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Sundström, Anna
Publications (10 of 37) Show all publications
Josefsson, M., Sundström, A., Pudas, S., Nordin Adolfsson, A., Nyberg, L. & Adolfsson, R. (2019). Memory profiles predict dementia over 23–28 years in normal but not successful aging. International psychogeriatrics
Open this publication in new window or tab >>Memory profiles predict dementia over 23–28 years in normal but not successful aging
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2019 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: Prospective studies suggest that memory deficits are detectable decades before clinical symptoms of dementia emerge. However, individual differences in long-term memory trajectories prior to diagnosis need to be further elucidated. The aim of the current study was to investigate long-term dementia and mortality risk for individuals with different memory trajectory profiles in a well-characterized population-based sample.

Methods: 1062 adults (aged 45–80 years) who were non-demented at baseline were followed over 23–28 years. Dementia and mortality risk were studied for three previously classified episodic memory trajectory groups: maintained high performance (Maintainers; 26%), average decline (Averages; 64%), and accelerated decline (Decliners; 12%), using multistate modeling to characterize individuals’ transitions from an initial non-demented state, possibly to a state of dementia and/or death.

Results: The memory groups showed considerable intergroup variability in memory profiles, starting 10–15 years prior to dementia diagnosis, and prior to death. A strong relationship between memory trajectory group and dementia risk was found. Specifically, Decliners had more than a fourfold risk of developing dementia compared to Averages. In contrast, Maintainers had a 2.6 times decreased dementia risk compared to Averages, and in addition showed no detectable memory decline prior to dementia diagnosis. A similar pattern of association was found for the memory groups and mortality risk, although only among non-demented.

Conclusion: There was a strong relationship between accelerated memory decline and dementia, further supporting the prognostic value of memory decline. The intergroup differences, however, suggest that mechanisms involved in successful memory aging may delay symptom onset.

Place, publisher, year, edition, pages
Cambridge University Press, 2019
Keywords
memory decline, episodic memory, death, competing risk, multistate model
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:umu:diva-165499 (URN)10.1017/S1041610219001844 (DOI)31762427 (PubMedID)
Available from: 2019-11-25 Created: 2019-11-25 Last updated: 2019-11-26
Oudin, A., Andersson, J., Sundström, A., Nordin Adolfsson, A., Oudin Åström, D., Adolfsson, R., . . . Nordin, M. (2019). Traffic-Related Air Pollution as a Risk Factor for Dementia: No Clear Modifying Effects of APOEɛ4 in the Betula Cohort. Journal of Alzheimer's Disease, 71(3), 733-740
Open this publication in new window or tab >>Traffic-Related Air Pollution as a Risk Factor for Dementia: No Clear Modifying Effects of APOEɛ4 in the Betula Cohort
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2019 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, no 3, p. 733-740Article in journal (Refereed) Published
Abstract [en]

It is widely known that the apolipoprotein E (APOE) ɛ4 allele imposes a higher risk for Alzheimer’s disease (AD). Recent evidence suggests that exposure to air pollution is also a risk factor for AD, and results from a few studies indicate that the effect of air pollution on cognitive function and dementia is stronger in APOE ɛ4 carriers than in non-carriers. Air pollution and interaction with APOE ɛ4 on AD risk thus merits further attention. We studied dementia incidence over a 15-year period from the longitudinal Betula study in Northern Sweden. As a marker for long-term exposure to traffic-related air pollution, we used modelled annual mean nitrogen oxide levels at the residential address of the participants at start of follow-up. Nitrogen oxide correlate well with fine particulate air pollution levels in the study area. We had full data on air pollution, incidence of AD and vascular dementia (VaD), APOE ɛ4 carrier status, and relevant confounding factors for 1,567 participants. As expected, air pollution was rather clearly associated with dementia incidence. However, there was no evidence for a modifying effect by APOE ɛ4 on the association (p-value for interaction > 0.30 for both total dementia (AD+VaD) and AD). The results from this study do not imply that adverse effects of air pollution on dementia incidence is limited to, or stronger in, APOE ɛ4 carriers than in the total population.

Place, publisher, year, edition, pages
IOS Press, 2019
Keywords
Air pollution, Alzheimer’s disease, apolipoprotein E, dementia
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-163266 (URN)10.3233/JAD-181037 (DOI)31450491 (PubMedID)
Available from: 2019-09-12 Created: 2019-09-12 Last updated: 2019-11-15Bibliographically approved
Lebedeva, A., Sundström, A., Lindgren, L., Stomby, A., Stomby, A., Aarsland, D., . . . Nyberg, L. (2018). Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatrica Scandinavica, 167(6), 491-502
Open this publication in new window or tab >>Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus
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2018 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 167, no 6, p. 491-502Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Depression is associated with accelerated aging and age-related diseases. However, mechanisms underlying this relationship remain unclear. The aim of this study was to longitudinally assess the link between depressive symptoms, brain atrophy, and cortisol levels.

METHOD: Participants from the Betula prospective cohort study (mean age = 59 years, SD = 13.4 years) underwent clinical, neuropsychological and brain 3T MRI assessments at baseline and a 4-year follow-up. Cortisol levels were measured at baseline in four saliva samples. Cortical and hippocampal atrophy rates were estimated and compared between participants with and without depressive symptoms (n = 81) and correlated with cortisol levels (n = 49).

RESULTS: Atrophy in the left superior frontal gyrus and right lingual gyrus developed in parallel with depressive symptoms, and in the left temporal pole, superior temporal cortex, and supramarginal cortex after the onset of depressive symptom. Depression-related atrophy was significantly associated with elevated cortisol levels. Elevated cortisol levels were also associated with widespread prefrontal, parietal, lateral, and medial temporal atrophy.

