114 results on '"Paajanen T"'
Search Results
2. The Cognitive Function at Work Questionnaire (CFWQ):a new scale for measuring cognitive complaints in occupational population
- Author
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Heikkinen, A.-L. (Anna-Leena), Hänninen, T. (Tuomo), Kuikka, P. (Pekka), Akila, R. (Ritva), Savolainen, A. (Aslak), Valtonen, T. (Teppo), Umer, A. (Adil), Lötjönen, J. (Jyrki), Hublin, C. (Christer), Remes, A. M. (Anne M.), Paajanen, T. (Teemu), Heikkinen, A.-L. (Anna-Leena), Hänninen, T. (Tuomo), Kuikka, P. (Pekka), Akila, R. (Ritva), Savolainen, A. (Aslak), Valtonen, T. (Teppo), Umer, A. (Adil), Lötjönen, J. (Jyrki), Hublin, C. (Christer), Remes, A. M. (Anne M.), and Paajanen, T. (Teemu)
- Abstract
Cognitive functioning is a relevant work and health related topic, however, validated methods to assess subjective cognitive complaints (SCC) at work are lacking. We introduce the Cognitive Function at Work Questionnaire (CFWQ) for measuring SCC in occupational settings. 1-year follow-up data of 418 employees from a Finnish public media service company was analyzed. Participants completed web-based CFWQ, cognitive tests and a broad set of questionnaires for evaluating depression, anxiety, insomnia, daytime sleepiness, burnout, stress, mental job burden, work ability, cognitive errors, and perceived health. The factor analysis yielded a model with the CFWQ subdomains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control and Name Memory. The internal consistency (Cronbach’s alpha = 0.87) and the test-retest constancy (ICC = 0.84) reflected good reliability. Correlation between the CFWQ and cognitive errors at work ranged from 0.25 to 0.64 indicating adequate concurrent validity. Employees with depression, insomnia and burnout symptoms had higher (p < 0.001) CFWQ scores than participants without these symptoms. Depression and burnout symptom severity as well as accumulation of mood, sleep, and psychosocial stressors were associated with higher CFWQ scores (p < 0.001 in all). The CFWQ appears psychometrically sound measure for the assessment of SCC in occupational population.
- Published
- 2023
3. CERAD-tehtäväsarjaan koulutustason huomioivat katkaisurajat ja kokonaispistemäärä käyttöön
- Author
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Hallikainen, I. (Ilona), Alenius, M. (Minna), Hokkanen, L. (Laura), Karrasch, M. (Mira), Krüger, J. (Johanna), Ngandu, T. (Tiia), Paajanen, T. (Teemu), Rosenvall, A. (Ari), Suhonen, N. (Noora), Hänninen, T. (Tuomo), Hallikainen, I. (Ilona), Alenius, M. (Minna), Hokkanen, L. (Laura), Karrasch, M. (Mira), Krüger, J. (Johanna), Ngandu, T. (Tiia), Paajanen, T. (Teemu), Rosenvall, A. (Ari), Suhonen, N. (Noora), and Hänninen, T. (Tuomo)
- Abstract
Tiivistelmä Väestön vanhetessa muistisairauksien varhaiseen tunnistamiseen perusterveydenhuollossa tarvitaan paljon lisää resursseja. Kognitiivinen tehtäväsarja CERAD on osoittautunut hyvin toimivaksi välineeksi Alzheimerin taudin ensivaiheen arvioinnissa. Koulutus ja ikä vaikuttavat kognitiivisissa testeissä suoriutumiseen, joten ne on tärkeää huomioida tulosten tulkinnassa. Tehtäväsarjaan on päivitetty koulutustason huomioivat katkaisurajat sekä uutena kokonaispistemäärän käyttö.
- Published
- 2023
4. New insights into the genetic etiology of Alzheimer's disease and related dementias
- Author
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Bellenguez, C., Küçükali, F., Jansen, I. E., Kleineidam, L., Moreno-Grau, S., Amin, N., Naj, A. C., Campos-Martin, R., Grenier-Boley, B., Andrade, V., Holmans, P. A., Boland, A., Damotte, V., van der Lee, S. J., Costa, M. R., Kuulasmaa, T., Yang, Q., de Rojas, I., Bis, J. C., Yaqub, A., Prokic, I., Chapuis, J., Ahmad, S., Giedraitis, V., Aarsland, D., Garcia-Gonzalez, P., Abdelnour, C., Alarcón-Martín, E., Alcolea, D., Alegret, M., Alvarez, I., Álvarez, V., Armstrong, N. J., Tsolaki, A., Antúnez, C., Appollonio, I., Arcaro, M., Archetti, S., Pastor, A. A., Arosio, B., Athanasiu, L., Bailly, H., Banaj, N., Baquero, M., Barral, S., Beiser, A., Pastor, A. B., Below, J. E., Benchek, P., Benussi, L., Berr, C., Besse, C., Bessi, V., Binetti, G., Bizarro, A., Blesa, R., Boada, M., Boerwinkle, E., Borroni, B., Boschi, S., Bossù, P., Bråthen, G., Bressler, J., Bresner, C., Brodaty, H., Brookes, K. J., Brusco, L. I., Buiza-Rueda, D., Bûrger, K., Burholt, V., Bush, W. S., Calero, M., Cantwell, L. B., Chene, G., Chung, J., Cuccaro, M. L., Carracedo, Á., Cecchetti, R., Cervera-Carles, L., Charbonnier, C., Chen, H. -H., Chillotti, C., Ciccone, S., Claassen, J. A. H. R., Clark, C., Conti, E., Corma-Gómez, A., Costantini, E., Custodero, C., Daian, D., Dalmasso, M. C., Daniele, A., Dardiotis, E., Dartigues, J. -F., de Deyn, P. P., de Paiva Lopes, K., de Witte, L. D., Debette, S., Deckert, J., del Ser, T., Denning, N., Destefano, A., Dichgans, M., Diehl-Schmid, J., Diez-Fairen, M., Rossi, P. D., Djurovic, S., Duron, E., Düzel, E., Dufouil, C., Eiriksdottir, G., Engelborghs, S., Escott-Price, V., Espinosa, A., Ewers, M., Faber, K. M., Fabrizio, T., Nielsen, S. F., Fardo, D. W., Farotti, L., Fenoglio, C., Fernández-Fuertes, M., Ferrari, R., Ferreira, C. B., Ferri, E., Fin, B., Fischer, P., Fladby, T., Fließbach, K., Fongang, B., Fornage, M., Fortea, J., Foroud, T. M., Fostinelli, S., Fox, N. C., Franco-Macías, E., Bullido, M. J., Frank-García, A., Froelich, L., Fulton-Howard, B., Galimberti, D., García-Alberca, J. M., García-González, P., Garcia-Madrona, S., Garcia-Ribas, G., Ghidoni, R., Giegling, I., Giorgio, G., Goate, A. M., Goldhardt, O., Gomez-Fonseca, D., González-Pérez, A., Graff, C., Grande, G., Green, E., Grimmer, T., Grünblatt, E., Grunin, M., Gudnason, V., Guetta-Baranes, T., Haapasalo, A., Hadjigeorgiou, G., Haines, J. L., Hamilton-Nelson, K. L., Hampel, H., Hanon, O., Hardy, J., Hartmann, A. M., Hausner, L., Harwood, J., Heilmann-Heimbach, S., Helisalmi, S., Heneka, M. T., Hernández, I., Herrmann, M. J., Hoffmann, P., Holmes, C., Holstege, H., Vilas, R. H., Hulsman, M., Humphrey, J., Biessels, G. J., Jian, X., Johansson, C., Jun, G. R., Kastumata, Y., Kauwe, J., Kehoe, P. G., Kilander, L., Ståhlbom, A. K., Kivipelto, M., Koivisto, A., Kornhuber, J., Kosmidis, M. H., Kukull, W. A., Kuksa, P. P., Kunkle, B. W., Kuzma, A. B., Lage, C., Laukka, E. J., Launer, L., Lauria, A., Lee, C. -Y., Lehtisalo, J., Lerch, O., Lleó, A., Longstreth, W., Lopez, O., de Munain, A. L., Love, S., Löwemark, M., Luckcuck, L., Lunetta, K. L., Ma, Y., Macías, J., Macleod, C. A., Maier, W., Mangialasche, F., Spallazzi, M., Marquié, M., Marshall, R., Martin, E. R., Montes, A. M., Rodríguez, C. M., Masullo, C., Mayeux, R., Mead, S., Mecocci, P., Medina, M., Meggy, A., Mehrabian, S., Mendoza, S., Menéndez-González, M., Mir, P., Moebus, S., Mol, M., Molina-Porcel, L., Montrreal, L., Morelli, L., Moreno, F., Morgan, K., Mosley, T., Nöthen, M. M., Muchnik, C., Mukherjee, S., Nacmias, B., Ngandu, T., Nicolas, G., Nordestgaard, B. G., Olaso, R., Orellana, A., Orsini, M., Ortega, G., Padovani, A., Paolo, C., Papenberg, G., Parnetti, L., Pasquier, F., Pastor, P., Peloso, G., Pérez-Cordón, A., Pérez-Tur, J., Pericard, P., Peters, O., Pijnenburg, Y. A. L., Pineda, J. A., Piñol-Ripoll, G., Pisanu, C., Polak, T., Popp, J., Posthuma, D., Priller, J., Puerta, R., Quenez, O., Quintela, I., Thomassen, J. Q., Rábano, A., Rainero, I., Rajabli, F., Ramakers, I., Real, L. M., Reinders, M. J. T., Reitz, C., Reyes-Dumeyer, D., Ridge, P., Riedel-Heller, S., Riederer, P., Roberto, N., Rodriguez-Rodriguez, E., Rongve, A., Allende, I. R., Rosende-Roca, M., Royo, J. L., Rubino, E., Rujescu, D., Sáez, M. E., Sakka, P., Saltvedt, I., Sanabria, Á., Sánchez-Arjona, M. B., Sanchez-Garcia, F., Juan, P. S., Sánchez-Valle, R., Sando, S. B., Sarnowski, C., Satizabal, C. L., Scamosci, M., Scarmeas, N., Scarpini, E., Scheltens, P., Scherbaum, N., Scherer, M., Schmid, M., Schneider, A., Schott, J. M., Selbæk, G., Seripa, D., Serrano, M., Sha, J., Shadrin, A. A., Skrobot, O., Slifer, S., Snijders, G. J. L., Soininen, H., Solfrizzi, V., Solomon, A., Song, Y. E., Sorbi, S., Sotolongo-Grau, O., Spalletta, G., Spottke, A., Squassina, A., Stordal, E., Tartan, J. P., Tárraga, L., Tesí, N., Thalamuthu, A., Thomas, T., Tosto, G., Traykov, L., Tremolizzo, L., Tybjærg-Hansen, A., Uitterlinden, A., Ullgren, A., Ulstein, I., Valero, S., Valladares, O., Broeckhoven, C. V., Vance, J., Vardarajan, B. N., van der Lugt, A., Dongen, J. V., van Rooij, J., van Swieten, J., Vandenberghe, R., Verhey, F., Vidal, J. -S., Vogelgsang, J., Vyhnalek, M., Wagner, M., Wallon, D., Wang, L. -S., Wang, R., Weinhold, L., Wiltfang, J., Windle, G., Woods, B., Yannakoulia, M., Zare, H., Zhao, Y., Zhang, X., Zhu, C., Zulaica, M., Laczo, J., Matoska, V., Serpente, M., Assogna, F., Piras, F., Ciullo, V., Shofany, J., Ferrarese, C., Andreoni, S., Sala, G., Zoia, C. P., Zompo, M. D., Benussi, A., Bastiani, P., Takalo, M., Natunen, T., Laatikainen, T., Tuomilehto, J., Antikainen, R., Strandberg, T., Lindström, J., Peltonen, M., Abraham, R., Al-Chalabi, A., Bass, N. J., Brayne, C., Brown, K. S., Collinge, J., Craig, D., Deloukas, P., Fox, N., Gerrish, A., Gill, M., Gwilliam, R., Harold, D., Hollingworth, P., Johnston, J. A., Jones, L., Lawlor, B., Livingston, G., Lovestone, S., Lupton, M., Lynch, A., Mann, D., Mcguinness, B., Mcquillin, A., O’Donovan, M. C., Owen, M. J., Passmore, P., Powell, J. F., Proitsi, P., Rossor, M., Shaw, C. E., Smith, A. D., Gurling, H., Todd, S., Mummery, C., Ryan, N., Lacidogna, G., Adarmes-Gómez, A., Mauleón, A., Pancho, A., Gailhajenet, A., Lafuente, A., Macias-García, D., Martín, E., Pelejà, E., Carrillo, F., Merlín, I. S., Garrote-Espina, L., Vargas, L., Carrion-Claro, M., Marín, M., Labrador, M., Buendia, M., Alonso, M. D., Guitart, M., Moreno, M., Ibarria, M., Periñán, M., Aguilera, N., Gómez-Garre, P., Cañabate, P., Escuela, R., Pineda-Sánchez, R., Vigo-Ortega, R., Jesús, S., Preckler, S., Rodrigo-Herrero, S., Diego, S., Vacca, A., Roveta, F., Salvadori, N., Chipi, E., Boecker, H., Laske, C., Perneczky, R., Anastasiou, C., Janowitz, D., Malik, R., Anastasiou, A., Parveen, K., López-García, S., Antonell, A., Mihova, K. Y., Belezhanska, D., Weber, H., Kochen, S., Solis, P., Medel, N., Lisso, J., Sevillano, Z., Politis, D. G., Cores, V., Cuesta, C., Ortiz, C., Bacha, J. I., Rios, M., Saenz, A., Abalos, M. S., Kohler, E., Palacio, D. L., Etchepareborda, I., Kohler, M., Novack, G., Prestia, F. A., Galeano, P., Castaño, E. M., Germani, S., Toso, C. R., Rojo, M., Ingino, C., Mangone, C., Rubinsztein, D. C., Teipel, S., Fievet, N., Deramerourt, V., Forsell, C., Thonberg, H., Bjerke, M., Roeck, E. D., Martínez-Larrad, M. T., Olivar, N., Cano, A., Macias, J., Maroñas, O., Nuñez-Llaves, R., Olivé, C., Adarmes-Gómez, A. D., Amer-Ferrer, G., Antequera, M., Burguera, J. A., Casajeros, M. J., Martinez