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Biomedical subjects

B Steen

Publications and source records attributed to B Steen.

At least 19 recordsLinked to original sources
PubMed2006

Prevalence of metabolic syndrome in an elderly Swedish population.

The prevalence of the metabolic syndrome in different elderly European populations has not been well studied. The aim of this study was to measure the prevalence of metabolic syndrome, as well as its individual components, in an elderly Swedish cohort. A random sample of 778 individuals (372 men and 406 women) was selected from a 70-year-old cohort in the H70 study, a gerontological and geriatric population study carried out in Gothenburg, Sweden. The study included medical and treatment history assessments, laboratory procedures and physical examinations to determine the presence of each of the five components of the metabolic syndrome as defined by the National Cholesterol Education Program Adult Treatment Panel III. Of the 508 adults (243 men and 265 women) included in the study, 22.6% had metabolic syndrome. The prevalence was higher in men (26.3%) than in women (19.2%). One third of the total sample had at least one of the five risk factors for metabolic syndrome. High blood pressure (> or =130/85 mmHg or use of antihypertensive/diuretic medication) was the most prevalent risk factor in both men (68.3%) and women (50.2%), while abdominal obesity was the overall second most common risk factor (27.2% of men and 42.7% of women). The prevalence of high fasting plasma glucose (> or =110 mg/dl or use of antidiabetic medication) was 29.0% in men and 19.1% in women. Metabolic syndrome was prevalent in a significant proportion of this elderly Swedish population, highlighting the underdiagnosis of a condition that is important to treat.

Aged↗
PubMed2006

A vascular risk factor index in relation to mortality and incident dementia.

To develop a method for quantifying risks of death and dementia in relation to vascular risk factors the Gothenburg H-70 1901-02 birth cohort was studied (n=380, was followed over 20 years, with 103 incident dementia cases). Separate vascular risk factor indices were calculated using 23 vascular risk factors to predict: (i) dementia-free-survival, and (ii) incident dementia derived from post hoc optimal separation of affected and unaffected cases. Classification of adverse outcomes (dementia/non-dementia; alive/dead) was assessed using receiver-operator characteristic (ROC) curves, and the area under the curve (AUC). Each index showed high separation between affected and unaffected cases. For dementia/non-dementia, the AUC was 0.74+/-0.02 for 10 year and 0.67+/-0.02 for 20 year; for death/survival, the AUC was 0.75+/-0.02 for 10 years and 0.79+/-0.03 for 20 years. Of note, few items were important in both indexes, and most showed reciprocal effects (e.g. decreased the risk of death but increased the risk of dementia). Our results suggest that vascular risk factor indexes can give robust estimates of dementia and life span prognoses in elderly people, but death and dementia have different risk profiles. This may be because of death being a competing risk for incident late-onset dementia.

Dementia↗
PubMed2005

High total cholesterol levels in late life associated with a reduced risk of dementia.

OBJECTIVE: To examine the longitudinal association between plasma total cholesterol and triglyceride levels and incident dementia. METHODS: Neuropsychiatric, anthropometric, laboratory, and other assessments were conducted for 392 participants of a 1901 to 1902 birth cohort first examined at age 70. Follow-up examinations were at ages 75, 79, 81, 83, 85, and 88. Information on those lost to follow-up was collected from case records, hospital linkage system, and death certificates. Cox proportional hazards regression examined lipid levels at ages 70, 75, and 79 and incident dementia between ages 70 and 88. RESULTS: Increasing cholesterol levels (per mmol/L) at ages 70 (hazard ratio [HR] 0.77, 95% CI: 0.61 to 0.96, p = 0.02), 75 (HR 0.70, CI: 0.52 to 0.93, p = 0.01), and 79 (HR 0.73, CI: 0.55 to 0.98, p = 0.04) were associated with a reduced risk of dementia between ages 79 and 88. Examination of cholesterol levels in quartiles showed that the risk reduction was apparent only among the highest quartile at ages 70 (8.03 to 11.44 mmol/L [311 to 442 mg/dL]; HR 0.31, CI: 0.11 to 0.85, p = 0.03), 75 (7.03 to 9.29 mmol/L [272 to 359 mg/dL]; HR 0.20, CI: 0.05 to 0.75, p = 0.02), and 79 (6.82 to 9.10 mmol/L [264 to 352 mg/dL]; HR 0.45, CI: 0.17 to 1.23, p = 0.12). Triglyceride levels were not associated with dementia. CONCLUSIONS: High cholesterol in late life was associated with decreased dementia risk, which is in contrast to previous studies suggesting high cholesterol in mid-life is a risk factor for later dementia. The conflicting results may be explained by the timing of the cholesterol measurements in relationship to age and the clinical onset of dementia.

