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Biomedical subjects

B Winblad

Publications and source records attributed to B Winblad.

At least 289 records · Page 16Linked to original sources
PubMed1994

Geographical distribution of haplotypes in Swedish families with Huntington's disease.

This study was planned to determine the number of origins of the mutation underlying Huntington's disease (HD) in Sweden. Haplotypes were constructed for 23 different HD families, using six different polymorphisms [(CCG)n, GT70, 674, BS1, E2 and 4.2], including two within the gene. In addition, extensive genealogical investigations were performed, and the geographical origin of the haplotypes was studied. Ten different haplotypes were observed suggesting multiple origins for the HD mutation in Sweden. Analysis of the two polymorphic markers within the HD gene (the CCG repeat and GT70) indicates that there are at least three origins for the HD mutation in Sweden. One of these haplotypes (7/A) accounts for 89% of the families, suggesting that the majority of the Swedish HD families are related through a single HD mutation of ancient origin. Furthermore, three of the families that were previously considered to be unrelated could be traced to a common ancestor in the 15th century, a finding that is consistent with this hypothesis.

Alleles↗
PubMed1994

Evidence for biochemical heterogeneity in schizophrenia: a multivariate study of monoaminergic indices in human post-mortal brain tissue.

A previously performed post-mortem study comparing monoaminergic indices in the brains of 14 schizophrenic patients and 10 patients with psychosis not diagnosed as schizophrenia, with age-matched control cases without any known neuropsychiatric illness, was re-investigated, using multivariate analysis. The monoaminergic patterns showing up in this analysis suggested the existence of at least two different forms of the disease, both of which could be distinguished from the controls as well as from each other. One of the schizophrenic groups consisted of paranoid cases, and had a relatively mild family history, whereas the other group, mainly consisting of hebephrenic cases, had a severe family history. The former group showed low levels of dopamine and high levels of serotonergic precursor and metabolite, whereas the latter group in some respects tended to show the opposite aberrations. Neuroleptic treatment did not seem to account for the different biochemical profiles, unless one assumes that this treatment can cause completely different monoaminergic aberrations in different individuals. Instead, one could argue that the different biochemical profiles found are characteristic of the disease.

Adult↗
PubMed1994

Insulin-like growth factor-1 receptors in human spinal cord: changes in amyotrophic lateral sclerosis.

Neurotrophic factors are important for neuronal survival and maintenance in the adult nervous system. The regional distribution of insulin-like growth factor-1 (IGF-1) receptors in human spinal cords from controls and amyotrophic lateral sclerosis (ALS) patients was studied by immunohistochemistry and quantitative autoradiography. When comparing 125I-IGF-1 binding in the different spinal levels of normal spinal cord the same distribution pattern was found in which the binding was highest in the central canal > dorsal horn > ventral horn > white matter. In the ALS cases although a general upregulation of IGF-1 receptors was observed throughout the spinal cord, significant increases were observed in the cervical and sacral segments compared to controls. IGF-1 receptor immunoreactivity showed a similar pattern to that for 125I-IGF-1 binding, with immunoreactivity being found in the gray matter of the spinal cord and enhanced immunoreactivity occuring in ALS patients compared to controls. In agreement with the distribution of IGF-1 receptors, IGF-1 immunoreactivity was found within the gray matter of the spinal cord. The cartography of IGF-1 receptors in the normal spinal cord as well as the change of these receptors in diseased spinal cord may be of importance in future treatment strategies of ALS.

Aged↗
PubMed1994

A novel anticholinesterase THB013: biochemical and behavioural studies.

Clinical trials with tacrine (THA) have resulted in elevations of liver enzymes in Alzheimer patients that showed improvement. In an effort to minimize these side effects several THA analogues were synthesized. These analogues were compared to THA in biochemical as well as behavioural studies. In this study, the biochemical effects of THA and one of these analogs, THB 013, on plasma cholinesterase activity, cholinergic receptors as well as the effect of these drugs on spatial learning in adult rats were examined. THB 013 was, at lower concentration, more efficacious in inhibiting plasma cholinesterase as well as blocking the scopolamine induced disruption of spatial learning when administered 10 min before the scopolamine injection. It is possible that THB 013 with more potent cholinergic effects than THA might be useful in the treatment of Alzheimer's disease.

Alzheimer Disease↗
PubMed1994

A comparison of multiplex and simplex families with Alzheimer's disease/senile dementia of Alzheimer type within a well defined population.