de Pancorbo, M., Hevilla, S., Espinosa, M. A. L., Legaz, A., Manzanares, S., Marín-Muñoz, J., Marín, T., Martínez, B., Martínez, V., Martínez-Lage Álvarez, P., Iriarte, M. M., Periñán-Tocino, M. T., Real de Asúa, D., Rodrigo, S., Sastre, I., Vicente, M. P., Vivancos, L., Epelbaum, J., Hannequin, D., Campion, D., Deramecourt, V., Tzourio, C., Brice, A., Dubois, B., Williams, A., Thomas, C., Davies, C., Nash, W., Dowzell, K., Morales, A. C., Bernardo-Harrington, M., Turton, J., Lord, J., Brown, K., Vardy, E., Fisher, E., Warren, J. D., Ryan, N. S., Guerreiro, R., Uphill, J., Bass, N., Heun, R., Kölsch, H., Schürmann, B., Lacour, A., Herold, C., Powell, J., Patel, Y., Hodges, A., Becker, T., Warden, D., Wilcock, G., Clarke, R., Ben-Shlomo, Y., Hooper, N. M., Pickering-Brown, S., Sussams, R., Warner, N., Bayer, A., Heuser, I., Drichel, D., Klopp, N., Mayhaus, M., Riemenschneider, M., Pinchler, S., Feulner, T., Gu, W., van den Bussche, H., Hüll, M., Frölich, L., Wichmann, H. -E., Jöckel, K. -H., O’Donovan, M., Owen, M., Bahrami, S., Bosnes, I., Selnes, P., Bergh, S., Palotie, A., Daly, M., Jacob, H., Matakidou, A., Runz, H., John, S., Plenge, R., Mccarthy, M., Hunkapiller, J., Ehm, M., Waterworth, D., Fox, C., Malarstig, A., Klinger, K., Call, K., Behrens, T., Loerch, P., Mäkelä, T., Kaprio, J., Virolainen, P., Pulkki, K., Kilpi, T., Perola, M., Partanen, J., Pitkäranta, A., Kaarteenaho, R., Vainio, S., Turpeinen, M., Serpi, R., Laitinen, T., Mäkelä, J., Kosma, V. -M., Kujala, U., Tuovila, O., Hendolin, M., Pakkanen, R., Waring, J., Riley-Gillis, B., Liu, J., Biswas, S., Diogo, D., Marshall, C., Hu, X., Gossel, M., Graham, R., Cummings, B., Ripatti, S., Schleutker, J., Arvas, M., Carpén, O., Hinttala, R., Kettunen, J., Mannermaa, A., Laukkanen, J., Julkunen, V., Remes, A., Kälviäinen, R., Peltola, J., Tienari, P., Rinne, J., Ziemann, A., Esmaeeli, S., Smaoui, N., Lehtonen, A., Eaton, S., Lahdenperä, S., van Adelsberg, J., Michon, J., Kerchner, G., Bowers, N., Teng, E., Eicher, J., Mehta, V., Gormley, P., Linden, K., Whelan, C., Xu, F., Pulford, D., Färkkilä, M., Pikkarainen, S., Jussila, A., Blomster, T., Kiviniemi, M., Voutilainen, M., Georgantas, B., Heap, G., Rahimov, F., Usiskin, K., Lu, T., Oh, D., Kalpala, K., Miller, M., Mccarthy, L., Eklund, K., Palomäki, A., Isomäki, P., Pirilä, L., Kaipiainen-Seppänen, O., Huhtakangas, J., Lertratanakul, A., Hochfeld, M., Bing, N., Gordillo, J. E., Mars, N., Pelkonen, M., Kauppi, P., Kankaanranta, H., Harju, T., Close, D., Greenberg, S., Chen, H., Betts, J., Ghosh, S., Salomaa, V., Niiranen, T., Juonala, M., Metsärinne, K., Kähönen, M., Junttila, J., Laakso, M., Pihlajamäki, J., Sinisalo, J., Taskinen, M. -R., Tuomi, T., Challis, B., Peterson, A., Chu, A., Parkkinen, J., Muslin, A., Joensuu, H., Meretoja, T., Aaltonen, L., Mattson, J., Auranen, A., Karihtala, P., Kauppila, S., Auvinen, P., Elenius, K., Popovic, R., Schutzman, J., Loboda, A., Chhibber, A., Lehtonen, H., Mcdonough, S., Crohns, M., Kulkarni, D., Kaarniranta, K., Turunen, J. A., Ollila, T., Seitsonen, S., Uusitalo, H., Aaltonen, V., Uusitalo-Järvinen, H., Luodonpää, M., Hautala, N., Loomis, S., Strauss, E., Podgornaia, A., Hoffman, J., Tasanen, K., Huilaja, L., Hannula-Jouppi, K., Salmi, T., Peltonen, S., Koulu, L., Harvima, I., Wu, Y., Choy, D., Pussinen, P., Salminen, A., Salo, T., Rice, D., Nieminen, P., Palotie, U., Siponen, M., Suominen, L., Mäntylä, P., Gursoy, U., Anttonen, V., Sipilä, K., Davis, J. W., Quarless, D., Petrovski, S., Wigmore, E., Chen, C. -Y., Bronson, P., Tsai, E., Huang, Y., Maranville, J., Shaikho, E., Mohammed, E., Wadhawan, S., Kvikstad, E., Caliskan, M., Chang, D., Bhangale, T., Pendergrass, S., Holzinger, E., Chen, X., Hedman, Å., King, K. S., Wang, C., Xu, E., Auge, F., Chatelain, C., Rajpal, D., Liu, D., Xia, T. -H., Brauer, M., Kurki, M., Karjalainen, J., Havulinna, A., Jalanko, A., Palta, P., della Briotta Parolo, P., Zhou, W., Lemmelä, S., Rivas, M., Harju, J., Lehisto, A., Ganna, A., Llorens, V., Laivuori, H., Rüeger, S., Niemi, M. E., Tukiainen, T., Reeve, M. P., Heyne, H., Palin, K., Garcia-Tabuenca, J., Siirtola, H., Kiiskinen, T., Lee, J., Tsuo, K., Elliott, A., Kristiansson, K., Hyvärinen, K., Ritari, J., Koskinen, M., Pylkäs, K., Kalaoja, M., Karjalainen, M., Mantere, T., Kangasniemi, E., Heikkinen, S., Laakkonen, E., Sipeky, C., Heron, S., Karlsson, A., Jambulingam, D., Rathinakannan, V. S., Kajanne, R., Aavikko, M., Jiménez, M. G., della Briotta Parola, P., Kanai, M., Kaunisto, M., Kilpeläinen, E., Sipilä, T. P., Brein, G., Awaisa, G., Shcherban, A., Donner, K., Loukola, A., Laiho, P., Sistonen, T., Kaiharju, E., Laukkanen, M., Järvensivu, E., Lähteenmäki, S., Männikkö, L., Wong, R., Mattsson, H., Hiekkalinna, T., Paajanen, T., Pärn, K., Gracia-Tabuenca, J., Abner, E., Adams, P. M., Aguirre, A., Albert, M. S., Albin, R. L., Allen, M., Alvarez, L., Apostolova, L. G., Arnold, S. E., Asthana, S., Atwood, C. S., Ayres, G., Baldwin, C. T., Barber, R. C., Barnes, L. L., Beach, T. G., Becker, J. T., Beecham, G. W., Beekly, D., Benitez, B. A., Bennett, D., Bertelson, J., Margaret, F. E., Bird, T. D., Blacker, D., Boeve, B. F., Bowen, J. D., Boxer, A., Brewer, J., Burke, J. R., Burns, J. M., Buxbaum, J. D., Cairns, N. J., Cao, C., Carlson, C. S., Carlsson, C. M., Carney, R. M., Carrasquillo, M. M., Chasse, S., Chesselet, M. -F., Chesi, A., Chin, N. A., Chui, H. C., Craft, S., Crane, P. K., Cribbs, D. H., Crocco, E. A., Cruchaga, C., Cullum, M., Darby, E., Davis, B., De Jager, P. L., Decarli, C., Detoledo, J., Dick, M., Dickson, D. W., Dombroski, B. A., Doody, R. S., Duara, R., Ertekin-Taner, N., Evans, D. A., Fairchild, T. J., Fallon, K. B., Farlow, M. R., Farrell, J. J., Fernandez-Hernandez, V., Ferris, S., Frosch, M. P., Galasko, D. R., Gamboa, A., Gearing, M., Geschwind, D. H., Ghetti, B., Gilbert, J. R., Grabowski, T. J., Graff-Radford, N. R., Grant, S. F. A., Green, R. C., Growdon, J. H., Hakonarson, H., Hall, J., Hamilton, R. L., Harari, O., Harrell, L. E., Haut, J., Head, E., Henderson, V. W., Hernandez, M., Hohman, T., Honig, L. S., Huebinger, R. M., Huentelman, M. J., Hulette, C. M., Hyman, B. T., Hynan, L. S., Ibanez, L., Jarvik, G. P., Jayadev, S., Jin, L. -W., Johnson, K., Johnson, L., Kamboh, M. I., Karydas, A. M., Katz, M. J., Kaye, J. A., Keene, C. D., Khaleeq, A., Kim, R., Knebl, J., Kowall, N. W., Kramer, J. H., Laferla, F. M., Lah, J. J., Larson, E. B., Lee, E. B., Lerner, A., Leung, Y. Y., Leverenz, J. B., Levey, A. I., Li, M., Lieberman, A. P., Lipton, R. B., Logue, M., Lyketsos, C. G., Malamon, J., Mains, D., Marson, D. C., Martiniuk, F., Mash, D. C., Masliah, E., Massman, P., Masurkar, A., Mccormick, W. C., Mccurry, S. M., Mcdavid, A. N., Mckee, A. C., Mesulam, M., Mez, J., Miller, B. L., Miller, C. A., Miller, J. W., Montine, T. J., Monuki, E. S., Morris, J. C., Myers, A. J., Nguyen, T., O’Bryant, S., Olichney, J. M., Ory, M., Palmer, R., Parisi, J. E., Paulson, H. L., Pavlik, V., Paydarfar, D., Perez, V., Peskind, E., Petersen, R. C., Phillips-Cremins, J. E., Pierce, A., Polk, M., Poon, W. W., Potter, H., Qu, L., Quiceno, M., Quinn, J. F., Raj, A., Raskind, M., Reiman, E. M., Reisberg, B., Reisch, J. S., Ringman, J. M., Roberson, E. D., Rodriguear, M., Rogaeva, E., Rosen, H. J., Rosenberg, R. N., Royall, D. R., Sager, M. A., Sano, M., Saykin, A. J., Schneider, J. A., Schneider, L. S., Seeley, W. W., Small, S., Smith, A. G., Smith, J. P., Sonnen, J. A., Spina, S., George-Hyslop, P. 