Age Distribution↗
PubMed2005

Performance of the SF-36 health survey in screening for depressive and anxiety disorders in an elderly female Swedish population.

OBJECTIVE: To assess the sensitivity, specificity and predictive validity of suggested cut-off scores in the SF-36 mental health (MH) and mental component summary (MCS) in screening for depressive and anxiety disorders in a population sample of older Swedish women. METHOD: The sample comprised 586 randomly selected females aged 70-84 years who took part in an in-depth psychiatric examination. This provided the 'gold standard' against which the usefulness of SF-36 recommended thresholds for screening for depressive and anxiety disorders in older Swedish women was examined. RESULTS: Based on DSM-III-R criteria, 69 women (12%) were diagnosed with depression (major depression, dysthymia and/or depression NOS) and 49 (8%) with generalised anxiety and panic disorders. The previously recommended MH and MCS cut-offs (i.e. 52 and 42) gave a specificity for diagnosis of depression of 92 and 82% and sensitivity of 58 and 71%, respectively. Both the MH and MCS were good predictors of depressive disorders but poor predictors of anxiety disorders. CONCLUSION: The study supports the predictive validity of suggested SF-36 MH and MCS cut-off scores in screening for depressive disorder but not for anxiety disorder in older women in Sweden.

Age Factors↗
PubMed2005

Obesity in 70-year-old Swedes: secular changes over 30 years.

OBJECTIVE: Secular increases in obesity have been widely reported in middle-aged adults, but less is known about such trends among the elderly. The primary purpose of this paper is to document the most recent wave of the obesity epidemic in population-based samples of 70-y-old men and women from Göteborg. Additionally, we will investigate the influences of physical activity, smoking and education on these secular trends. POPULATIONS AND METHODS: Five population-based samples of 3702 70-y-olds (1669 men and 2033 women) in Göteborg, Sweden, born between 1901 and 1930, were examined in the Gerontological and Geriatric Population Studies (H70) between 1971 and 2000. Cohort differences in anthropometric measures were the main outcomes studied. Physical activity, smoking habits and education were assessed by comparable methods in all cohorts. Subsamples of the women in the latest two cohorts (birth years 1922 and 1930) were also part of the Prospective Population Study of Women in Göteborg. In these women, it was possible to examine body mass index (BMI) and waist-to-hip circumference ratio (WHR) longitudinally since 1968. RESULTS AND CONCLUSIONS: Significant upward trends were found for height, weight, BMI, waist circumference (WC), WHR, prevalence of overweight (BMI> or =25 kg/m(2)) and obesity (BMI> or =30 kg/m(2)) across cohorts in both sexes. In 2000, 20% of the 70-y-old men born in 1930 were obese, and the largest increment (almost doubling) had occurred between the early 1980s and the early 1990s. In 70-y-old women the prevalence of obesity was 24% in 2000, a 50% increase compared to the cohort born 8 y earlier. BMI increased over time in all physical activity, smoking and education groups, with the exception of never-smoking men. Although 70-y-old women in 2000 were heavier than cohorts examined 8 y previously, data from the women studied longitudinally revealed that these differences were already present in earlier adulthood. In conclusion, the elderly population is very much part of the obesity epidemic, although secular trends in BMI were detected slightly earlier in men than in women. The health implications of these secular trends should be focused on in future gerontological research.

Aged↗
PubMed2004

Maximizing outcome of dementia treatment: the role of nutrition.

The dementia syndromes are multifactorial regarding etiology, prevention, diagnosis,therapy, and rehabilitation, which include genetics, histopathology, biochemistry as well as sociopsychology, clinical medicine and caring sciences. This review concentrates on nutritional aspects. This includes body composition, where sarcopenia and water deprivations are important issues. Body weight and body water decrease with age which together with the well-known deterioration of thirst perception in old age may give rise to e.g., circulatory collapse and confusion, which is such a common symptom in the elderly not the least in demented patients. We have shown that an improved meal environment in nursing home patients markedly improves the psychosocial and nutritional situation. Aspects on feeding behavior have been shown to be important as well. Epidemiologically, recent 18-year longitudinal data from the gerontological and geriatric population studies in Göteborg, Sweden(H70) suggest that overweight at high ages is a risk factor for dementia, particularly Alzheimer's disease, in women. Furthermore, overweight and obesity are important contributors to the presence of white matter lesions in the elderly.

