Search

Longer term knowledge of post-stroke fatigue (PSF) is limited. Our aim was to describe the prevalence of, and to identify baseline predictors associated with, PSF 5 years after stroke. We undertook a follow-up of stroke survivors from the 504 consecutively recruited participants in the observational "The Fall Study of Gothenburg", conducted between 2014 and 2016. The dependent variable, PSF, was assessed using the Swedish version of the Fatigue Assessment Scale (S-FAS) and defined as having a S-FAS score ≥ 24. The S-FAS questionnaire was mailed to potential participants in August 2020. The independent variables, previously obtained from medical records, included age; sex; comorbidities; stroke severity; hospital length of stay; body mass index (BMI); number of medications and lifestyle factors at index stroke. To identify predictors of PSF, univariable and multivariable logistic regression analyses were performed. Of the 305 eligible participants, 119 (39%) responded with complete S-FAS. Mean age at index stroke was 71 (SD 10.4) years and 41% were female. After a mean of 4.9 years after stroke, the prevalence of PSF was 52%. Among those with PSF, almost two thirds were classified as having both physical and mental PSF. In the multivariable analysis, only high BMI predicted PSF with an odds ratio of 1.25 (95% CI 1.11–1.41, p < 0.01). In conclusion, half of the participants reported PSF 5 years after index stroke and higher body mass index was identified as a predictor. The findings from this study are important for healthcare professionals, for planning health-related efforts and rehabilitation of stroke survivors. ClinicalTrials.gov, Identifier NCT02264470. [ABSTRACT FROM AUTHOR]

Background: There are limited data on long-term prevalence and predictors of health-related quality of life (HRQoL) in stroke survivors. Therefore, the aim was to describe the prevalence of impaired HRQoL, and to identify factors in acute stroke that are associated with impaired HRQoL, 5 years after stroke. Methods: The 305 (60.5%) stroke survivors of the original 504 participants from The Fall Study of Gothenburg were invited to participate in a 5-year follow-up including assessment of HRQoL using the EuroQol 5 Dimensions 3 Levels questionnaire (EQ-5D-3L). To identify baseline predictors of impaired HRQoL, based on the EQ-5D-3L's five dimensions, univariate and multivariate logistic regression analyses were performed. Results: A total of 129 participants (42.3% of the survivors) completed the questionnaire at a median follow-up time of 58 months. At baseline, their mean age was 70.6 years, and they had a median NIHSS score of 1. The median (interquartile range [IQR]) EQ-5D-3L index score was 0.87 (0.71–0.93) and the median (IQR) EQ-visual analogue scale was 70 (49.8–88). In total, 102 (79%) participants were classified as having impaired HRQoL, stated primarily (among 68.5%) related to Pain/Discomfort. Higher age was identified as a predictor of impaired HRQoL related to Mobility (Odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01–1.10) and Self-Care (OR 1.09, 95% CI 1.02–1.17), and longer hospital stay at baseline was identified as a predictor related to Mobility (OR 1.09, 95% CI 1.01–1.18), Self-Care (OR 1.10, 95% CI 1.02–1.18)) and Usual Activities. (OR 1.10, 95% CI 1.03–1.18). Conclusion: At 5 years after stroke, four out of five participants (79%) reported impaired HRQoL related to any of the five dimensions assessed by using the EQ-5D-3L. Most reported, impaired HRQoL was related to Pain/Discomfort. Higher age and longer hospital care period at index stroke were associated with impaired HRQoL. The findings could assist to identify individuals at high risk of low HRQoL, who might benefit from special attention and psychological support. [ABSTRACT FROM AUTHOR]

Objectives. There is limited knowledge of atrial fibrillation (AF) incidence among the very old. Data from longitudinal cohort studies may give us a better insight. The aim of the study was to investigate the incidence rate and prevalence of AF, as well as the impact of AF on mortality, in the general population, from 70 to 100 years of age. Design. This was a population-based prospective cohort study where three representative samples of 70-year-old men and women (n = 2,629) from the Gerontological and Geriatric Populations Studies in Gothenburg (H-70) were included between 1971 and 1982. The participants were examined at age 70 years and were re-examined repeatedly until 100 years of age. AF was diagnosed according to a 12-lead electrocardiogram (ECG) recording at baseline and follow-up examinations, from the Swedish National Patient Register (NPR), or from the Cause of Death Register. Results. The cumulative incidence of AF from 70 to 100 years of age was 65.6% for men and 52.8% for women. Mortality was significantly higher in participants with AF compared with those without, rate ratio (RR) 1.92 (95% CI 1.73-2.14). In a subgroup analysis comprising only participants with AF diagnosed by ECG at screening, the RR for death was 1.29 (95% C.I: 1.03-1.63). Conclusions. Among persons surviving to age 70, the cumulative incidence of AF was over 50% during follow-up. Mortality rate was twice as high in participants with AF compared to participants without AF. Among participants with AF first recorded at a screening examination, the increased risk was only 29%. [ABSTRACT FROM AUTHOR]