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M, Rossi, P, Djurovic, S, Duron, E, Düzel, E, Dufouil, C, Eiriksdottir, G, Engelborghs, S, Escott-Price, V, Espinosa, A, Ewers, M, Faber, K, Fabrizio, T, Nielsen, S, Fardo, D, Farotti, L, Fenoglio, C, Fernández-Fuertes, M, Ferrari, R, Ferreira, C, Ferri, E, Fin, B, Fischer, P, Fladby, T, Fließbach, K, Fongang, B, Fornage, M, Fortea, J, Foroud, T, Fostinelli, S, Fox, N, Franco-Macías, E, Bullido, M, Frank-García, A, Froelich, L, Fulton-Howard, B, Galimberti, D, García-Alberca, J, García-González, P, Garcia-Madrona, S, Garcia-Ribas, G, Ghidoni, R, Giegling, I, Giorgio, G, Goate, A, Goldhardt, O, Gomez-Fonseca, D, González-Pérez, A, Graff, C, Grande, G, Green, E, Grimmer, T, Grünblatt, E, Grunin, M, Gudnason, V, Guetta-Baranes, T, Haapasalo, A, Hadjigeorgiou, G, Haines, J, Hamilton-Nelson, K, Hampel, H, Hanon, O, Hardy, J, Hartmann, A, Hausner, L, Harwood, J, Heilmann-Heimbach, S, Helisalmi, S, Heneka, M, Hernández, I, Herrmann, M, Hoffmann, P, Holmes, C, Holstege, H, Vilas, R, Hulsman, M, Humphrey, J, Biessels, G, Jian, X, Johansson, C, Jun, G, Kastumata, Y, Kauwe, J, Kehoe, P, Kilander, L, Ståhlbom, A, Kivipelto, M, Koivisto, A, Kornhuber, J, Kosmidis, M, Kukull, W, Kuksa, P, Kunkle, B, Kuzma, A, Lage, C, Laukka, E, Launer, L, Lauria, A, Lee, C, Lehtisalo, J, Lerch, O, Lleó, A, Longstreth, W, Lopez, O, de Munain, A, Love, S, Löwemark, M, Luckcuck, L, Lunetta, K, Ma, Y, Macías, J, Macleod, C, Maier, W, Mangialasche, F, Spallazzi, M, Marquié, M, Marshall, R, Martin, E, Montes, A, Rodríguez, C, Masullo, C, Mayeux, R, Mead, S, Mecocci, P, Medina, M, Meggy, A, Mehrabian, S, Mendoza, S, Menéndez-González, M, Mir, P, Moebus, S, Mol, M, Molina-Porcel, L, Montrreal, L, Morelli, L, Moreno, F, Morgan, K, Mosley, T, Nöthen, M, Muchnik, C, Mukherjee, S, Nacmias, B, Ngandu, T, Nicolas, G, Nordestgaard, B, Olaso, R, Orellana, A, Orsini, M, Ortega, G, Padovani, A, Paolo, C, Papenberg, G, Parnetti, L, Pasquier, F, Pastor, P, Peloso, G, Pérez-Cordón, A, Pérez-Tur, J, Pericard, P, Peters, O, Pijnenburg, Y, Pineda, J, Piñol-Ripoll, G, Pisanu, C, Polak, T, Popp, J, Posthuma, D, Priller, J, Puerta, R, Quenez, O, Quintela, I, Thomassen, J, Rábano, A, Rainero, I, Rajabli, F, Ramakers, I, Real, L, Reinders, M, Reitz, C, Reyes-Dumeyer, D, Ridge, P, Riedel-Heller, S, Riederer, P, Roberto, N, Rodriguez-Rodriguez, E, Rongve, A, Allende, I, Rosende-Roca, M, Royo, J, Rubino, E, Rujescu, D, Sáez, M, Sakka, P, Saltvedt, I, Sanabria, Á, Sánchez-Arjona, M, Sanchez-Garcia, F, Juan, P, Sánchez-Valle, R, Sando, S, Sarnowski, C, Satizabal, C, Scamosci, M, Scarmeas, N, Scarpini, E, Scheltens, P, Scherbaum, N, Scherer, M, Schmid, M, Schneider, A, Schott, J, Selbæk, G, Seripa, D, Serrano, M, Sha, J, Shadrin, A, Skrobot, O, Slifer, S, Snijders, G, Soininen, H, Solfrizzi, V, Solomon, A, Song, Y, Sorbi, S, Sotolongo-Grau, O, Spalletta, G, Spottke, A, Squassina, A, Stordal, E, Tartan, J, Tárraga, L, Tesí, N, Thalamuthu, A, Thomas, T, Tosto, G, Traykov, L, Tremolizzo, L, Tybjærg-Hansen, A, Uitterlinden, A, Ullgren, A, Ulstein, I, Valero, S, Valladares, O, Broeckhoven, C, Vance, J, Vardarajan, B, van der Lugt, A, Dongen, J, van Rooij, J, van Swieten, J, Vandenberghe, R, Verhey, F, Vidal, J, Vogelgsang, J, Vyhnalek, M, Wagner, M, Wallon, D, Wang, L, Wang, R, Weinhold, L, Wiltfang, J, Windle, G, Woods, B, Yannakoulia, M, Zare, H, Zhao, Y, Zhang, X, Zhu, C, Zulaica, M, Andreoni, S, Ferrarese, C, Sala, G, Zoia, C, Farrer, L, Psaty, B, Ghanbari, M, Raj, T, Sachdev, P, Mather, K, Jessen, F, Ikram, M, de Mendonça, A, Hort, J, Tsolaki, M, Pericak-Vance, M, Amouyel, P, Williams, J, Frikke-Schmidt, R, Clarimon, J, Deleuze, J, Rossi, G, Seshadri, S, Andreassen, O, Ingelsson, M, Hiltunen, M, Sleegers, K, Schellenberg, G, van Duijn, C, Sims, R, van der Flier, W, Ruiz, A, Ramirez, A, Lambert, J, VU University medical center, Amsterdam Neuroscience - Neurodegeneration, Neurology, Human genetics, Amsterdam Neuroscience - Complex Trait Genetics, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, APH - Personalized Medicine, APH - Methodology, Bellenguez, Céline [0000-0002-1240-7874], Küçükali, Fahri [0000-0002-3835-9639], Amin, Najaf [0000-0002-8944-1771], Holmans, Peter A [0000-0003-0870-9412], van der Lee, Sven J [0000-0003-1606-8643], Costa, Marcos R [0000-0002-4928-2163], Kuulasmaa, Teemu [0000-0002-1795-7314], Yang, Qiong [0000-0002-3658-1375], de Rojas, Itziar [0000-0002-2148-381X], Bis, Joshua C [0000-0002-3409-1110], Yaqub, Amber [0000-0002-3579-8054], Prokic, Ivana [0000-0002-0370-1473], Chapuis, Julien [0000-0002-5802-2857], Ahmad, Shahzad [0000-0002-8658-3790], Giedraitis, Vilmantas [0000-0003-3423-2021], Garcia-Gonzalez, Pablo [0000-0003-0125-5403], Alcolea, Daniel [0000-0002-3819-3245], Alvarez, Ignacio [0000-0002-8537-3935], Tsolaki, Anthoula [0000-0002-5563-7776], Baquero, Miquel [0000-0002-6861-1831], Pastor, Ana Belén [0000-0001-9637-4688], Berr, Claudine [0000-0001-5254-7655], Bessi, Valentina [0000-0002-6176-3584], Boada, Mercè 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Sachdev, Perminder [0000-0002-9595-3220], Mather, Karen [0000-0003-4143-8941], Ikram, M Arfan [0000-0003-0372-8585], Tsolaki, Magda [0000-0002-2072-8010], Pericak-Vance, Margaret A [0000-0001-7283-8804], Amouyel, Philippe [0000-0001-9088-234X], Williams, Julie [0000-0002-4069-0259], Frikke-Schmidt, Ruth [0000-0003-4084-5027], Seshadri, Sudha [0000-0001-6135-2622], Andreassen, Ole A [0000-0002-4461-3568], Sleegers, Kristel [0000-0002-0283-2332], van Duijn, Cornelia M [0000-0002-2374-9204], Sims, Rebecca [0000-0002-3885-1199], van der Flier, Wiesje M [0000-0001-8766-6224], Ramirez, Alfredo [0000-0003-4991-763X], Lambert, Jean-Charles [0000-0003-0829-7817], Apollo - University of Cambridge Repository, Complex Trait Genetics, Clinical sciences, Neuroprotection & Neuromodulation, Pathologic Biochemistry and Physiology, Clinical Biology, Epidemiology, Internal Medicine, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA Med Staf Spec Psychiatrie (9), UAM. Departamento de Biología Molecular, University of Helsinki, Department of Neurosciences, HUS Internal Medicine and Rehabilitation, Timo Strandberg / Principal Investigator, Department of Medicine, Clinicum, HUS Neurocenter, Neurologian yksikkö, Centre of Excellence in Complex Disease Genetics, HUS Abdominal Center, Institut Pasteur, Institut National de la Santé et de la Recherche Médicale (France), European Commission, LabEx DISTALZ, Pérez-Tur, Jordi, University Children’s Hospital Basel (Suiza), INSERM (Francia), Lille Métropole Communauté Urbaine, Government of France (Francia), EADB, GR@ACE, DEGESCO, EADI, GERAD, Demgene, FinnGen, ADGC, CHARGE, Holmans, Peter A. [0000-0003-0870-9412], van der Lee, Sven J. [0000-0003-1606-8643], Costa, Marcos R. [0000-0002-4928-2163], Bis, Joshua C. [0000-0002-3409-1110], Brookes, Keeley J. [0000-0003-2427-2513], Bush, William S. [0000-0002-9729-6519], de Witte, Lot D. [0000-0002-7235-9958], del Ser, Teodoro [0000-0001-9806-7083], Fox, Nick C. [0000-0002-6660-657X], Bullido, María J. [0000-0002-6477-1117], Goate, Alison M. [0000-0002-0576-2472], Herrmann, Martin J. [0000-0001-9970-2122], Jun, Gyungah R. [0000-0002-3230-8697], Kehoe, Patrick G. [0000-0002-7542-1139], Kosmidis, Mary H. [0000-0001-8790-1220], Lunetta, Kathryn L. [0000-0002-9268-810X], MacLeod, Catherine A. [0000-0002-9314-7380], Nöthen, Markus M. [0000-0002-8770-2464], Nordestgaard, Børge G. [0000-0002-1954-7220], Pineda, Juan A. [0000-0002-3751-0296], Real, Luis M. [0000-0003-4932-7429], Reinders, Marcel J. T. [0000-0002-1148-1562], Satizabal, Claudia L. [0000-0002-1115-4430], Schott, Jonathan M. [0000-0003-2059-024X], Shadrin, Alexey A. [0000-0002-7467-250X], Farrer, Lindsay A. [0000-0001-5533-4225], Psaty, Bruce M. [0000-0002-7278-2190], Ikram, M. Arfan [0000-0003-0372-8585], Pericak-Vance, Margaret A. [0000-0001-7283-8804], Andreassen, Ole A. [0000-0002-4461-3568], van Duijn, Cornelia M. [0000-0002-2374-9204], van der Flier, Wiesje M. [0000-0001-8766-6224], and Molecular Neuroscience and Ageing Research (MOLAR)
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tau Proteins/genetics ,Alzheimer`s disease Donders Center for Medical Neuroscience [Radboudumc 1] ,Neurologi ,MED/03 - GENETICA MEDICA ,45/43 ,Medizin ,Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13] ,genetics [Alzheimer Disease] ,Genome-Wide Association Study ,Humans ,tau Proteins ,Alzheimer Disease ,Cognitive Dysfunction ,VARIANTS ,pathology [Alzheimer Disease] ,Tau Proteins ,Settore BIO/13 - Biologia Applicata ,Cognitive Dysfunction/psychology ,692/699/375/365/1283 ,IMPUTATION ,article ,1184 Genetics, developmental biology, physiology ,Biología y Biomedicina / Biología ,AMYLOID-BETA ,Settore MED/26 - NEUROLOGIA ,Neurology ,psychology [Cognitive Dysfunction] ,Medical Genetics ,Human ,Neuroscience(all) ,631/208/205/2138 ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,ddc:570 ,Genetics ,Genetic Predisposition to Disease ,GENOME-WIDE ASSOCIATION ,METAANALYSIS ,Medicinsk genetik ,MED/26 - NEUROLOGIA ,Alzheimer Disease/genetics ,neurology ,tau Protein ,NECROSIS-FACTOR-ALPHA ,RISK LOCI ,genetics [tau Proteins] ,PREDICTION MODELS ,Human medicine ,GENERATION ,RESPONSES - Abstract
25 páginas, 6 figuras, 2 tablas, Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele., This work was funded by a grant (EADB) from the EU Joint Programme – Neurodegenerative Disease Research. INSERM UMR1167 is also funded by the INSERM, Institut Pasteur de Lille, Lille Métropole Communauté Urbaine and French government’s LABEX DISTALZ program (development of innovative strategies for a transdisciplinary approach to AD). Full consortium acknowledgements and funding are in the Supplementary Not
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- 2022
5. EE323 Cost-Utility Analysis of Polygenic Risk Score in the Prevention of Type 2 Diabetes – An Object-Oriented Individual-Level Model With Probabilistic Sensitivity Analysis
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Martikainen, JA, primary, Lehtimäki, AV, additional, Jalkanen, K, additional, Lavikainen, P, additional, Paajanen, T, additional, Marjonen, H, additional, Kristiansson, K, additional, Lindström, J, additional, and Perola, M, additional
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- 2022
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6. Occupational complexity and cognition in the FINGER multidomain intervention trial
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Rydström, A. (Anders), Darin-Mattsson, A. (Alexander), Kåreholt, I. (Ingemar), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Sindi, S. (Shireen), Soininen, H. (Hilkka), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Mangialasche, F. (Francesca), Rydström, A. (Anders), Darin-Mattsson, A. (Alexander), Kåreholt, I. (Ingemar), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Sindi, S. (Shireen), Soininen, H. (Hilkka), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Mangialasche, F. (Francesca)
- Abstract
Introduction: Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions. Methods: In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. Results: Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function. Discussion: In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies.
