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Biomedical subjects

B Malmberg

Publications and source records attributed to B Malmberg.

11 recordsLinked to original sources

Serum C-reactive protein in elderly men and women: association with mortality, morbidity and various biochemical values.

OBJECTIVE: The primary aim of this study was to define the distribution and the prognostic value of serum C-reactive protein (s-CRP) measured by a high-sensitivity method in elderly subjects of both genders with special reference to the distribution below 10 mg/l. As a secondary aim, a possible gender difference of s-CRP was examined. MATERIAL AND METHODS: Baseline s-CRP was described in a population-based sample of opposite-sex, twin-pairs (197 F, 189 M available for blood-sampling) aged 71-80 years (mean age 74.5 years), considering mortality through the next 4 years, morbidity (myocardial infarction, angina pectoris, congestive heart failure, arterial hypertension, venous thromboembolism, stroke, diabetes, gout, psoriasis, rheumatoid arthritis) before and after blood sampling, biochemical values (serum levels of urate, urea, ApoA1, ApoB, folate, FSH, LH, oestradiol, progesterone, testosterone, cortisol) and anthropometric measurements (body mass index (BMI), circumference of waist, buttocks and hips). RESULTS: The level of s-CRP did not deviate substantially from what has been reported for younger subjects. Higher values indicated an increased risk of cardiovascular morbidity and diabetes in women but not in men. The s-CRP level was associated with serum levels of urate, progesterone, folate, ApoA1, ApoB and the quotient ApoB/ApoA1 as well as with BMI and waist circumference. CONCLUSIONS: For the 71-80 years age group, s-CRP below the 80th percentile (4.3 mg/l) seems to have prognostic capacity mainly in women. The highest association with mortality as well as with cardiovascular diseases, diabetes and rheumatoid arthritis is found for s-CRP above 10 mg/l, which is the arbitrary lower level for the earlier routine low-sensitivity s-CRP methods. The association of s-CRP with serum urate, folate and the ApoB/ApoA1 quotient should be considered.

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Gender differences in heritability of depressive symptoms in the elderly.

BACKGROUND: The present study aimed to investigate the relative importance of genetic and environmental influences on depressive symptoms in the elderly. METHOD: Depressive symptoms were assessed through the Center for Epidemiological Studies-Depression (CES-D) scale. The CES-D scale was administered to 959 twin pairs (123 female MZs, 90 male MZs, 207 same-sex female DZs, 109 same-sex male DZs and 430 opposite-sex DZs) aged 50 years or older (mean age 72 years). A dichotomous depressed state variable was constructed based on CES-D cut-offs and self-reported use of antidepressant medication. Structural equation models were fitted to the data to dissect genetic and environmental variance components. RESULTS: The sex-specific heritability estimates for depressive symptoms were 14% for males and 29% for females and 23% when constrained to be equal for men and women. The prevalence of clinically significant depressive symptoms was 16% for men and 24% for women. Heritability estimates for the dichotomous depressed state measure were 7% for males and 49% for females in the full model and 33% when constrained to be equal. CONCLUSION: Our results suggest that depressive symptoms in the elderly are moderately heritable, with a higher heritability for women than men, although differences in heritability estimates were not statistically significant.

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Gender differences in depression: a study of older unlike-sex twins.

Gender differences in depressive symptoms, in the diagnosis of major/minor depression, and in the use of antidepressant medication were investigated. The sample included 249 pairs of unlike-sex twins, who were between 70 and 80 years of age at the initial, baseline assessment. A follow-up, in which both members of 145 twin pairs participated, was carried out four years later. Participants completed the Centre for the Epidemiologic Studies Depression Scale (CES-D) for depressive symptoms. Current use of antidepressant medicine was assessed. Medical records of major/minor depression from the period 1985-1998, including a summary of those diagnoses in earlier years, were gathered from several sources. Women had a higher frequency of depressive symptoms and depression diagnoses than their twin brothers. Depressive symptoms and diagnosis of depression increased over time, slightly more among men. The gender difference and increase over time in the depressive symptoms were related to differences in socio-economic status and physical functioning in men and women. No gender difference was found in the use of antidepressant medication.

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Association between depressed mood in the elderly and a 5-HTR2A gene variant.

The aim of this study was to investigate any possible association between depressed mood in the elderly and two candidate SNPs in the serotonin system: one in the 5-HTR2A gene promotor (-1438 G/A) and one in the 5-HT transporter gene (-925 C/A). DNA from a population-based Swedish twin sample (N = 1,592; mean age = 73) was genotyped using Pryosequencing trade mark. An association was found between the 5-HTR2A gene promotor polymorphism and depressed mood (OR: 1.5, CI: 1.1-2.1) for the A/A genotype in the total sample. When the sample was analyzed by gender, a significant association (OR: 2.4, CI: 1.4-4.4) was found for males and the A/A genotype, but not for females. The 5-HT transporter gene was not associated with depressed mood in this elderly population. These results suggest that there might be different genetic mechanisms for males and females contributing to the development of depressed mood in the elderly.

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Health effects of occupational exposure to acrylamide using hemoglobin adducts as biomarkers of internal dose.