Background: A declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34 years.Methods: Six population-based, cross-sectional samples of women (n = 2294) mean age: 49.8 years (range: 45-54), living in Gothenburg, Sweden, were investigated between 1980 and 2014.Results: Body mass index (BMI) increased over time, with a mean BMI of 24.7 kg/m2 in 1980 to 25.7 kg/m2 in 2013-2014, corresponding to a weight gain of 4.5 kg, together with an increase in the proportion of obese individuals (BMI ≥ 30 kg/m2) from 10.4 to 16.6% (p = 0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p = 0.0006) and from 37.7 to 24.5% (p < 0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013-2014 (p < 0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013-2014 (p < 0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38-2.41), compared with women born in 1925-1934.Conclusion: The trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the feasibility of a simple new fifteen-item FFQ as a tool for screening risk of poor dietary patterns in a healthy middle-aged population and to investigate how the results of the FFQ correlated with cardiovascular risk factors and socio-economic factors. Design: A randomized population-based cross-sectional study. Metabolic measurements for cardiovascular risk factors and information about lifestyle were collected. A fifteen-item FFQ was created to obtain information about dietary patterns. From the FFQ, a healthy eating index was created with three dietary groups: good, average and poor. Multivariate logistic regression was used to assess relationships between dietary patterns and cardiovascular risk factors. Setting: Sweden. Subjects: Men and women aged 50 years and living in Gothenburg, Sweden. Results: In total, 521 middle-aged adults (257 men, 264 women) were examined. With good dietary pattern as the reference, there was a gradient association of having obesity, hypertension and high serum TAG in those with average and poor dietary patterns. After adjustment for education and lifestyle factors, individuals with a poor dietary pattern still had significantly higher risk (OR; 95 % CI) of obesity (2·33; 1·10, 4·94), hypertension (2·73; 1·44, 5·20) and high serum TAG (2·62; 1·33, 5·14) compared with those with a good dietary pattern. Conclusions: Baseline data collected by a short FFQ can predict cardiovascular risk factors in middle-aged Swedish men and women. The FFQ could be a useful tool in health-care settings, when screening for risk of poor dietary patterns. [ABSTRACT FROM AUTHOR]

Background A frequently used clinical test to assess mobility after stroke is the Timed Up & Go. Knowledge regarding whether or not the Timed Up & Go is able to detect change over time in patients with stroke, whether improvements in mobility exist after the first three months and whether or not longitudinal change in mobility after stroke depend on the patients' age, is limited or unclear. The objectives were to investigate the distribution-based responsiveness of the Timed Up & Go (TUG) during the first three months after a first event of stroke, to measure the longitudinal change in TUG time during the first year after stroke and to establish whether recovery in TUG time differs between different age groups. Methods Ninety-one patients with first-ever stroke were assessed using the Timed Up & Go at the 1st week and at 3, 6 and 12 months after stroke. The non-parametric sign-test, the parametric t-test and a mixed model approach to linear regression for repeated measurements (Proc mixed) were used for the statistical analyses. Results The median TUG time was reduced from 17 to 12 seconds (p < 0.001) between the 1st week and 3 months. No further improvement was seen between 3 and 12 months after stroke. In a mixed model approach to linear regression, there was a significant age difference. Patients at age 80 and above tended to deteriorate in terms of TUG time between 3 and 12 months after stroke, while patients < 80 years did not (p = 0.011 for the interaction between age group and time). Conclusion The Timed Up & Go demonstrates ability to detect change in mobility over time in patients with stroke. A significant improvement in TUG time from the 1st week to 3 months after stroke was found, as expected, but thereafter no statistically significant change was detected. After 3 months, patients ⩾80 years tended to deteriorate in terms of TUG time, while the younger patients did not. [ABSTRACT FROM AUTHOR]

Abstract: Background: Atrial fibrillation is one of the most common arrhythmias in clinical practice and it is often diagnosed after a complication occurs. The study aimed to evaluate the predictive value of atrial natriuretic peptide (ANP) for atrial fibrillation in a male population-based study. Methods and results: This study is a part of the “Study of Men Born in 1913 and 1923”, a longitudinal prospective cohort study of men, living in the city of Gothenburg in Sweden. A population-based sample of 528 men was investigated in 1988 when they were aged 65years (n =134) and 75years (n =394), and they were followed up for 16years. Blood samples were collected from all 528 men at baseline and plasma ANP levels were analyzed by radioimmunoassay. Hazard ratios were estimated by competing-risk regression analysis. One hundred five participants were excluded because of a prior diagnosis of atrial fibrillation, congestive heart failure, severe hypertension, or severe chronic renal insufficiency. Of the remaining 423 participants, 90 men were diagnosed with atrial fibrillation over the 16-year follow-up. In multivariable analysis, men in the two highest quartiles of ANP levels had a significantly higher risk for atrial fibrillation compared with men in the lowest ANP quartile. The adjusted ratio was 3.14 (95% CI 1.59–6.20) for the third ANP quartile and 3.36 (95% CI 1.72–6.54) for the highest quartile of ANP level. Conclusions: In this population-based longitudinal study, we found that elevated ANP levels at baseline predicted atrial fibrillation during a follow-up time of 16years. [Copyright &y& Elsevier]