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- 2022
7. The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER)
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Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Korkki, S. (Saana), Solomon, A. (Alina), Coley, N. (Nicola), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Lindström, J. (Jaana), Laatikainen, T. (Tiina), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Korkki, S. (Saana), Solomon, A. (Alina), Coley, N. (Nicola), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Lindström, J. (Jaana), Laatikainen, T. (Tiina), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), and Kivipelto, M. (Miia)
- Abstract
Introduction: Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses). Methods: FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention (ClinicalTrials.gov NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores. Results: Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function. Discussion: Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential.
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- 2022
8. Associations of depressive symptoms and cognition in the FINGER trial:a secondary analysis of a randomised clinical trial
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Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Solomon, A. (Alina), Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Solomon, A. (Alina)
- Abstract
Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60–77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient −0.006, 95% CI −0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (−0.140, p = 0.005) and memory (−0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung −0.096, 95% CI −0.163 to −0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
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- 2022
9. Telomere length change in a multidomain lifestyle intervention to prevent cognitive decline:a randomized clinical trial
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Sindi, S. (Shireen), Solomon, A. (Alina), Kåreholt, I. (Ingemar), Hovatta, I. (Iiris), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Levälahti, E. (Esko), Laatikainen, T. (Tiina), Lehtisalo, J. (Jenni), Lindström, J. (Jaana), Paajanen, T. (Teemu), Peltonen, M. (Markku), Singh Khalsa, D. (Dharma), Wolozin, B. (Benjamin), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Ngandu, T. (Tiia), Kivipelto, M. (Miia), and F. S. (FINGER Study Group)
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behavioural intervention ,dementia prevention ,telomeres ,older adults - Abstract
Background: Shorter leukocyte telomere length (LTL) is associated with aging and dementia. Impact of lifestyle changes on LTL, and relation to cognition and genetic susceptibility for dementia, has not been investigated in randomized controlled trials (RCTs). Methods: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability is a 2-year RCT enrolling 1260 participants at risk for dementia from the general population, aged 60–77 years, randomly assigned (1:1) to multidomain lifestyle intervention or control group. The primary outcome was cognitive change (Neuropsychological Test Battery z-score). Relative LTL was measured using quantitative real-time polymerase chain reaction (trial registration: NCT01041989). Results: This exploratory LTL substudy included 756 participants (377 intervention, 379 control) with baseline and 24-month LTL measurements. The mean annual LTL change (SD) was −0.016 (0.19) in the intervention group and −0.023 (0.17) in the control group. Between-group difference was nonsignificant (unstandardized β-coefficient 0.007, 95% CI −0.015 to 0.030). Interaction analyses indicated better LTL maintenance among apolipoprotein E (APOE)-ε4 carriers versus noncarriers: 0.054 (95% CI 0.007 to 0.102); younger versus older participants: −0.005 (95% CI −0.010 to −0.001); and those with more versus less healthy lifestyle changes: 0.047 (95% CI 0.005 to 0.089). Cognitive intervention benefits were more pronounced among participants with better LTL maintenance for executive functioning (0.227, 95% CI 0.057 to 0.396) and long-term memory (0.257, 95% CI 0.024 to 0.489), with a similar trend for Neuropsychological Test Battery total score (0.127, 95% CI −0.011 to 0.264). Conclusions: This is the first large RCT showing that a multidomain lifestyle intervention facilitated LTL maintenance among subgroups of older people at risk for dementia, including APOE-ε4 carriers. LTL maintenance was associated with more pronounced cognitive intervention benefits. Clinical Trials Registration Number: NCT01041989
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- 2021
10. Biopsychosocial profiles of patients with cardiac disease in remote rehabilitation processes : Mixed methods grounded theory approach
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Anttila, M. -R, Söderlund, Anne, Paajanen, T., Kivistö, H., Kokko, K., Sjögren, T., Anttila, M. -R, Söderlund, Anne, Paajanen, T., Kivistö, H., Kokko, K., and Sjögren, T.
- Abstract
Background: Digital development has caused rehabilitation services and rehabilitees to become increasingly interested in using technology as a part of rehabilitation. This study was based on a previously published study that categorized 4 groups of patients with cardiac disease based on different experiences and attitudes toward technology (e-usage groups): feeling outsider, being uninterested, reflecting benefit, and enthusiastic using. Objective: This study identifies differences in the biopsychosocial profiles of patients with cardiac disease in e-usage groups and deepen the understanding of these profiles in cardiac rehabilitation. Methods: Focus group interviews and measurements were conducted with 39 patients with coronary heart disease, and the mean age was 54.8 (SD 9.4, range 34-77) years. Quantitative data were gathered during a 12-month rehabilitation period. First, we used analysis of variance and Tukey honestly significant difference test, a t test, or nonparametric tests—Mann–Whitney and Kruskal–Wallis tests—to compare the 4 e-usage groups—feeling outsider, being uninterested, reflecting benefit, and enthusiastic using—in biopsychosocial variables. Second, we compared the results of the 4 e-groups in terms of recommended and reference values. This analysis contained 13 variables related to biomedical, psychological, and social functioning. Finally, we formed biopsychosocial profiles based on the integration of the findings by constant comparative analysis phases through classic grounded theory. Results: The biomedical variables were larger for waistline (mean difference [MD] 14.2; 95% CI 1.0-27.5; P=.03) and lower for physical fitness (MD −0.72; 95% CI −1.4 to −0.06; P=.03) in the being uninterested group than in the enthusiastic using group. The feeling outsider group had lower physical fitness (MD −55.8; 95% CI −110.7 to −0.92; P=.047) than the enthusiastic using group. For psychosocial variables, such as the degree of self-determination in exercise (
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- 2021
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11. Memory is affected by sounds presented with time-locking to EEG delta: P597
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Huotilainen, M., Leminen, M., Gröhn, M., Hublin, C., Paajanen, T., Saure, E., Virkkala, J., and Paunio, T.
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- 2014
12. Auditory stimulation evokes slow oscillations and spindle activity: P312
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Virkkala, J., Leminen, M., Saure, E., Paajanen, T., Huotilainen, M., and Paunio, T.
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- 2014
13. cCOG:a web‐based cognitive test tool for detecting neurodegenerative disorders
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Rhodius-Meester, H. F. (Hanneke F.M.), Paajanen, T. (Teemu), Koikkalainen, J. (Juha), Mahdiani, S. (Shadi), Bruun, M. (Marie), Baroni, M. (Marta), Lemstra, A. W. (Afina W.), Scheltens, P. (Philip), Herukka, S.-K. (Sanna-Kaisa), Pikkarainen, M. (Maria), Hall, A. (Anette), Hänninen, T. (Tuomo), Ngandu, T. (Tiia), Kivipelto, M. (Miia), van Gils, M. (Mark), Hasselbalch, S. G. (Steen Gregers), Mecocci, P. (Patrizia), Remes, A. (Anne), Soininen, H. (Hilkka), van der Flier, W. M. (Wiesje M.), Lötjönen, J. (Jyrki), Rhodius-Meester, H. F. (Hanneke F.M.), Paajanen, T. (Teemu), Koikkalainen, J. (Juha), Mahdiani, S. (Shadi), Bruun, M. (Marie), Baroni, M. (Marta), Lemstra, A. W. (Afina W.), Scheltens, P. (Philip), Herukka, S.-K. (Sanna-Kaisa), Pikkarainen, M. (Maria), Hall, A. (Anette), Hänninen, T. (Tuomo), Ngandu, T. (Tiia), Kivipelto, M. (Miia), van Gils, M. (Mark), Hasselbalch, S. G. (Steen Gregers), Mecocci, P. (Patrizia), Remes, A. (Anne), Soininen, H. (Hilkka), van der Flier, W. M. (Wiesje M.), and Lötjönen, J. (Jyrki)
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Introduction: Web‐based cognitive tests have potential for standardized screening in neurodegenerative disorders. We examined accuracy and consistency of cCOG, a computerized cognitive tool, in detecting mild cognitive impairment (MCI) and dementia. Methods: Clinical data of 306 cognitively normal, 120 mild cognitive impairment (MCI), and 69 dementia subjects from three European cohorts were analyzed. Global cognitive score was defined from standard neuropsychological tests and compared to the corresponding estimated score from the cCOG tool containing seven subtasks. The consistency of cCOG was assessed comparing measurements administered in clinical settings and in the home environment. Results: cCOG produced accuracies (receiver operating characteristic‐area under the curve [ROC‐AUC]) between 0.71 and 0.84 in detecting MCI and 0.86 and 0.94 in detecting dementia when administered at the clinic and at home. The accuracy was comparable to the results of standard neuropsychological tests (AUC 0.69–0.77 MCI/0.91–0.92 dementia). Conclusions: cCOG provides a promising tool for detecting MCI and dementia with potential for a cost‐effective approach including home‐based cognitive assessments.
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- 2020
14. Experimental investigation of jet drying of birch and spruce veneers and modelling with a simplified approach
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Hanhijärvi, A., Hukka, A., Paajanen, T., Pulkkinen, P., and Sundman, S.
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- 2003
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15. FINGER-elintapaohjelma:toimintamalli kognitiivisen toimintakyvyn tukemiseen
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Kivipelto, M. (Miia), Kulmala, J. (Jenni), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Lindström, J. (Jaana), Rauramaa, R. (Rainer), Peltonen, M. (Markku), Laatikainen, T. (Tiina), Havulinna, S. (Satu), Soininen, H. (Hilkka), Tuomilehto, J. (Jaakko), Hänninen, T. (Tuomo), Paajanen, T. (Teemu), Antikainen, R. (Riitta), Strandberg, T. (Timo), and Ngandu, T. (Tiia)
- Abstract
Tiivistelmä Suomessa toteutettu FINGER-tutkimus tarjoaa toimintamallin maailmanlaajuisen muistisairausepidemian hillitsemiseksi. Monimuotoinen ohjelma voi pienentää muistihäiriöiden riskiä jopa 30 %. Ohjelman kulmakivet ovat käytännönläheinen ravitsemusohjaus, nousujohteinen liikuntaharjoittelu, muistiharjoittelu sekä sydän- ja verisuonitautien riskitekijöiden hallinta. Muistisairauksien ehkäisyn toimintamalli tulisi integroida nykyisiin sydän- ja verisuonitautien ja diabeteksen ehkäisytoimiin. Abstract The Finnish Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was globally the first randomized controlled trial showing that intensive lifestyle intervention targeting simultaneously several modifiable dementia-related risk factors has beneficial effects on the cognition of older persons who are at increased risk for cognitive decline. FINGER intervention included simultaneous nutritional guidance, physical exercise, cognitive training and social activities, and management of vascular risk factors. The control group received regular health advice. FINGER results showed that persons in the intervention group had a 30% lower risk for cognitive decline during the 2-year intervention compared with the control group. Beneficial effects were also seen for physical functioning and quality of life. Successful FINGER intervention serves as a model for effective dementia prevention. The model should be integrated into existing cardiovascular disease and diabetes prevention strategies.
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- 2019
16. Self and informant memory reports in FINGER:associations with two-year cognitive change
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Vaskivuo, L. (Laura), Hokkanen, L. (Laura), Hänninen, T. (Tuomo), Antikainen, R. (Riitta), Bäckman, L. (Lars), Laatikainen, T. (Tiina), Paajanen, T. (Teemu), Stigsdotter-Neely, A. (Anna), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
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cognition ,memory ,Aging ,dementia - Abstract
Background:Subjective memory complaints (SMCs) may be the first sign of cognitive decline in aging. Objective:To examine whether SMCs reported by oneself and informant predict cognitive change over 2 years among at-risk elderly people, and to determine the relationship of different types of SMCs (prospective and retrospective memory complaints) and change in cognitive function. Methods:This investigation is part of the FINGER project, which is a multicenter randomized controlled trial aiming at preventing cognitive decline in cognitively healthy older adults with increased risk of dementia. A subsample of 303 control-group participants (aged 60–80 years) and their informants (n = 261) rated the frequency of SMCs, using the Prospective and Retrospective Memory Questionnaire (PRMQ). Cognitive performance was measured at baseline and at 1- and 2-year follow-up visits using a neuropsychological test battery. Results:Participants who reported more SMCs improved less in global cognition, executive function, and memory during the subsequent 2 years in the fully-adjusted analyses. Self-reported retrospective memory problems predicted less improvement in all cognitive domains, whereas prospective memory problems did not. Informant-reported memory problems were not linked to subsequent change in cognition. Conclusion:Our results indicate that self-reported SMCs, measured with PRMQ, predict future cognitive change in several cognitive domains. By contrast, reports by informants were not linked to changes in cognition. Among cognitively healthy at-risk elderly individuals, the persons themselves observe more easily problems relevant for their future cognitive trajectories than their informants.
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- 2019
17. Dietary changes and cognition over 2 years within a multidomain intervention trial:the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)
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Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Hänninen, T. (Tuomo), Paajanen, T. (Teemu), Peltonen, M. (Markku), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Strandberg, T. (Timo), Soininen, H. (Hilkka), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Hänninen, T. (Tuomo), Paajanen, T. (Teemu), Peltonen, M. (Markku), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Strandberg, T. (Timo), Soininen, H. (Hilkka), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
- Abstract
Introduction: Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. Methods: We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60–77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. Results: Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). Discussion: Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition.