A study was made on 150 clinically demented patients presenting at autopsy at Umeå University Hospital in Sweden. In 90 of the cases dementia was considered to be primary in nature and of these forty six per cent (41 cases), fulfilled both the clinical and histopathological criteria for the diagnosis of Alzheimer's disease/Senile dementia of Alzheimer type (AD/SDAT). The families of these 41 AD/SDAT cases were then studied, and a family history obtained through interviews with multiple family informants and from civil and medical records. Additional diseased family members suffering from progressive dementia (multiplex families) were observed in 12 probands out of 41 (29%). Multiplex families exhibited similar clinical and histopathological characteristics as simplex families containing a single affected individual. The secondary cases in the multiplex families exhibited similar demographic and clinical characteristics as the probands. 39% of the multiplex and 14% of the simplex cases had an early age of onset of the disease, that was under 65 years. The overall prevalence of progressive dementia disorders in the 41 families was 5.9%. The prevalence of a progressive dementia disorder was 11% in the multiplex families (14% for the early onset cases) and 3.5% in the simplex families (2% for the early onset cases). The prevalence of progressive dementia disorder for family members who had passed the mean age of the onset of the disease for their family, was 45% for multiplex and 18% for simplex families. Furthermore the incidence rate for dementia was significantly higher (p < 0.005) in multiplex families (5.5 per 1,000 person years) when compared to simplex families (2.5 per 1,000 person years). No differences could be seen in parental age at birth of the diseased when comparing the two sets of families. However in multiplex families the duration of the disease was significantly (p < 0.025) shorter, in subjects with parental age at birth over 35 years compared to those with a parental age under 35 years. The multiplex families contained significantly (p < 0.025) larger sibships; and showed a significantly lower age of onset for the disease (p < 0.001), and a significantly longer duration of disease (p < 0.05) compared to the simplex families. A significant intra familial correlation of age at disease onset was observed in both sets of the families.

Age of Onset↗
PubMed1994

Hypertension in the elderly population: prevalence data from an urban area in Sweden.

Data from the total urban elderly population (75 years and older) in Kungsholmen, Stockholm, were used to calculate age- and sex-specific prevalence of hypertension. Blood pressure was measured as part of the examination in the population survey (the Kungsholmen Project). The blood pressure of 1751 elderly people and any antihypertensive treatment were recorded. The prevalence of hypertension was 54 and 59 per 100 population for men and women, respectively. No great variation was observed with age or sex. Isolated systolic hypertension was most frequent with increasing prevalence in advanced ages, while isolated diastolic hypertension and systolic and diastolic hypertension showed a tendency of decreased prevalence with age. In the subjects studied, 18% were being treated for hypertension. Hypertension was detected in 47% of those not undergoing treatment. Among those, 76% had high blood pressure measurements. Our data demonstrate that hypertension is a prevalent disease in the very old, in both sexes, and support the need for hypertension screening programs as well as programs to evaluate the efficacy and benefits of treatment in this age group.

Age Distribution↗
PubMed1994

The significance of the Swedish APP670/671 mutation for the development of Alzheimer's disease amyloidosis.

Alzheimer's disease is characterized histopathologically by the detection of amyloid plaques and tangles in the brains of its victims. A major component of the amyloid plaques, the beta-amyloid peptide, is a metabolite of a larger transmembrane protein termed the amyloid precursor protein (APP). Several pathogenic mutations causing Alzheimer's disease have been identified in the APP gene, situated on chromosome 21. One of these is a double missense mutation in exon 16 of the APP gene which occurs in a large Swedish pedigree. Studies with transfected cell cultures have shown that cells expressing this double mutation release approximately 7 times more beta-amyloid than their wild type counterparts. Possible mechanisms whereby the APP mutations cause Alzheimer's disease are considered here against the background of current understanding of the physiological role and processing of APP.

Alzheimer Disease↗
PubMed1994

Preconditions for communication in the care of bilingual demented persons.

This study describes how demented immigrants' communicative performance together with caregivers who speak/do not speak these people's native language relates to the demented persons' cognitive, linguistic, and neuropsychological abilities. The study was carried out among demented persons who were born in Finland and had immigrated to Sweden. Their life history, linguistic history and linguistic behavior, and communication in standardized situations were assessed. neuropsychological and medical examinations were performed for diagnostic reasons. The results show that many of these Finnish immigrants had difficulties communicating with their Swedish-speaking caregivers, while their communication with a Finnish-speaking caregiver was adequate. The frequent misunderstanding of a person's message often leads to a one-way communication, in which the caregiver commands and interrupts the demented person. The demented Finnish immigrants functioned on a level of manifest competence that seemed far below their level of latent competence. It seems reasonable that the presence of Finnish-speaking caregivers is an environmental change that would markedly enhance the demented Finnish immigrants' performance and quality of life and also reduce the costs for their care.