Aged↗
PubMed2004

Body mass index and white matter lesions in elderly women. An 18-year longitudinal study.

BACKGROUND: We investigated the longitudinal relationship between body mass index (BMI), a major vascular risk factor, and white matter lesions (WMLs) in older women. METHODS: Twenty-seven Swedish women were followed from age 70 to 88. Measurements of BMI, and systolic and diastolic blood pressures were conducted at 70, 75, 79, 85, and 88 years. WMLs were measured using computerized tomography at age 85 and 88 (85/88). RESULTS: Women with any WMLs at age 85/88 had higher BMI at age 70 (p = 0.003) and 75 (p = 0.006), compared to women without WMLs. Increasing severity of WMLs was related to BMI at age 70 (p < 0.001), 75 (p < 0.001), 79 (p = 0.017), and 85 (p = 0.025). After consideration of other vascular factors, BMI at age 70, 75, and 79 was most significantly related to WML at 85/88. Every 1.0 kg/m2 increase in BMI at age 70 increased risk of WMLs twofold. CONCLUSIONS: Overweight and obesity may be important contributors to the presence of WMLs in the elderly.

Aged↗
PubMed2004

Secular trends in diet among elderly Swedes -- cohort comparisons over three decades.

OBJECTIVE: The purpose of this study was to compare dietary practices among different birth cohorts of 70-year-old Swedes, who were examined between 1971 and 2000. SETTING: Göteborg, Sweden. DESIGN: Four population-based samples of 1360 70-year-olds, born in 1901, 1911, 1922 and 1930, have undergone health examinations and dietary assessments over a period of almost three decades. One-hour diet history (DH) interviews were conducted in 1971, 1981, 1992 and 2000 with a total of 758 women and 602 women. The formats and contents of the dietary examinations were similar over the years. Statistical analysis of linear trends was conducted, using year of examination as the independent variable, to detect secular trends in food and nutrient intakes across cohorts. RESULTS: At the 2000 examination, the majority of 70-year-olds consumed nutritionally adequate diets. Later-born cohorts consumed more yoghurt, breakfast cereals, fruit, vegetables, chicken, rice and pasta than earlier-born cohorts. Consumption of low-fat spread and milk also increased, along with that of wine, light beer and candy. In contrast, potatoes, cakes and sugar were consumed less in 2000 than in 1971. The ratio of reported energy intake to estimated basal metabolic rate did not show any systematic trend over time in women, but showed a significant upward trend in men. CONCLUSIONS: The diet history method has captured changes in food selections in the elderly without changing in general format over three decades. Dietary quality has improved in a number of ways, and these findings in the elderly are consistent with national food consumption trends in the general population.

Aged↗
PubMed2003

Body composition estimated by bioelectrical impedance in the Swedish elderly. Development of population-based prediction equation and reference values of fat-free mass and body fat for 70- and 75-y olds.

OBJECTIVE: To develop a bioelectrical impedance (BIA) prediction equation for fat-free mass (FFM(BIA)) and present reference values of FFM and body fat (BF) for healthy Swedish elderly from population-based representative samples. SUBJECTS: This study is based on 823 (344 males, 479 females) participants from two systematic samples of birth cohorts in Göteborg aged 70 (cohort H70V, 201 males and 299 females) and 75 (cohort NORA75, 143 males and 180 females). METHODS: Body composition was measured with BIA (BIA-101, RJL system, Detroit) in both cohorts and was estimated by a four-compartment (4C) model from total body water (TBW) and total body potassium (TBK) in a sub-sample of the NORA75 cohort. The FFM(BIA) was validated against the FFM from the 4C model (FFM(4C)). RESULTS: The FFM(BIA) correlated well with FFM(4C) (r=0.95, SEE=2.64 kg). The FFM(BIA) (kg) in 70-y-old males and females were 58.5+/-5.4 and 43.4+/-4.4, and for 75-y-old males and females were 56.1+/-4.7 and 42.5+/-4, respectively. The body fat in kg (FM) among 70-y-old males and females were 25.2+/-8.1 and 25.7+/-8.4, and for 75-y-old males and females were 21.7+/-7.1 and 22.8+7.2, respectively. The percent body fat (BF%) among 70-y-old males and females were 29.5+/-5.8 and 36.3+/-6.4, and for 75-y-old males and females were 27.3+/-6 and 34.1+/-6.1, respectively. CONCLUSION: The FFM, FM and BF% from this study might be used as reference values for Swedish elderly aged 70 and 75 y.

Adipose Tissue↗
PubMed2003

Reduction of plasma homocysteine and serum methylmalonate concentrations in apparently healthy elderly subjects after treatment with folic acid, vitamin B12 and vitamin B6: a randomised trial.