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- 2019
18. Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics:the FINGER trial
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Rosenberg, A. (Anna), Ngandu, T. (Tiia), Rusanen, M. (Minna), Antikainen, R. (Riitta), Bäckman, L. (Lars), Havulinna, S. (Satu), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Peltonen, M. (Markku), Soininen, H. (Hilkka), Stigsdotter-Neely, A. (Anna), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Solomon, A. (Alina), and Kivipelto, M. (Miia)
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Cognitive impairment ,Randomized controlled trial ,Prevention ,Dementia ,Intervention ,Alzheimer's disease ,Lifestyle ,Multidomain - Abstract
Introduction: The 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle intervention trial (NCT01041989) demonstrated beneficial effects on cognition. We investigated whether sociodemographics, socioeconomic status, baseline cognition, or cardiovascular factors influenced intervention effects on cognition. Methods: The FINGER recruited 1260 people from the general Finnish population (60–77 years, at risk for dementia). Participants were randomized 1:1 to multidomain intervention (diet, exercise, cognition, and vascular risk management) and regular health advice. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Prespecified analyses to investigate whether participants’ characteristics modified response to intervention were carried out using mixed-model repeated-measures analyses. Results: Sociodemographics (sex, age, and education), socioeconomic status (income), cognition (Mini–Mental State Examination), cardiovascular factors (body mass index, blood pressure, cholesterol, fasting glucose, and overall cardiovascular risk), and cardiovascular comorbidity did not modify response to intervention (P-values for interaction > .05). Conclusions: The FINGER intervention was beneficial regardless of participants’ characteristics and can thus be implemented in a large elderly population at increased risk for dementia.
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- 2018
19. Muscle strength and cognition in ageing men and women: The DR's EXTRA study
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Pentikäinen, H., Savonen, K., Komulainen, P., Kiviniemi, V., Paajanen, T., Kivipelto, M., Soininen, H., and Rauramaa, R.
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- 2017
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20. Non-pharmacological interventions of insomnia among shift workers: an RCT trial in occupational health setting
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Järnefelt, H., primary, Härmä, M., additional, Martimo, K.-P., additional, Paajanen, T., additional, Paunio, T., additional, Sallinen, M., additional, Virkkala, J., additional, and Hublin, C., additional
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- 2017
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21. Baseline telomere length and effects of a multidomain lifestyle intervention on cognition : The FINGER randomized controlled trial
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Sindi, S., Ngandu, T., Hovatta, I., Kåreholt, Ingemar, Antikainen, R., Hänninen, T., Levälahti, E., Laatikainend, T., Lindström, J., Paajanen, T., Peltonen, M., Khalsa, D. S., Wolozin, B., Strandberg, T., Tuomilehto, J., Soininen, H., Kivipelto, M., Solomon, A., Sindi, S., Ngandu, T., Hovatta, I., Kåreholt, Ingemar, Antikainen, R., Hänninen, T., Levälahti, E., Laatikainend, T., Lindström, J., Paajanen, T., Peltonen, M., Khalsa, D. S., Wolozin, B., Strandberg, T., Tuomilehto, J., Soininen, H., Kivipelto, M., and Solomon, A.
- Abstract
Leukocyte telomere length (LTL) is a biomarker of aging, and it is associated with lifestyle. It is currently unknown whether LTL is associated with the response to lifestyle interventions. The goal is to assess whether baseline LTL modified the cognitive benefits of a 2-year multidomain lifestyle intervention (exploratory analyses). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a 2-year randomized controlled trial including 1,260 people at risk of cognitive decline, aged 60-77 years identified from the general population. Participants were randomly assigned to the lifestyle intervention (diet, exercise, cognitive training, and vascular risk management) and control (general health advice) groups. Primary outcome was change in cognition (comprehensive neuropsychological test battery). Secondary outcomes were changes in cognitive domains: Memory, executive functioning, and processing speed. 775 participants (392 control, 383 intervention) had baseline LTL (peripheral blood DNA). Mixed effects regression models with maximum likelihood estimation were used to analyze change in cognition as a function of randomization group, time, baseline LTL, and their interaction. Intervention and control groups did not significantly differ at baseline. Shorter LTL was related to less healthy baseline lifestyle. Intervention benefits on executive functioning were more pronounced among those with shorter baseline LTL (p-value for interaction was 0.010 adjusted for age and sex, and 0.007 additionally adjusted for baseline lifestyle factors). The FINGER intervention cognitive benefits were more pronounced with shorter baseline LTL, particularly for executive functioning, indicating that the multidomain lifestyle intervention was especially beneficial among higher-risk individuals.
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- 2017
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22. Health-related quality of life in a multidomain intervention trial to prevent cognitive decline (FINGER)
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Strandberg, T.E., primary, Levälahti, E., additional, Ngandu, T., additional, Solomon, A., additional, Kivipelto, M., additional, Lehtisalo, J., additional, Laatikainen, T., additional, Soininen, H., additional, Strandberg, T., additional, Antikainen, R., additional, Jula, A., additional, Tuomilehto, J., additional, Peltonen, M., additional, Lindström, J., additional, Rauramaa, R., additional, Pajala, S., additional, Hänninen, T., additional, Paajanen, T., additional, and Mangialasche, F., additional
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- 2017
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23. CERAD Neuropsychological Total Scores Reflect Cortical Thinning in Prodromal Alzheimer's Disease
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Paajanen, T, Hänninen, T, Aitken, A, Hallikainen, M, Westman, E, Wahlund, Lo, Sobow, T, Mecocci, Patrizia, Tsolaki, M, Vellas, B, Muehlboeck, S, Spenger, C, Lovestone, S, Simmons, A, Soininen, H, and Addneuromed, Consortium
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medicine.medical_specialty ,Cognitive Neuroscience ,Cortical thinning ,Disease ,lcsh:Geriatrics ,Audiology ,lcsh:RC346-429 ,Cortical thickness ,AddNeuroMed study ,Cognition ,Magnetic resonance imaging ,Memory ,Neuropsychology ,Cognitive Changes ,mental disorders ,medicine ,Original Research Article ,Disease markers ,Psychiatry ,lcsh:Neurology. Diseases of the nervous system ,medicine.diagnostic_test ,Mild cognitive impairment ,Alzheimer's disease ,Control subjects ,lcsh:RC952-954.6 ,Psychiatry and Mental health ,Alzheimer’s disease ,Psychology - Abstract
Background: Sensitive cognitive global scores are beneficial in screening and monitoring for prodromal Alzheimer's disease (AD). Early cortical changes provide a novel opportunity for validating established cognitive total scores against the biological disease markers. Methods: We examined how two different total scores of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) battery and the Mini-Mental State Examination (MMSE) are associated with cortical thickness (CTH) in mild cognitive impairment (MCI) and prodromal AD. Cognitive and magnetic resonance imaging (MRI) data of 22 progressive MCI, 78 stable MCI, and 98 control subjects, and MRI data of 103 AD patients of the prospective multicenter study were analyzed. Results: CERAD total scores correlated with mean CTH more strongly (r = 0.34-0.38, p < 0.001) than did MMSE (r = 0.19, p = 0.01). Of those vertex clusters that showed thinning in progressive MCI, 60-75% related to the CERAD total scores and 3% to the MMSE. Conclusion: CERAD total scores are sensitive to the CTH signature of prodromal AD, which supports their biological validity in detecting early disease-related cognitive changes.
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- 2014
24. APOE ε2 allele is associated with larger regional cortical thicknesses and volumes
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Liu, Y, Paajanen, T, Westman, E, Zhang, Y, Wahlund, Lo, Simmons, A, Tunnard, C, Sobow, T, Proitsi, P, Powell, J, Mecocci, Patrizia, Tsolaki, M, Vellas, B, Muehlboeck, S, Evans, A, Spenger, C, Lovestone, S, and Soininen, H.
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Cerebral Cortex ,Male ,Heterozygote ,Genotype ,Apolipoprotein E2 ,Brain ,Neuropsychological Tests ,Magnetic Resonance Imaging ,Gene Frequency ,Alzheimer Disease ,Data Interpretation, Statistical ,Image Processing, Computer-Assisted ,Humans ,Female ,Age of Onset ,Cognition Disorders ,Alleles ,Aged - Abstract
The protective effect of the apolipoprotein E (APOE) ε2 allele against Alzheimer's disease (AD) is controversial.Our purpose was to clarify if the ε2 allele affects regional cortical thicknesses and volumes.Regional cortical thicknesses and volumes were measured with an automated pipeline in 109 subjects with mild cognitive impairment, 114 AD patients and 105 age-matched healthy controls.In the mild cognitive impairment group, the ε2 carriers had thicker regional cortices at the transverse temporal cortex and parahippocampal gyrus than the subjects with ε3/ε3, and a larger cerebral gray matter and smaller lateral ventricles than the ε3/ε3 and ε4 carriers. In the AD group, the ε2 carriers had significantly thicker entorhinal and transverse temporal cortices, a larger whole cerebral gray matter, and smaller lateral ventricles than the subjects with the ε3/ε3 genotype, and a significantly thicker entorhinal cortex and larger cerebral gray matter than ε4 carriers. No APOE2 effect was found in the control group.The APOE ε2 allele is associated with larger regional cortical thicknesses and volumes in mild cognitive impairment and AD.
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- 2010
25. Effect of APOE ε4 allele on cortical thicknesses and volumes: the AddNeuroMed study
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Liu, Y, Paajanen, T, Westman, E, Wahlund, Lo, Simmons, A, Tunnard, C, Sobow, T, Proitsi, P, Powell, J, Mecocci, Patrizia, Tsolaki, M, Vellas, B, Muehlboeck, S, Evans, A, Spenger, C, Lovestone, S, and Soininen, H.
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- 2010
26. O3.19: A multidomain two-year randomized controlled trial to prevent cognitive impairment – the FINGER study
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Kivipelto, M., primary, Ngandu, T., additional, Lehtisalo, J., additional, Hänninen, T., additional, Jula, A., additional, Laatikainen, T., additional, Lindström, J., additional, Paajanen, T., additional, Pajala, S., additional, Peltonen, M., additional, Stigsdotter-Neely, A., additional, Levalahti, E., additional, Strandberg, T.E., additional, Tuomilehto, J., additional, and Soininen, H., additional
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- 2014
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27. Number of religious homeschoolers surprise some
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Lighthiser, Tom and Paajanen, T.
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COUNTRYSIDE: I just finished the story about homeschooling and I must say I am somewhat disappointed that the stories you chose to run seemed to be all leaning towards the […]
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- 2004
28. 75 Predict Alzheimer's disease tools for early diagnosis
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Liu, Y., primary, Mattila, J., additional, Paajanen, T., additional, Koikkalainen, J., additional, vanGils, M., additional, Herukka, S.-K., additional, Waldemar, G., additional, Lötjönen, J., additional, and Soininen, Hilkka, additional
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- 2012
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29. CERAD Neuropsychological Total Scores Reflect Cortical Thinning in Prodromal Alzheimer's Disease.
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Paajanen, T., Hänninen, T., Aitken, A., Hallikainen, M., Westman, E., Wahlund, L.-O., Sobow, T., Mecocci, P., Tsolaki, M., Vellas, B., Muehlboeck, S., Spenger, C., Lovestone, S., Simmons, A., and Soininen, H.
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- 2013
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30. Comparison of a novel whole blood transglutaminase-based ELISA with a whole blood rapid antibody test and established conventional serological celiac disease assays.
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Raivio T, Korponay-Szabó IR, Paajanen T, Ashorn M, Iltanen S, Collin P, Laurila K, Nemes E, Kovács JB, Carrard G, Saramäki M, Mäki M, Kaukinen K, Raivio, Tiina, Korponay-Szabó, Ilma R, Paajanen, Tuula, Ashorn, Merja, Iltanen, Sari, Collin, Pekka, and Laurila, Kaija
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- 2008
31. Country conversation & feedback.
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Johnson, Dave, Richardson, Shawna, Hall, Lauren, Anonymous, Casler, Dave, Bachner, Leslie, Lighthiser, Tom, Paajanen, T., Hicinbothem, William, Donze, Bill, Braun, Carole, Jack, Jeff, Doerr, Paul, Miller, Michael S., Lorane, Ellen C., Loftis, Terri, Schmid, Patricia, Kern, Rose Marie, Faa, J., and Smith, Mark
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LETTERS to the editor ,COUNTRY life ,AGRICULTURE ,FANS (Machinery) ,BEANS ,BERRIES - Abstract
Presents letters to the editor about country life and homesteading. Instructions for making an improvised fan that can be used during hot weather conditions; Recommendation to reduce the side effects of eating beans; Tips on using wheat berries.