Aged↗
PubMed1994

Predicting episodic memory performance in dementia: is severity all there is?

Whether individual differences in demographic, psychometric, and biological domains can predict episodic memory in dementia was investigated. Mildly to moderately demented very old persons performed episodic memory tasks (free recall and recognition of slowly and rapidly presented random words, free and cued recall of organizable words, and recognition of dated and contemporary famous faces). A factor analysis of the memory measures yielded 2 factors, 1 indexing recall and 1 recognition. Controlling for severity of dementia, only 2 predictors contributed to performance: (a) Block Design (a marker of fluid intelligence) was positively related to recall, and (b) age was negatively related to recognition. Although these results are similar to data reported on predictors of episodic memory in normal aging, (a) the number of predictive variables appears to be reduced in dementia, and (b) age seems to affect recall and recognition differentially in normal aging and dementia.

Activities of Daily Living↗
PubMed1994

Visual impairment related to cognition and loneliness in old age.

Reported problems in visual acuity were examined as determinants of loneliness experienced by community dwelling people with either impaired or unimpaired cognition. The Mini-Mental State Examination (MMSE) was used as a screening instrument to form a cognitively-impaired (MMSE 20-23/30) and a cognitively-intact group (MMSE 28-30/30). A total of 147 subjects took part in the study and were examined by an optometrist. Subjects with intact cognition tended to report visual problems more often than subjects with cognitive deficits. One out of two subjects had slight visual impairment, in both cognitive groups. After acuity had been optimally corrected, six to seven out of ten subjects' visual acuity did improve. In a multiple regression analysis, higher MMSE score and visual improvement were significantly related to lower levels of self-reported loneliness among the elderly with their cognition intact, but not among the subjects with impaired cognition.

Aged↗
PubMed1994

Cobalamin levels are not reduced in Alzheimer's disease: results from a population-based study.

OBJECTIVE: To determine whether there is a relationship between serum cobalamin levels, normal aging, and Alzheimer's Disease (AD). DESIGN: Cross-sectional survey. SETTING: A district (Kungsholmen) in Stockholm, Sweden. PARTICIPANTS: Population-based cohort of 545 subjects aged more than 74 years. The sample was selected on the basis of evidence of cognitive impairment from all inhabitants in an area of Stockholm (2368 individuals), both living at home or in institutions. MEASUREMENTS: Serum cobalamin levels and diagnostic evaluation for a diagnosis of dementia and type of dementia. RESULTS: The serum cobalamin levels in non-demented individuals decreased 5.5 pmol/L with an increase of 1 year of age (regression coefficient = -5.53; P < 0.0001). However, the regression coefficient was 0.21 (P = 0.91) in demented people and 2.57 (P = 0.32) in AD subjects. There was no difference between serum cobalamin levels in demented, AD, and non-demented subjects, except for the oldest ages where demented people and AD sufferers showed higher values. AD patients still living in their own homes had significantly lower cobalamin concentrations compared with institutionalized AD sufferers. The prevalence rate of cobalamin deficiency was 15.5% (95% CI = 11.5-19.5) in normal aging and 18.1% (95% CI = 10.3-25.9) in AD. CONCLUSIONS: These data suggest that serum cobalamin levels decrease in normal aging, but not in dementia or AD. A lower cobalamin concentration observed in AD sufferers still living in their own homes compared with institutionalized persons with AD seemed to be related to but not fully explained by eating habits. Patients with AD living in their own homes are at risk of developing cobalamin deficiency, and monitoring of serum cobalamin concentrations might be useful in this group.

Aged↗
PubMed1994

The perceived importance of appearance and oral function, comfort and health for severely demented persons rated by relatives, nursing staff and hospital dentists.