OBJECTIVES: To investigate, in an elderly population: (1) the effects of oral B-vitamin therapy on P-tHcys, S-MMA and Hb/MCV, (2) the appropriate decision limit for 'high' metabolite concentrations and (3) the estimated prevalence of vitamin B(12)/folate deficiency on the basis of different decision limits. DESIGN: Double-blind placebo-controlled intervention study. SETTING: Outpatient clinic. SUBJECTS: A total of 209 community-dwelling subjects, median age 76 y (range 70-93) y. INTERVENTION: Four months of oral daily supplementation with 0.5 mg cyanocobalamin, 0.8 mg folic acid and 3 mg vitamin B(6). RESULTS: High P- tHcys was found in 64% of men and 45% of women, high S-MMA in 11% of both. Vitamin B(12) deficiency was observed in 7.2% and folate deficiency in 11% of all subjects. Health-related upper reference limits for the metabolites at the start were higher than the laboratory's upper reference limits. The latter were, however, similar to those of the vitamin replete group. There was a significant decrease in P-tHcys (P<0.001) and S-MMA (P=0.009) after 4 months of vitamin treatment. In a multivariate analysis, the P-Hcys change correlated positively with baseline P-tHcys and inversely with baseline P-folate and transferrin saturation (Fe/TIBC ratio). The S-MMA change correlated with baseline S-MMA and inversely with baseline vitamin B(12) and age. CONCLUSIONS: Suboptimal vitamin status is an important cause of elevated P-tHcys and S-MMA in apparently healthy elderly subjects. Oral B-vitamin therapy is an effective and convenient way to normalise P-tHcys and S-MMA.

Aged↗
PubMed2002

Health and well-being among 70-year-old migrants living in Sweden--results from the H 70 gerontological and geriatric population studies in Göteborg.

BACKGROUND: Comparative epidemiological studies in migrants in Sweden have shown increased prevalence of psychosocial morbidity in young adults, but there is paucity of information on health in people aged 65 years and over. AIMS: We aim to compare prevalence of mental, physical and social health problems, rates of hospital admission, and mortality in Swedish and non-Swedish born people aged 70 years living in Göteborg, Sweden, and examine associations between social factors, physical health, mood and life satisfaction in the ethnic groups. In addition, we aim to test for the hypothesis that differences in mental health between migrants and natives are explained by social disadvantages rather than ethnicity. METHOD: Semi-structured interviews were administered to 84 migrants (47 women and 37 men randomly selected) with the help of bilingual interpreters, and 409 Swedes (183 males and 226 females) used as "controls". Complementary health and social data obtained from official sources on the total sample (N = 764, including non-participants in overall medical interviews) were used in comparative analyses of in-patient care and mortality and to check for the possibility of sampling bias. RESULTS: Migrants--originating mainly from Estonia, Poland, Yugoslavia, Germany, Italy and Nordic countries other than Sweden--reported more dizziness, poor vision and urinary problems, and fewer gall bladder problems than indigenous people (p < 0.05). Migrants also had higher levels of anxiety and depression and bodily pain, and lower levels of general health, social and emotional functioning, satisfaction with physical health status, family contacts, housing conditions and economic status than natives (p <0.05). Satisfaction with physical health seemed to be one of the strongest factors related to a lower prevalence of anxiety and depression together with family support and time spent in leisure pursuits. No significant differences in inpatient care in several ICD categories and all-cause mortality were found between overall migrants and the control group notwithstanding differences in self-reported health. CONCLUSION: The results indicate poorer subjective health in older migrants than natives in Göteborg, and also point to a "healthy migrant" effect on survival.

Activities of Daily Living↗
PubMed2002

Masticatory ability in 80-year-old subjects and its relation to intake of energy, nutrients and food items.

OBJECTIVE: The aim of the present study was to analyse the relationship between masticatory ability (self-assessed masticatory ability and bite force) and intake of energy, nutrients and food items in a population sample of elderly subjects. DESIGN AND SUBJECTS: From a population sample of 80-year-old people, 160 individuals (74 men and 86 women) took part in an odontological study. MAIN OUTCOME MEASURES: A dental examination including bite force recording, a questionnaire focusing on self-assessed masticatory ability, and a dietary interview. SETTING: Department of Geriatric Medicine, Göteborg University, Sweden. RESULTS: The dental status among the participants varied much (from edentulous in both jaws--22%--to more than 20 natural teeth--30%). The mean maximum bite force was higher in men (165 N) than in women (105 N). Bite force was significantly correlated to the Eichner index and to the number of teeth. One third of the subjects reported no masticatory problem, whereas 18% identified > or = 3 such problems. The intake of energy and nutrients varied much but the means were well above recommended values. The correlations between dental status and bite force on one side and dietary intake on the other side were in general weak and most often statistically non-significant. Impaired general health and reduced dentition were both associated with more masticatory problems. CONCLUSION: The examined sample of 80-year-old subjects had a great variation in dental status, bite force and self-assessed masticatory ability, but these factors had only a minor influence on dietary selection and intake, which on average were well above recommended values.