OBJECTIVES: This study assessed the health effects of occupational acrylamide exposure using hemoglobin (Hb) adducts as biomarkers of internal dose. METHODS: Two hundred and ten tunnel workers exposed for about 2 months to a chemical-grouting agent containing acrylamide and N-methylolacrylamide underwent a health examination. Blood samples were drawn for the analysis of Hb adducts of acrylamide. Fifty workers claiming recently developed or deteriorated symptoms of the peripheral nervous system (PNS) were referred to a neurophysiological examination. Workers with Hb-adduct levels exceeding 0.3 nmol/g globin attended follow-up examinations 6, 12, and 18 months after exposure cessation. RESULTS: Forty-seven workers had Hb-adduct levels within the normal background range (0.02-0.07 nmol/g globin), while the remaining 163 had increased levels up to a maximum of 17.7 nmol/g globin. Clear-cut dose-response associations were found between the Hb-adduct levels and PNS symptoms. Thirty-nine percent of those with Hb-adduct levels exceeding 1 nmol/g globin experienced tingling or numbness in their hands or feet. A no-observed adverse effect level of 0.51 nmol/g globin was estimated for numbness or tingling in the feet or legs. For 23 workers there was strong evidence of PNS impairment due to occupational exposure to acrylamide. All but two had recovered 18 months after the cessation of exposure. CONCLUSIONS: Occupational exposure to a grouting agent containing acrylamide resulted in PNS symptoms and signs. The use of Hb adducts of acrylamide as a biomarker of internal dose revealed strong dose-response associations. The PNS symptoms were, however, generally mild, and in almost all cases they were reversible.

Acrylamide↗

Powdering floor polish and mucous membrane irritation in secondary school pupils.

OBJECTIVES: Acrylate-styrene copolymer polish has been used to protect the surface of linoleum flooring since the 1960s. Problems with powdering of floor polish were observed at an early stage. In a secondary school in Linköping, Sweden, this phenomenon occurred in the winter of 1994-1995 and the pupils frequently reported irritative symptoms from the eyes and airways. This study was undertaken to assess the potential effect of powdering floor polish on the mucous membranes of the eyes and respiratory tract. METHODS: Repeated questionnaire-based surveys were conducted with identical questions in the spring of 1995 (during the powdering period) and in the autumn of 1995 (after the polish was removed). The questions dealt with irritative symptoms from the nose, eye, throat and lower respiratory tract. RESULTS: A preventive effect related to the removal of polish was found for irritative symptoms in all locations mentioned above, but was particularly clear for the lower respiratory tract (prevalence rate ratio = 0.37, 95% CI = 0.23-0.59). CONCLUSIONS: The results of this study indicate that the powdering of floor polish may cause irritative symptoms from the eyes and airways in school children.

Acrylates↗

Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale.

OBJECTIVE: To assess burden of caregivers to stroke patients three year after primary stroke and to test validity and reliability of a novel caregiver burden scale (CB scale). DESIGN: A longitudinal community-based 3-year follow-up study of 35 consecutive primary stoke patients initially admitted to an Acute Medical Unit (mean age 82 yr). The validity of the CB scale was studied in 150 patients (mean age 77 yr): 83 demented outpatients with stroke from a general geriatric day-care unit. Reliability was studied in another 23 outpatients (mean age 72 yr) with stroke from the same unit. METHODS: A 22-item CB scale for different types of caregiver burden and scales for neuroticism and extroversion (Eysenck Personality Inventory) and quality of life (11-item scale). Activities of daily life were assessed by a 6-item, scale, initially and 3 years later. OUTCOME MEASURE: Reliability and validity of the CB scale. Improvements of activities of daily life of stroke patients. RESULTS: Factor analyses of the CB scale gave five indices--general strain, isolation, disappointment, emotional involvement, and environment--having good kappa values, .89 to 1.00 and Cronbach's alpha, .70 to .87, except for environment. A higher burden was related to a closer relationship but not to the living situation. The highest caregiver burden was found among patients showing the greatest improvements of ADL, when divided into tertiles. The patient's degree of extroversion and quality of life were negatively correlated to caregiver burden, -.46(p < .05) and .59(p < .01). CONCLUSIONS: The CB scale proved to be a valid and reliable instrument to assess caregiver burden. To improve the caregiver situation, individual patient personality characteristics, like extroversion, feeling of quality of life, and progression of the disease, must be considered.

Activities of Daily Living↗

Changes in functional competency in the oldest old. A longitudinal study.

Changes in everyday functioning and cognitive abilities are studied longitudinally in a representative sample of the oldest old. Respondents were selected by using census records from all people aged 84, 86, 88, and 90 years old living in an area of South Central Sweden, and then were assessed at 2-year intervals. The findings show high base rates for disabilities and high incidence of cognitive and functional deficits among survivors. Mortality is associated with higher rates of disability at the previous time of assessment. Because of this increased mortality rate among disabled individuals, prevalence does not rise as much as would be expected from the high incidence. Instead, new cases of disabled are partly replacing disabled individuals who died since the previous evaluation.

Activities of Daily Living↗

Group homes for people with dementia: a Swedish example.

We describe the development and evaluation of group homes for dementia patients in Sweden. Group homes have been established on a social model of care to provide a better quality of life than in institutional settings, while making a small savings on cost. An enriched program of activities uses familiar, everyday household tasks, with staff trained to model appropriate behaviors. An evaluation of four homes indicated that residents could be well accommodated in the setting, even as their disabilities increased. Although there were some initial problems, staff satisfaction was high and turnover low.

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