Dental health is an aspect of the quality of life. Oral treatment goals for, the severely demented and the benefits of oral treatment are complex issues. Severely demented people can neither express their wishes nor make rational decisions about oral care. Acting "in the best interests" of a demented person who refuses or does not understand the purpose of treatment depends on what perspective and treatment priorities the advocate has. For oral treatment of a demented person the advocate may be a relative, a member of the ward staff or a hospital dentist. In a structured interview, the relatives of demented patients in a Stockholm hospital and members of the nursing staff were asked to rate the importance of goals for dental care. These ratings were also recorded for hospital dentists. In this study there was agreement on the importance of freedom from oral pain and fear of aspiration. Nursing personnel gave priority to aspects of good care such as being able to chew and enjoy eating. Relatives were also concerned with social behaviour and communication such as fresh breath, normal speech, and normal appearance. The ratings by the hospital dentists were generally lower which might reflect professional awareness of the limitations of treatment success implied by cognitive impairment.

Adult↗
PubMed1994

Severity of dementia and institutionalization in the elderly: prevalence data from an urban area in Sweden.

This study investigated the severity of dementia in relation to disease type and sociodemographic variables. The dementia cases were detected with a two-phase study design in a population aged over 74 years in Stockholm. The prevalence of questionable, mild, moderate, and severe dementia was 1.0, 3.1, 5.5, and 2.3 per 100, respectively. Women aged over 84 had the highest prevalence of severe dementia. More severe cases and a higher institutionalization rate were present for vascular dementia than for Alzheimer's disease. Fifty-five percent of the demented subjects but only 3% of the nondemented were institutionalized. The institutionalized demented subjects were affected mostly by moderate-severe dementia (88.6%), while the noninstitutionalized were affected more often by a questionable-mild form (68.3%).

Aged↗
PubMed1994

Association of age, sex, cognitive dysfunction, and disability with major depressive symptoms in an elderly sample.

OBJECTIVE: Previous studies have yielded conflicting results regarding the association of age, sex, and cognitive deficit with depression in the elderly. However, there is agreement about a relationship between depressive symptoms and disability. The authors previously conducted a factor analysis of the symptoms of major depression in elderly subjects and found that the symptoms clustered into factors of mood disturbance and motivation disturbance. The aim of the present study was to replicate these findings in a larger population sample and relate some of the variables possibly associated with depression to these two factors. METHOD: A population sample of 1,304 persons aged 75 years or older registered in a parish of Stockholm were examined by physicians to determine DSM-III-R depressive symptoms and disability in activities of daily living. The Mini-Mental State examination was also performed. RESULTS: Factor analysis showed factors of mood and motivation symptoms, and these were related differently to the associated variables. When the other associated variables were controlled for, age was unrelated to both types of symptoms. Women had more mood disturbance, but men had slightly more motivation disturbance. As cognitive function declined, mood disturbance first increased, then decreased. Motivation symptoms increased sharply with decreasing cognitive function. A relationship was found between increasing disability and both the mood and motivation symptoms. CONCLUSIONS: In the elderly, symptoms of depression involve either mood or motivation disturbance and the two types of symptoms are associated with different variables.

Activities of Daily Living↗
PubMed1994

Loneliness and living conditions of the oldest old.

This paper describes 211 of the oldest old, 90 years or older, in a broad perspective based upon well-being, living conditions and the living situation during a period of two and a half years. The subjects were interviewed, and at the first contact four out of five old persons were living in their own homes, 66% regarded themselves as healthy and three out of five depended on help for primary ADL. Approximately one of two experienced loneliness, the same proportion in each age group 90, 91 etc. Slight relations were found between experienced loneliness and age and subjective health. Slight relations were also found between subjective health and cognitive impairments. During the follow-up period 43% of the old people had died, and all were being cared for in institutions in their final stage of life.

Activities of Daily Living↗
PubMed1994

Comparing motor and process ability of persons with suspected dementia in home and clinic settings.

OBJECTIVES: Evaluating functional level of persons with diagnosed or suspected dementia is an important part of occupational therapy. The importance of the environment is often highlighted. We investigated the ability of clients with suspected dementia to perform instrumental activities of daily living (IADLs) in the clinic versus in their homes. METHOD: We used the Assessment of Motor and Process Skills (AMPS) to measure the motor and process skill ability of 19 clients with suspected dementia. RESULTS: Using two-tailed paired t-tests, we found no overall difference in IADL motor or process performance between the clinic and home setting. However, of the 19 clients, 6 had motor ability measures, whereas 5 had process ability measures that differed significantly between the two settings. CONCLUSION: The results suggest that if we want to know how a person with suspected dementia performs in IADLs in a specific environment we should test him or her in that environment.

Activities of Daily Living↗