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- 2004
32. Subjective memory complaints and the effect of a multidomain lifestyle intervention on cognition - the FINGER trial.
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Vaskivuo L, Hokkanen L, Levälahti E, Hänninen T, Antikainen R, Bäckman L, Laatikainen T, Paajanen T, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, and Ngandu T
- Abstract
Objectives: Older people reporting subjective memory complaints (SMCs) may have greater risk of cognitive decline. Multidomain lifestyle interventions are a promising strategy for the prevention of cognitive decline. The aim of this study was to investigate whether the presence of SMCs affects the efficacy of a 2-year multidomain lifestyle intervention on cognition., Methods: This study is part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) project. Participants (a sub-sample of 568 individuals, baseline age 60 to 77 years) were randomized (1:1) to receive a 2-year multidomain lifestyle intervention group including dietary advice, exercise, cognitive training, and vascular risk management, or regular health advice control group. Cognitive performance was assessed at baseline and at 1- and 2-year visits, using a neuropsychological test battery, including tests assessing memory, executive functions, and processing speed. Participants rated the frequency of SMCs using the Prospective and Retrospective Memory Questionnaire., Results: Having more retrospective SMCs was linked to a less favorable cognitive trajectory over 2 years. The difference between the intervention and control groups in annual change in tested memory performance was 0.077 (95 % CI 0.008-0.146) among those reporting more retrospective SMCs and -0.011 (-0.074-0.053) among those with less SMCs; interaction effect p=0.019. No other interactions between SMCs and intervention allocation were observed., Discussion: A lifestyle intervention may be beneficial for older adults with and without SMCs. Persons having more retrospective SMCs may benefit more from the intervention regarding memory functioning., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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33. Unique genetic and risk-factor profiles in clusters of major depressive disorder-related multimorbidity trajectories.
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Gezsi A, Van der Auwera S, Mäkinen H, Eszlari N, Hullam G, Nagy T, Bonk S, González-Colom R, Gonda X, Garvert L, Paajanen T, Gal Z, Kirchner K, Millinghoffer A, Schmidt CO, Bolgar B, Roca J, Cano I, Kuokkanen M, Antal P, and Juhasz G
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- Humans, Risk Factors, Male, Female, Middle Aged, Adult, United Kingdom epidemiology, Finland epidemiology, Spain epidemiology, Aged, Genetic Predisposition to Disease, Young Adult, Depressive Disorder, Major genetics, Depressive Disorder, Major epidemiology, Multimorbidity, Bayes Theorem
- Abstract
The heterogeneity and complexity of symptom presentation, comorbidities and genetic factors pose challenges to the identification of biological mechanisms underlying complex diseases. Current approaches used to identify biological subtypes of major depressive disorder (MDD) mainly focus on clinical characteristics that cannot be linked to specific biological models. Here, we examined multimorbidities to identify MDD subtypes with distinct genetic and non-genetic factors. We leveraged dynamic Bayesian network approaches to determine a minimal set of multimorbidities relevant to MDD and identified seven clusters of disease-burden trajectories throughout the lifespan among 1.2 million participants from cohorts in the UK, Finland, and Spain. The clusters had clear protective- and risk-factor profiles as well as age-specific clinical courses mainly driven by inflammatory processes, and a comprehensive map of heritability and genetic correlations among these clusters was revealed. Our results can guide the development of personalized treatments for MDD based on the unique genetic, clinical and non-genetic risk-factor profiles of patients., (© 2024. The Author(s).)
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- 2024
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34. Multicentric Assessment of a Multimorbidity-Adjusted Disability Score to Stratify Depression-Related Risks Using Temporal Disease Maps: Instrument Validation Study.
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González-Colom R, Mitra K, Vela E, Gezsi A, Paajanen T, Gál Z, Hullam G, Mäkinen H, Nagy T, Kuokkanen M, Piera-Jiménez J, Roca J, Antal P, Juhasz G, and Cano I
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- Humans, Retrospective Studies, Female, Male, Middle Aged, Risk Assessment methods, Adult, Aged, Spain, Depressive Disorder, Major epidemiology, Bayes Theorem, Disease Progression, United Kingdom, Depression epidemiology, Finland epidemiology, Multimorbidity
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Background: Comprehensive management of multimorbidity can significantly benefit from advanced health risk assessment tools that facilitate value-based interventions, allowing for the assessment and prediction of disease progression. Our study proposes a novel methodology, the Multimorbidity-Adjusted Disability Score (MADS), which integrates disease trajectory methodologies with advanced techniques for assessing interdependencies among concurrent diseases. This approach is designed to better assess the clinical burden of clusters of interrelated diseases and enhance our ability to anticipate disease progression, thereby potentially informing targeted preventive care interventions., Objective: This study aims to evaluate the effectiveness of the MADS in stratifying patients into clinically relevant risk groups based on their multimorbidity profiles, which accurately reflect their clinical complexity and the probabilities of developing new associated disease conditions., Methods: In a retrospective multicentric cohort study, we developed the MADS by analyzing disease trajectories and applying Bayesian statistics to determine disease-disease probabilities combined with well-established disability weights. We used major depressive disorder (MDD) as a primary case study for this evaluation. We stratified patients into different risk levels corresponding to different percentiles of MADS distribution. We statistically assessed the association of MADS risk strata with mortality, health care resource use, and disease progression across 1 million individuals from Spain, the United Kingdom, and Finland., Results: The results revealed significantly different distributions of the assessed outcomes across the MADS risk tiers, including mortality rates; primary care visits; specialized care outpatient consultations; visits in mental health specialized centers; emergency room visits; hospitalizations; pharmacological and nonpharmacological expenditures; and dispensation of antipsychotics, anxiolytics, sedatives, and antidepressants (P<.001 in all cases). Moreover, the results of the pairwise comparisons between adjacent risk tiers illustrate a substantial and gradual pattern of increased mortality rate, heightened health care use, increased health care expenditures, and a raised pharmacological burden as individuals progress from lower MADS risk tiers to higher-risk tiers. The analysis also revealed an augmented risk of multimorbidity progression within the high-risk groups, aligned with a higher incidence of new onsets of MDD-related diseases., Conclusions: The MADS seems to be a promising approach for predicting health risks associated with multimorbidity. It might complement current risk assessment state-of-the-art tools by providing valuable insights for tailored epidemiological impact analyses of clusters of interrelated diseases and by accurately assessing multimorbidity progression risks. This study paves the way for innovative digital developments to support advanced health risk assessment strategies. Further validation is required to generalize its use beyond the initial case study of MDD., (©Rubèn González-Colom, Kangkana Mitra, Emili Vela, Andras Gezsi, Teemu Paajanen, Zsófia Gál, Gabor Hullam, Hannu Mäkinen, Tamas Nagy, Mikko Kuokkanen, Jordi Piera-Jiménez, Josep Roca, Peter Antal, Gabriella Juhasz, Isaac Cano. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 24.06.2024.)
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- 2024
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35. Cognitive behavioural therapy for insomnia (CBT-I) in schizophrenia and schizoaffective disorder: protocol for a randomised controlled trial.
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Tanskanen TE, Wegelius A, Härkönen T, Gummerus EM, Stenberg JH, Selinheimo SIK, Alakuijala A, Tenhunen M, Paajanen T, Järnefelt H, Kajaste S, Blom K, Kieseppä T, Tuisku K, and Paunio T
- Subjects
- Humans, Randomized Controlled Trials as Topic, Adult, Female, Male, Finland, Sleep Initiation and Maintenance Disorders therapy, Sleep Initiation and Maintenance Disorders etiology, Cognitive Behavioral Therapy methods, Schizophrenia therapy, Schizophrenia complications, Psychotic Disorders therapy, Psychotic Disorders complications, Quality of Life
- Abstract
Introduction: Insomnia is a common symptom among patients with schizophrenia and schizoaffective disorder, negatively impacting symptom severity, functioning and well-being; however, it is rarely the direct focus of treatment. The main recommended treatment for insomnia is cognitive behavioural therapy (CBT-I). There is some evidence that CBT-I can also be used to treat insomnia in patients with schizophrenia, but only a few randomised controlled trials (RCTs) have been published. The aim of this ongoing RCT is to determine whether we can alleviate symptoms of insomnia and improve the quality of life in patients with schizophrenia and schizoaffective disorder through CBT-I delivered via the internet or in a group mode., Methods and Analyses: The aim of this study is to recruit 84-120 outpatients from the Psychosis Clinics of Helsinki University Hospital and the City of Helsinki Health Services. The main inclusion criteria are a diagnosis of schizophrenia or schizoaffective disorder and self-reported sleep problems. The study will be performed on a cyclic basis, with a target of 12-24 patients per cycle. Participants are randomly assigned into three groups: (1) a group receiving only treatment as usual (TAU), (2) internet-based individual therapy for insomnia (iCBT-I)+TAU or (3) group therapy for insomnia (GCBT-I) conducted via a virtual platform+TAU. The primary outcome measures are quantitative changes in the Insomnia Severity Index score and/or changes in health-related quality of life using the 15D quality of life measure. Secondary outcomes include self-reported variables for sleep, health, stress and the severity of psychotic and depressive symptoms; objective outcomes include actigraphy and bed sensor data to evaluate circadian rhythms and motor activity. Outcome measures are assessed at baseline and after the treatment period at weeks 12, 24 and 36., Ethics and Dissemination: The Coordinating Ethics Committee of the Hospital District of Helsinki and Uusimaa, Finland, approved the study protocol. The results will be published in peer-reviewed journals., Trial Registration Number: NCT04144231., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2024
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36. Intelligent digital tools for screening of brain connectivity and dementia risk estimation in people affected by mild cognitive impairment: the AI-Mind clinical study protocol.
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Haraldsen IH, Hatlestad-Hall C, Marra C, Renvall H, Maestú F, Acosta-Hernández J, Alfonsin S, Andersson V, Anand A, Ayllón V, Babic A, Belhadi A, Birck C, Bruña R, Caraglia N, Carrarini C, Christensen E, Cicchetti A, Daugbjerg S, Di Bidino R, Diaz-Ponce A, Drews A, Giuffrè GM, Georges J, Gil-Gregorio P, Gove D, Govers TM, Hallock H, Hietanen M, Holmen L, Hotta J, Kaski S, Khadka R, Kinnunen AS, Koivisto AM, Kulashekhar S, Larsen D, Liljeström M, Lind PG, Marcos Dolado A, Marshall S, Merz S, Miraglia F, Montonen J, Mäntynen V, Øksengård AR, Olazarán J, Paajanen T, Peña JM, Peña L, Peniche DL, Perez AS, Radwan M, Ramírez-Toraño F, Rodríguez-Pedrero A, Saarinen T, Salas-Carrillo M, Salmelin R, Sousa S, Suyuthi A, Toft M, Toharia P, Tveitstøl T, Tveter M, Upreti R, Vermeulen RJ, Vecchio F, Yazidi A, and Rossini PM
- Abstract
More than 10 million Europeans show signs of mild cognitive impairment (MCI), a transitional stage between normal brain aging and dementia stage memory disorder. The path MCI takes can be divergent; while some maintain stability or even revert to cognitive norms, alarmingly, up to half of the cases progress to dementia within 5 years. Current diagnostic practice lacks the necessary screening tools to identify those at risk of progression. The European patient experience often involves a long journey from the initial signs of MCI to the eventual diagnosis of dementia. The trajectory is far from ideal. Here, we introduce the AI-Mind project, a pioneering initiative with an innovative approach to early risk assessment through the implementation of advanced artificial intelligence (AI) on multimodal data. The cutting-edge AI-based tools developed in the project aim not only to accelerate the diagnostic process but also to deliver highly accurate predictions regarding an individual's risk of developing dementia when prevention and intervention may still be possible. AI-Mind is a European Research and Innovation Action (RIA H2020-SC1-BHC-06-2020, No. 964220) financed between 2021 and 2026. First, the AI-Mind Connector identifies dysfunctional brain networks based on high-density magneto- and electroencephalography (M/EEG) recordings. Second, the AI-Mind Predictor predicts dementia risk using data from the Connector , enriched with computerized cognitive tests, genetic and protein biomarkers, as well as sociodemographic and clinical variables. AI-Mind is integrated within a network of major European initiatives, including The Virtual Brain, The Virtual Epileptic Patient, and EBRAINS AISBL service for sensitive data, HealthDataCloud, where big patient data are generated for advancing digital and virtual twin technology development. AI-Mind's innovation lies not only in its early prediction of dementia risk, but it also enables a virtual laboratory scenario for hypothesis-driven personalized intervention research. This article introduces the background of the AI-Mind project and its clinical study protocol, setting the stage for future scientific contributions., Competing Interests: CH-H was employed by BrainSymph AS. VAy, JP, and LP were employed by Lurtis Rules S.L. EC was employed by Pre Diagnostics AS. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Haraldsen, Hatlestad-Hall, Marra, Renvall, Maestú, Acosta-Hernández, Alfonsin, Andersson, Anand, Ayllón, Babic, Belhadi, Birck, Bruña, Caraglia, Carrarini, Christensen, Cicchetti, Daugbjerg, Di Bidino, Diaz-Ponce, Drews, Giuffrè, Georges, Gil-Gregorio, Gove, Govers, Hallock, Hietanen, Holmen, Hotta, Kaski, Khadka, Kinnunen, Koivisto, Kulashekhar, Larsen, Liljeström, Lind, Marcos Dolado, Marshall, Merz, Miraglia, Montonen, Mäntynen, Øksengård, Olazarán, Paajanen, Peña, Peña, Peniche, Perez, Radwan, Ramírez-Toraño, Rodríguez-Pedrero, Saarinen, Salas-Carrillo, Salmelin, Sousa, Suyuthi, Toft, Toharia, Tveitstøl, Tveter, Upreti, Vermeulen, Vecchio, Yazidi and Rossini.)