Aged↗
PubMed2001

[Biological aging--a mini review. Focus on heart/blood pressure and nutrition].

The mechanisms for cellular aging have yet to be elucidated, but most data are in favor of a combination of processes. Such theories include a neuroendocrine group of theories, an immunological theory, the theory with a limited number of cell divisions as a basis, and the "wear-and-tear" theories together with e.g. oxidative stress and DNA damage. New data on cardiac aging have implications for geriatric medicine. With advancing age, although body cell mass decreases, the amount of body fat is relatively unchanged, while a more marked change from age 70 entails a reduction in body water. Data on successful attempts to prolong life in man are scarce, even if life-span in animals has been manipulated.

Aged↗
PubMed2001

[The elderly yesterday, today and tomorrow. Aspects of cohort differences and prevention of the manifestations of aging].

Larger and different groups of elderly persons will meet us in the next few decades. This review describes cohort differences during a couple of decades from the gerontological and geriatric population studies in Göteborg, Sweden (H 70), regarding for example anthropometry, hearing, cognitive function, dietary habits and oral health. The sometimes great cohort differences have an obvious impact on for example planning of health care. Preventive possibilities are dealt with within the fields of nutrition and physical activity.

Aged↗
PubMed2001

Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.

Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.

Aged↗
PubMed2001

Cognitive function and functional ability. A cross-sectional and longitudinal study at ages 85 and 95 in a non-demented population.

We studied the relationship between cognitive function and ability in daily life activities (ADL) at ages 85 (N=332) and 95 (N=63) cross-sectionally and longitudinally in representative populations of non-demented persons, in order to focus on manifestations related to healthy aging. Among the 85-year olds, 31% were independent, 42% were dependent on personal assistance in instrumental ADL (IADL) and 27% in personal ADL (PADL); the corresponding figures for the 95-year olds were 8, 40 and 52%, respectively. Regarding the relationship between cognitive function and ADL, the analysis could only be performed in the cross-sectional data. At age 85 a significant trend was found regarding nearly all cognitive tests for both men and women, indicating that subjects who were ADL-independent had better results than those dependent in IADL, and both IADL and PADL. At age 95, no such trend was found in males, but in females the trend was significant, and those dependent in ADL had poorer results in the separate cognitive tests. By combining the different cognitive tests into a compiled cognitive index, it was seen that the most ADL-dependent persons were more cognitively impaired both at ages 85 and 95, compared to persons who were ADL-independent. Not only cognitive functioning (OR 3.3), but also mobility (OR 4.9) and tiredness (OR 3.3) were independent predictors for ADL-dependence among the 85-year olds.

Activities of Daily Living↗
PubMed2001

Color and form as support for picture recognition in old age.

This study examined the effect of color and form as support for picture recognition measured immediately and after a period of 20 minutes in two groups: a random sample of 80-year-old men and women, with a Mini-Mental-State-Examination (MMSE) score of >26 points (N=142), and individuals with confirmed diagnosis of Alzheimer's disease (AD) with a MMSE score ranging from 7-26 points (N=50). The result showed that individuals with AD could make use of spatial support for recognition at a significantly lower level than among the cognitively intact 80-year olds, but most interestingly with a similar pattern. Chromatic pictures had an advantage over achromatic ones on immediate recognition measured as less time consumption and a higher number of correct answers in both groups. However, after 20 minutes' retention time, achromatic pictures were better recognized than chromatic ones by both the 80-year olds and the individuals with AD. It is suggested that immediate recognition had most support from self-generated cues concerning color, in contrast to retained recognition where instead cues concerning form had the strongest impact. Gender and age had no influence on recognition. Visual function and abstract vs concrete objects showed a slight impact on the result. Factors of intelligence and memory in the group of 80-year olds only had a minor influence on recognition, contrary to dementia which had a profound impact. It is concluded that spatial support as to color and form could be used for recognition in old age groups. The result will encourage further experimental research in using coding and cueing strategies for future implications in clinical practice.

Aged↗