detection level of 0.1 vol% hydrogen gas. We further investigated the effect of film transparency on the sensing performance, and it was found that the sensing performance first increased with film transparency and reached an optimum value at a transparency of 55%. [ABSTRACT FROM AUTHOR]

Abstract: A number of studies have explored the relationships of apolipoprotein E (APOE) genotype and education with dementia over the last decade. However, observations concerning the possible modifying effect of education on the APOE-dementia association are limited. The objective of this study was to test the hypothesis that education may decrease the risk of APOE ε4 on dementia. Pooled data from 3 major population-based studies in Northern Europe were used in this study, with a total of 3436 participants aged 65 and older derived from the Kungsholmen project and the Gothenburg Birth Cohort studies in Sweden, and the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) project in Finland. The main outcome measure was dementia, which was diagnosed in 219 persons according to standard criteria. APOE ε4 was associated with increased risk of dementia independent of the effect of education (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.9–3.4 for 1 ε4 carrier and OR, 3.7; 95% CI, 1.8–7.2 for 2 ε4 carriers). High education (8 years and more) was related to a lower dementia risk (OR, 0.5; 95% CI, 0.3–0.6). An interaction between education and APOE ε4 was observed. Compared with those with less education and no ε4, the odds of dementia among persons with low education who carried any ε4 allele was 2.7 (95% CI, 1.9–3.9), and 1.2 (0.7–1.8) if they had higher education. This study suggests that genetic (APOE ε4) and environmental (education) factors are not only independently but also interactively related to dementia risk and that high education may buffer the negative effect of APOE ε4 on dementia occurrence. [Copyright &y& Elsevier]

Abstract: Apolipoprotein E (APOE) ε4 is a major risk factor for Alzheimer''s disease (AD) and dementia, but not all ε4 carriers develop dementia. We sought to identify factors that may play a role in modifying the risk of dementia due to ε4. A cognitively intact cohort (n = 932, age ≥ 75) was followed for 9 years to detect incident dementia cases. At baseline, information on education, leisure activities, and vascular risk factors was collected, and APOE was genotyped. During the follow-up, 324 subjects developed dementia, including 247 AD cases. The hazard ratio (HR, 95% confidence interval [95% CI]) of dementia related to the ε4 was 1.39 (1.11–1.76), while the risk was reduced when ε4 carriers had high education, no vascular risk factors, or high score of leisure activities. Among ε4 carriers, the multiadjusted HRs of dementia that were associated with high education, high level of leisure activities, and absence of vascular risk factors were 0.59 (0.40–0.87), 0.49 (0.29–0.85), and 0.61 (0.41–0.90), respectively. The ε4 carriers with these factors had about 1.2 years delayed time to dementia onset compared with those without these factors. High education, active leisure activities, or maintaining vascular health seems to reduce the risk of dementia related to APOE ε4. The ε4 carriers with these characteristics appear to have similar dementia-free survival time to non-ε4 carriers. [Copyright &y& Elsevier]

Abstract: Allele-frequency comparisons between younger and older populations suggest an effect of apolipoprotein E gene (APOE) on mortality, not consistently confirmed by longitudinal data. Our aim was to assess the effect of APOE on survival taking into account the possible contribution of Alzheimer''s disease, other dementias, ischemic heart- and cerebrovascular disease (IHCD). In a community-based longitudinal study, the Kungsholmen Project, 75+ year-old individuals (n =1094) were examined, and followed for 18 years. An increased mortality-risk of 22% in those with the ɛ4 allele was detected; whereas a 28% decreased mortality-risk was detected in those with the ɛ2 allele compared to those with the ɛ3ɛ3 genotype. IHCD adjustment did not change the mortality-risk in those with the ɛ4 allele or the ɛ2 allele. Dementia accounted for the majority of the increased mortality-risk associated with the ɛ4 allele, but the protective effect of the ɛ2 allele remained. Both effects of the ɛ4 allele and the ɛ2 allele were strongly modified by gender. A 49% elevated risk for death in men was related to the ɛ4 allele, and a 36% decreased mortality-risk was found in women with the ɛ2 allele. These findings suggest different roles for the APOE alleles in survival by gender in old age. [Copyright &y& Elsevier]

Abstract Depression has been found to be associated with cognitive decline. This study evaluated the association of general depressive symptoms and motivational-related symptoms with cognitive impairment 6 years later and to explore the role of potential underlying mechanisms. In 2690 cognitively healthy persons aged ≥60 from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) depressive symptoms were derived from the Montgomery Åsberg Depression Rating Scale (MADRS). Cognitive performance was assessed at baseline and 6 years later in 1810 persons with the Mini Mental State Examination (global cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Clock-test (visuospatial construction), and the 5-item test (immediate and delayed recall). Bi-factor analysis on the MADRS yielded a General Depression factor and an unrelated Motivational factor. After adjusting for demographics, the General Depression factor was only associated with 6-year impairment in delayed recall (OR (95% CI): 1.18 (1.04–1.34)). This association was no longer significant after adjusting for demographics, cardiovascular risk, lifestyle factors and medication use. The Motivational factor was not significantly associated with future cognitive impairments after adjusting for demographics. Concluding, almost all associations of general depressive symptoms and motivational-related symptoms with future cognitive impairments appeared to be confounded by demographics. Only the association of general depressive symptoms with future memory impairments appeared to be explained by a combination of demographics, cardiovascular risk, lifestyle and medication use. [ABSTRACT FROM AUTHOR]