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- 2024
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37. cCOG Web-Based Cognitive Assessment Tool.
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Rhodius-Meester HFM, Paajanen T, and Lötjönen J
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- Humans, Diagnosis, Differential, Cognition, Internet, Biomarkers, Disease Progression, Cognitive Dysfunction diagnosis, Alzheimer Disease diagnosis
- Abstract
Cognitive testing is an essential part of clinical diagnostics and clinical trials in Alzheimer's disease. Digital cognitive tests hold a great opportunity to provide more versatile and cost-efficient patient pathways through flexible testing including at home. In this work, we describe a web-based cognitive test, cCOG, that can be used in screening, differential diagnosis, and monitoring the progression of neurodegenerative diseases., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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38. The Cognitive Function at Work Questionnaire (CFWQ): A new scale for measuring cognitive complaints in occupational population.
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Heikkinen AL, Hänninen T, Kuikka P, Akila R, Savolainen A, Valtonen T, Umer A, Lötjönen J, Hublin C, Remes AM, and Paajanen T
- Abstract
Cognitive functioning is a relevant work and health related topic, however, validated methods to assess subjective cognitive complaints (SCC) at work are lacking. We introduce the Cognitive Function at Work Questionnaire (CFWQ) for measuring SCC in occupational settings. 1-year follow-up data of 418 employees from a Finnish public media service company was analyzed. Participants completed web-based CFWQ, cognitive tests and a broad set of questionnaires for evaluating depression, anxiety, insomnia, daytime sleepiness, burnout, stress, mental job burden, work ability, cognitive errors, and perceived health. The factor analysis yielded a model with the CFWQ subdomains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control and Name Memory. The internal consistency (Cronbach's alpha = .87) and the test-retest constancy (ICC = .84) reflected good reliability. Correlation between the CFWQ and cognitive errors at work ranged from .25 to .64 indicating adequate concurrent validity. Employees with depression, insomnia and burnout symptoms had higher ( p < .001) CFWQ scores than participants without these symptoms. Depression and burnout symptom severity as well as accumulation of mood, sleep, and psychosocial stressors were associated with higher CFWQ scores ( p < .001 in all). The CFWQ appears psychometrically sound measure for the assessment of SCC in occupational population.
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- 2023
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39. Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease.
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Arola A, Laakso HM, Heinonen H, Pitkänen J, Ahlström M, Lempiäinen J, Paajanen T, Virkkala J, Koikkalainen J, Lötjönen J, Korvenoja A, Melkas S, and Jokinen H
- Abstract
Objective: Subjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI., Method: In the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15)., Results: Subjective cognitive complaints correlated significantly with informant reports ( r =0.40-0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL., Conclusions: Neither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment., Competing Interests: MA has received a personal fee for educational event from Merck KGaA. AK has received payment for expert testimony from the Finnish National Insurance Centre, for a neuroradiologist expert testimony on a court of justice, support for travel from Helsinki University Hospital and is the board member of the Finnish Radiological Society. JK and JL are shareholders at Combinostics Ltd. TP is a board member at the Finnish Brain Council, the Finnish Neuropsychological Society, and the Finnish Alzheimer's Disease Research Society. The other authors report no competing of interests., (© 2023 The Authors.)
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- 2023
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40. Data Resource Profile: Nationwide registry data for high-throughput epidemiology and machine learning (FinRegistry).
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Viippola E, Kuitunen S, Rodosthenous RS, Vabalas A, Hartonen T, Vartiainen P, Demmler J, Vuorinen AL, Liu A, Havulinna AS, Llorens V, Detrois KE, Wang F, Ferro M, Karvanen A, German J, Jukarainen S, Gracia-Tabuenca J, Hiekkalinna T, Koskelainen S, Kiiskinen T, Lahtela E, Lemmelä S, Paajanen T, Siirtola H, Reeve MP, Kristiansson K, Brunfeldt M, Aavikko M, Gen F, Perola M, and Ganna A
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- Humans, Algorithms, Routinely Collected Health Data, Machine Learning
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- 2023
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41. The Added Value of Remote Technology in Cardiac Rehabilitation on Physical Function, Anthropometrics, and Quality of Life: Cluster Randomized Controlled Trial.
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Lahtio H, Heinonen A, Paajanen T, and Sjögren T
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- Female, Humans, Male, Middle Aged, Body Mass Index, Exercise, Quality of Life, Telemedicine, Cardiac Rehabilitation, Cardiovascular Diseases, Heart Diseases
- Abstract
Background: Cardiovascular diseases (CVDs) cause most deaths globally and can reduce quality of life (QoL) of rehabilitees with cardiac disease. The risk factors of CVDs are physical inactivity and increased BMI. With physical activity, it is possible to prevent CVDs, improve QoL, and help maintain a healthy body mass. Current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated owing to the studies' high heterogeneity. In addition, the added value of this technology has not been studied well, especially in cardiac rehabilitation., Objective: We aimed to examine the effectiveness of added remote technology in cardiac rehabilitation on physical function, anthropometrics, and QoL in rehabilitees with CVD compared with conventional rehabilitation., Methods: Rehabilitees were cluster randomized into 3 remote technology intervention groups (n=29) and 3 reference groups (n=30). The reference group received conventional cardiac rehabilitation, and the remote technology intervention group received conventional cardiac rehabilitation with added remote technology, namely, the Movendos mCoach app and Fitbit charge accelerometer. The 12 months of rehabilitation consisted of three 5-day in-rehabilitation periods in the rehabilitation center. Between these periods were two 6-month self-rehabilitation periods. Outcome measurements included the 6-minute walk test, body mass, BMI, waist circumference, and World Health Organization QoL-BREF questionnaire at baseline and at 6 and 12 months. Between-group differences were assessed using 2-tailed t tests and Mann-Whitney U test. Within-group differences were analyzed using a paired samples t test or Wilcoxon signed-rank test., Results: Overall, 59 rehabilitees aged 41 to 66 years (mean age 60, SD 6 years; n=48, 81% men) were included in the study. Decrement in waist circumference (6 months: 1.6 cm; P=.04; 12 months: 3 cm; P<.001) and increment in self-assessed QoL were greater (environmental factors: 0.5; P=.02) in the remote technology intervention group than the reference group. Both groups achieved statistically significant improvements in the 6-minute walk test in both time frames (P=.01-.03). Additionally, the remote technology intervention group achieved statistically significant changes in the environmental domain at 0-6 months (P=.03) and waist circumference at both time frames (P=.01), and reference group achieve statistically significant changes in waist circumference at 0-6 months (P=.02)., Conclusions: Remote cardiac rehabilitation added value to conventional cardiac rehabilitation in terms of waist circumference and QoL. The results were clinically small, but the findings suggest that adding remote technology to cardiac rehabilitation may increase beneficial health outcomes. There was some level of systematic error during rehabilitation intervention, and the sample size was relatively small. Therefore, care must be taken when generalizing the study results beyond the target population. To confirm assumptions of the added value of remote technology in rehabilitation interventions, more studies involving different rehabilitees with cardiac disease are required., Trial Registration: ISRCTN Registry ISRCTN61225589; https://www.isrctn.com/ISRCTN61225589., (©Heli Lahtio, Ari Heinonen, Teemu Paajanen, Tuulikki Sjögren. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.04.2023.)
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- 2023
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42. Author Correction: FinnGen provides genetic insights from a well-phenotyped isolated population.
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Kurki MI, Karjalainen J, Palta P, Sipilä TP, Kristiansson K, Donner KM, Reeve MP, Laivuori H, Aavikko M, Kaunisto MA, Loukola A, Lahtela E, Mattsson H, Laiho P, Della Briotta Parolo P, Lehisto AA, Kanai M, Mars N, Rämö J, Kiiskinen T, Heyne HO, Veerapen K, Rüeger S, Lemmelä S, Zhou W, Ruotsalainen S, Pärn K, Hiekkalinna T, Koskelainen S, Paajanen T, Llorens V, Gracia-Tabuenca J, Siirtola H, Reis K, Elnahas AG, Sun B, Foley CN, Aalto-Setälä K, Alasoo K, Arvas M, Auro K, Biswas S, Bizaki-Vallaskangas A, Carpen O, Chen CY, Dada OA, Ding Z, Ehm MG, Eklund K, Färkkilä M, Finucane H, Ganna A, Ghazal A, Graham RR, Green EM, Hakanen A, Hautalahti M, Hedman ÅK, Hiltunen M, Hinttala R, Hovatta I, Hu X, Huertas-Vazquez A, Huilaja L, Hunkapiller J, Jacob H, Jensen JN, Joensuu H, John S, Julkunen V, Jung M, Junttila J, Kaarniranta K, Kähönen M, Kajanne R, Kallio L, Kälviäinen R, Kaprio J, Kerimov N, Kettunen J, Kilpeläinen E, Kilpi T, Klinger K, Kosma VM, Kuopio T, Kurra V, Laisk T, Laukkanen J, Lawless N, Liu A, Longerich S, Mägi R, Mäkelä J, Mäkitie A, Malarstig A, Mannermaa A, Maranville J, Matakidou A, Meretoja T, Mozaffari SV, Niemi MEK, Niemi M, Niiranen T, O Donnell CJ, Obeidat ME, Okafo G, Ollila HM, Palomäki A, Palotie T, Partanen J, Paul DS, Pelkonen M, Pendergrass RK, Petrovski S, Pitkäranta A, Platt A, Pulford D, Punkka E, Pussinen P, Raghavan N, Rahimov F, Rajpal D, Renaud NA, Riley-Gillis B, Rodosthenous R, Saarentaus E, Salminen A, Salminen E, Salomaa V, Schleutker J, Serpi R, Shen HY, Siegel R, Silander K, Siltanen S, Soini S, Soininen H, Sul JH, Tachmazidou I, Tasanen K, Tienari P, Toppila-Salmi S, Tukiainen T, Tuomi T, Turunen JA, Ulirsch JC, Vaura F, Virolainen P, Waring J, Waterworth D, Yang R, Nelis M, Reigo A, Metspalu A, Milani L, Esko T, Fox C, Havulinna AS, Perola M, Ripatti S, Jalanko A, Laitinen T, Mäkelä TP, Plenge R, McCarthy M, Runz H, Daly MJ, and Palotie A
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- 2023
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43. FinnGen provides genetic insights from a well-phenotyped isolated population.
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Kurki MI, Karjalainen J, Palta P, Sipilä TP, Kristiansson K, Donner KM, Reeve MP, Laivuori H, Aavikko M, Kaunisto MA, Loukola A, Lahtela E, Mattsson H, Laiho P, Della Briotta Parolo P, Lehisto AA, Kanai M, Mars N, Rämö J, Kiiskinen T, Heyne HO, Veerapen K, Rüeger S, Lemmelä S, Zhou W, Ruotsalainen S, Pärn K, Hiekkalinna T, Koskelainen S, Paajanen T, Llorens V, Gracia-Tabuenca J, Siirtola H, Reis K, Elnahas AG, Sun B, Foley CN, Aalto-Setälä K, Alasoo K, Arvas M, Auro K, Biswas S, Bizaki-Vallaskangas A, Carpen O, Chen CY, Dada OA, Ding Z, Ehm MG, Eklund K, Färkkilä M, Finucane H, Ganna A, Ghazal A, Graham RR, Green EM, Hakanen A, Hautalahti M, Hedman ÅK, Hiltunen M, Hinttala R, Hovatta I, Hu X, Huertas-Vazquez A, Huilaja L, Hunkapiller J, Jacob H, Jensen JN, Joensuu H, John S, Julkunen V, Jung M, Junttila J, Kaarniranta K, Kähönen M, Kajanne R, Kallio L, Kälviäinen R, Kaprio J, Kerimov N, Kettunen J, Kilpeläinen E, Kilpi T, Klinger K, Kosma VM, Kuopio T, Kurra V, Laisk T, Laukkanen J, Lawless N, Liu A, Longerich S, Mägi R, Mäkelä J, Mäkitie A, Malarstig A, Mannermaa A, Maranville J, Matakidou A, Meretoja T, Mozaffari SV, Niemi MEK, Niemi M, Niiranen T, O Donnell CJ, Obeidat ME, Okafo G, Ollila HM, Palomäki A, Palotie T, Partanen J, Paul DS, Pelkonen M, Pendergrass RK, Petrovski S, Pitkäranta A, Platt A, Pulford D, Punkka E, Pussinen P, Raghavan N, Rahimov F, Rajpal D, Renaud NA, Riley-Gillis B, Rodosthenous R, Saarentaus E, Salminen A, Salminen E, Salomaa V, Schleutker J, Serpi R, Shen HY, Siegel R, Silander K, Siltanen S, Soini S, Soininen H, Sul JH, Tachmazidou I, Tasanen K, Tienari P, Toppila-Salmi S, Tukiainen T, Tuomi T, Turunen JA, Ulirsch JC, Vaura F, Virolainen P, Waring J, Waterworth D, Yang R, Nelis M, Reigo A, Metspalu A, Milani L, Esko T, Fox C, Havulinna AS, Perola M, Ripatti S, Jalanko A, Laitinen T, Mäkelä TP, Plenge R, McCarthy M, Runz H, Daly MJ, and Palotie A
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- Humans, Middle Aged, Estonia, Finland, Genetic Predisposition to Disease genetics, Genome-Wide Association Study, Meta-Analysis as Topic, United Kingdom, White People genetics, Disease genetics, Gene Frequency genetics, Phenotype
- Abstract
Population isolates such as those in Finland benefit genetic research because deleterious alleles are often concentrated on a small number of low-frequency variants (0.1% ≤ minor allele frequency < 5%). These variants survived the founding bottleneck rather than being distributed over a large number of ultrarare variants. Although this effect is well established in Mendelian genetics, its value in common disease genetics is less explored
1,2 . FinnGen aims to study the genome and national health register data of 500,000 Finnish individuals. Given the relatively high median age of participants (63 years) and the substantial fraction of hospital-based recruitment, FinnGen is enriched for disease end points. Here we analyse data from 224,737 participants from FinnGen and study 15 diseases that have previously been investigated in large genome-wide association studies (GWASs). We also include meta-analyses of biobank data from Estonia and the United Kingdom. We identified 30 new associations, primarily low-frequency variants, enriched in the Finnish population. A GWAS of 1,932 diseases also identified 2,733 genome-wide significant associations (893 phenome-wide significant (PWS), P < 2.6 × 10-11 ) at 2,496 (771 PWS) independent loci with 807 (247 PWS) end points. Among these, fine-mapping implicated 148 (73 PWS) coding variants associated with 83 (42 PWS) end points. Moreover, 91 (47 PWS) had an allele frequency of <5% in non-Finnish European individuals, of which 62 (32 PWS) were enriched by more than twofold in Finland. These findings demonstrate the power of bottlenecked populations to find entry points into the biology of common diseases through low-frequency, high impact variants., (© 2023. The Author(s).)- Published
- 2023
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44. Occupational complexity and cognition in the FINGER multidomain intervention trial.
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Rydström A, Darin-Mattsson A, Kåreholt I, Ngandu T, Lehtisalo J, Solomon A, Antikainen R, Bäckman L, Hänninen T, Laatikainen T, Levälahti E, Lindström J, Paajanen T, Havulinna S, Peltonen M, Sindi S, Soininen H, Neely AS, Strandberg T, Tuomilehto J, Kivipelto M, and Mangialasche F
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- Aged, Humans, Cognition, Executive Function, Research Design, Cognition Disorders etiology, Cognitive Dysfunction prevention & control, Cognitive Dysfunction complications
- Abstract
Introduction: Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions., Methods: In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles., Results: Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function., Discussion: In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies., (© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2022
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45. Economic evaluation of using polygenic risk score to guide risk screening and interventions for the prevention of type 2 diabetes in individuals with high overall baseline risk.
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Martikainen J, Lehtimäki AV, Jalkanen K, Lavikainen P, Paajanen T, Marjonen H, Kristiansson K, Lindström J, and Perola M
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Type 2 diabetes (T2D) with increasing prevalence is a significant global public health challenge. Obesity, unhealthy diet, and low physical activity are one of the major determinants of the rise in T2D prevalence. In addition, family history and genetic risk of diabetes also play a role in the process of developing T2D. Therefore, solutions for the early identification of individuals at high risk for T2D for early targeted detection of T2D, prevention, and intervention are highly preferred. Recently, novel genomic-based polygenic risk scores (PRSs) have been suggested to improve the accuracy of risk prediction supporting the targeting of preventive interventions to those at highest risk for T2D. Therefore, the aim of the present study was to assess the cost-utility of an additional PRS testing information (as a part of overall risk assessment) followed by a lifestyle intervention and an additional medical therapy when estimated 10-year overall risk for T2D exceeded 20% among Finnish individuals screened as at the high-risk category (i.e., 10%-20% 10-year overall risk of T2D) based on traditional risk factors only. For a cost-utility analysis, an individual-level state-transition model with probabilistic sensitivity analysis was constructed. A 1-year cycle length and a lifetime time horizon were applied in the base-case. A 3% discount rate was used for costs and QALYs. Cost-effectiveness acceptability curve (CEAC) and estimates for the expected value of perfect information (EVPI) were calculated to assist decision makers. The use of the targeted PRS strategy reclassified 12.4 percentage points of individuals to be very high-risk individuals who would have been originally classified as high risk using the usual strategy only. Over a lifetime horizon, the targeted PRS was a dominant strategy (i.e., less costly, more effective). One-way and scenario sensitivity analyses showed that results remained dominant in almost all simulations. However, there is uncertainty, since the probability (EVPI) of cost-effectiveness at a WTP of 0€/QALY was 63.0% (243€) indicating the probability that the PRS strategy is a dominant option. In conclusion, the results demonstrated that the PRS provides moderate additional value in Finnish population in risk screening leading to potential cost savings and better quality of life when compared with the current screening methods for T2D risk., Competing Interests: JM is a founding partner of ESiOR Oy and a board member of Siltana Oy. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Martikainen, Lehtimäki, Jalkanen, Lavikainen, Paajanen, Marjonen, Kristiansson, Lindström and Perola.)
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- 2022
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46. The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER).
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Ngandu T, Lehtisalo J, Korkki S, Solomon A, Coley N, Antikainen R, Bäckman L, Hänninen T, Lindström J, Laatikainen T, Paajanen T, Havulinna S, Peltonen M, Neely AS, Strandberg T, Tuomilehto J, Soininen H, and Kivipelto M
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- Cognition, Humans, Life Style, Neuropsychological Tests, Cognition Disorders, Cognitive Dysfunction prevention & control
- Abstract
Introduction: Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses)., Methods: FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention (ClinicalTrials.gov NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores., Results: Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function., Discussion: Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential., (© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2022
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47. Associations of Depressive Symptoms and Cognition in the FINGER Trial: A Secondary Analysis of a Randomised Clinical Trial.
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Neuvonen E, Lehtisalo J, Ngandu T, Levälahti E, Antikainen R, Hänninen T, Laatikainen T, Lindström J, Paajanen T, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, and Solomon A
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Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60-77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient -0.006, 95% CI -0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (-0.140, p = 0.005) and memory (-0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung -0.096, 95% CI -0.163 to -0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
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- 2022
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48. Synergistic associations of cognitive and motor impairments with functional outcome in covert cerebral small vessel disease.
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Jokinen H, Laakso HM, Ahlström M, Arola A, Lempiäinen J, Pitkänen J, Paajanen T, Sikkes SAM, Koikkalainen J, Lötjönen J, Korvenoja A, Erkinjuntti T, and Melkas S
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- Activities of Daily Living, Aged, Cognition, Humans, Magnetic Resonance Imaging, Neuropsychological Tests, Quality of Life, Cerebral Small Vessel Diseases complications, Cerebral Small Vessel Diseases diagnostic imaging, Cerebral Small Vessel Diseases psychology, Cognitive Dysfunction complications, Cognitive Dysfunction etiology, Motor Disorders complications, White Matter diagnostic imaging
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Background: Cognitive and motor impairments are the key clinical manifestations of cerebral small vessel disease (SVD), but their combined effects on functional outcome have not been elucidated. This study investigated the interactions and mediating effects of cognitive and motor functions on instrumental activities of daily living (IADL) and quality of life in older individuals with various degrees of white matter hyperintensities (WMH)., Methods: Participants of the Helsinki Small Vessel Disease Study (n = 152) were assessed according to an extensive clinical, physical, neuropsychological and MRI protocol. Volumes of WMH and gray matter (GM) were obtained with automated segmentation., Results: Cognitive (global cognition, executive functions, processing speed, memory) and motor functions (gait speed, single-leg stance, timed up-and-go) had strong interrelations with each other, and they were significantly associated with IADL, quality of life as well as WMH and GM volumes. A consistent pattern on significant interactions between cognitive and motor functions was found on informant-evaluated IADL, but not on self-evaluated quality of life. The association of WMH volume with IADL was mediated by global cognition, whereas the association of GM volume with IADL was mediated by global cognition and timed up-and-go performance., Conclusion: The results highlight the complex interplay and synergism between motor and cognitive abilities on functional outcome in SVD. The combined effect of motor and cognitive disturbances on IADL is likely to be greater than their individual effects. Patients with both impairments are at disproportionate risk for poor outcome. WMH and brain atrophy contribute to disability through cognitive and motor impairment., (© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
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- 2022
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49. Biopsychosocial Profiles of Patients With Cardiac Disease in Remote Rehabilitation Processes: Mixed Methods Grounded Theory Approach.
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Anttila MR, Soderlund A, Paajanen T, Kivistö H, Kokko K, and Sjögren T
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Background: Digital development has caused rehabilitation services and rehabilitees to become increasingly interested in using technology as a part of rehabilitation. This study was based on a previously published study that categorized 4 groups of patients with cardiac disease based on different experiences and attitudes toward technology (e-usage groups): feeling outsider, being uninterested, reflecting benefit, and enthusiastic using., Objective: This study identifies differences in the biopsychosocial profiles of patients with cardiac disease in e-usage groups and deepen the understanding of these profiles in cardiac rehabilitation., Methods: Focus group interviews and measurements were conducted with 39 patients with coronary heart disease, and the mean age was 54.8 (SD 9.4, range 34-77) years. Quantitative data were gathered during a 12-month rehabilitation period. First, we used analysis of variance and Tukey honestly significant difference test, a t test, or nonparametric tests-Mann-Whitney and Kruskal-Wallis tests-to compare the 4 e-usage groups-feeling outsider, being uninterested, reflecting benefit, and enthusiastic using-in biopsychosocial variables. Second, we compared the results of the 4 e-groups in terms of recommended and reference values. This analysis contained 13 variables related to biomedical, psychological, and social functioning. Finally, we formed biopsychosocial profiles based on the integration of the findings by constant comparative analysis phases through classic grounded theory., Results: The biomedical variables were larger for waistline (mean difference [MD] 14.2; 95% CI 1.0-27.5; P=.03) and lower for physical fitness (MD -0.72; 95% CI -1.4 to -0.06; P=.03) in the being uninterested group than in the enthusiastic using group. The feeling outsider group had lower physical fitness (MD -55.8; 95% CI -110.7 to -0.92; P=.047) than the enthusiastic using group. For psychosocial variables, such as the degree of self-determination in exercise (MD -7.3; 95% CI -13.5 to -1.1; P=.02), the being uninterested group had lower values than the enthusiastic using group. Social variables such as performing guided tasks in the program (P=.03) and communicating via messages (P=.03) were lower in the feeling outsider group than in the enthusiastic using group. The feeling outsider and being uninterested groups had high-risk lifestyle behaviors, and adherence to the web-based program was low. In contrast, members of the being uninterested group were interested in tracking their physical activity. The reflecting benefit and enthusiastic using groups had low-risk lifestyle behavior and good adherence to web-based interventions; however, the enthusiastic using group had low self-efficacy in exercise. These profiles showed how individuals reflected their lifestyle risk factors differently. We renamed the 4 groups as building self-awareness, increasing engagement, maintaining a healthy lifestyle balance, and strengthening self-confidence., Conclusions: The results facilitate more effective and meaningful personalization guidance and inform the remote rehabilitation. Professionals can tailor individual web-based lifestyle risk interventions using these biopsychosocial profiles., (©Marjo-Riitta Anttila, Anne Soderlund, Teemu Paajanen, Heikki Kivistö, Katja Kokko, Tuulikki Sjögren. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 03.11.2021.)
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- 2021
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50. A Web Portal for Communicating Polygenic Risk Score Results for Health Care Use-The P5 Study.
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Marjonen H, Marttila M, Paajanen T, Vornanen M, Brunfeldt M, Joensuu A, Halmesvaara O, Aro K, Alanne-Kinnunen M, Jousilahti P, Borodulin K, Koskinen S, Tuomi T, Ilanne-Parikka P, Lindström J, Laine MK, Auro K, Kääriäinen H, Perola M, and Kristiansson K
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We present a method for communicating personalized genetic risk information to citizens and their physicians using a secure web portal. We apply the method for 3,177 Finnish individuals in the P5 Study where estimates of genetic and absolute risk, based on genetic and clinical risk factors, of future disease are reported to study participants, allowing individuals to participate in managing their own health. Our method facilitates using polygenic risk score as a personalized tool to estimate a person's future disease risk while offering a way for health care professionals to utilize the polygenic risk scores as a preventive tool in patient care., Competing Interests: Authors KAu and KAr were employed by the company Negen Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Marjonen, Marttila, Paajanen, Vornanen, Brunfeldt, Joensuu, Halmesvaara, Aro, Alanne-Kinnunen, Jousilahti, Borodulin, Koskinen, Tuomi, Ilanne-Parikka, Lindström, Laine, Auro, Kääriäinen, Perola and Kristiansson.)
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- 2021
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