CONCLUSION: Depressive symptoms and elevated cortisol levels are associated with atrophy of the prefrontal and limbic areas of the brain.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
depressive symptomatology, neuroimaging, superior temporal gyrus, superior frontal gyrus, MRI
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-146479 (URN)10.1111/acps.12860 (DOI)000433560700006 ()29457245 (PubMedID)
Available from: 2018-04-10 Created: 2018-04-10 Last updated: 2019-05-21Bibliographically approved
Andersson, J., Oudin, A., Sundström, A., Forsberg, B., Adolfsson, R. & Nordin, M. (2018). Road traffic noise, air pollution, and risk of dementia: results from the Betula project. Environmental Research, 166, 334-339
Open this publication in new window or tab >>Road traffic noise, air pollution, and risk of dementia: results from the Betula project
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2018 (English)In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 166, p. 334-339Article in journal (Refereed) Published
Abstract [en]

Background: There is growing evidence for a negative impact of traffic-related air pollution on risk of dementia. However, the contribution of noise exposure to this association has been rarely examined.

Objective: We aimed to investigate the individual and combined effect of noise and air pollution on risk of dementia.

Methods: Data on dementia incidence over a 15 year period was obtained from the Betula project, a longitudinal study on health and ageing. Estimates of annual mean levels of nitrogen oxides (NOx) at the participants’ residential address were obtained using a land-use regression model. Modelled data provided road traffic noise levels (Leq. 24 h) at the participants’ residential address at baseline. Cox proportional hazard regression was used to calculate hazard ratios (HR).

Results: Of 1721 participants at baseline, 302 developed dementia during the follow up period. Exposure to noise levels (Leq. 24 h) > 55 dB had no significant effect on dementia risk (HR 0.95; CI: 0.57, 1.57). Residing in the two highest quartiles of NOx exposure was associated with an increased risk of dementia. The risk associated with NOx was not modified by adjusting for noise. Moreover, we found no significant interaction effects between NOx and road traffic noise on dementia risk.

Conclusion: We found no evidence that exposure to road traffic noise, either independently or in combination with traffic air pollution, was associated with risk of dementia in our study area. Our results suggest that pollution should be considered the main component in the association between traffic related exposures and dementia.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Epidemiology, Alzheimer's disease, Vascular dementia, Land-use regression model
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-149090 (URN)10.1016/j.envres.2018.06.008 (DOI)000445318200035 ()29909174 (PubMedID)2-s2.0-85048442726 (Scopus ID)
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2019-11-15Bibliographically approved
Oudin, A., Forsberg, B., Lind, N., Nordin, S., Oudin Åström, D., Sundström, A. & Nordin, M. (2017). Is long-term exposure to air pollution associated with episodic memory?: a longitudinal study from northern Sweden. Scientific Reports, 7, Article ID 12789.
Open this publication in new window or tab >>Is long-term exposure to air pollution associated with episodic memory?: a longitudinal study from northern Sweden
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2017 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, article id 12789Article in journal (Refereed) Published
Abstract [en]

Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: -0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.

Place, publisher, year, edition, pages
Nature Publishing Group, 2017
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-140373 (URN)10.1038/s41598-017-13048-1 (DOI)000412492400015 ()28986549 (PubMedID)
Available from: 2017-10-09 Created: 2017-10-09 Last updated: 2018-06-09Bibliographically approved
Awad, A., Lundqvist, R., Rolandsson, O., Sundström, A. & Eliasson, M. (2017). Lower cognitive performance among long-term type 1 diabetes survivors: A case-control study. Journal of diabetes and its complications, 31(8), 1328-1331
Open this publication in new window or tab >>Lower cognitive performance among long-term type 1 diabetes survivors: A case-control study
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2017 (English)In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 31, no 8, p. 1328-1331Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Patients with type 1 diabetes (T1D) have an increased risk of cognitive dysfunction. The cognitive decrement is believed to depend on macro- and microvascular complications and long disease duration. Some patients do not develop these complications, but still report cognitive symptoms. We examined if long-standing T1D without complications is associated with lower cognitive performance.

METHODS: A group of patients (n=43) with long-standing T1D (>30years) without micro- or macro vascular complications was compared with a non-diabetic control group (n=86) on six cognitive tests which probed episodic memory, semantic memory, episodic short-term memory, visual attention and psychomotor speed. Each patient was matched with two controls regarding age, gender and education. A linear mixed effect model was used to analyze the data.

RESULTS: The mean age was 57years and mean duration was 41years. Patients with diabetes had lower diastolic blood pressure but BMI, waist circumference, systolic blood pressure and smoking did not differ between groups. Patients had lower results than non-diabetic controls in episodic short-term memory (p<0.001) and also lower values on a test that mirrors visual attention and psychomotor speed (p=0.019).

CONCLUSIONS: Long-standing T1D was associated with lower cognitive performance, regardless of other diabetes-related complications.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Cognition, Complications, Memory, Psychomotor speed, Type 1-diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:umu:diva-136399 (URN)10.1016/j.jdiacomp.2017.04.023 (DOI)000406081200016 ()28579311 (PubMedID)
Available from: 2017-06-16 Created: 2017-06-16 Last updated: 2019-05-16Bibliographically approved
Rönnlund, M., Sundström, A. & Pudas, S. (2017). Midlife level and 15-year changes in general cognitive ability in a sample of men: the role of education, early adult ability, BMI, and pulse pressure. Intelligence, 61, 78-84
Open this publication in new window or tab >>Midlife level and 15-year changes in general cognitive ability in a sample of men: the role of education, early adult ability, BMI, and pulse pressure
2017 (English)In: Intelligence, ISSN 0160-2896, E-ISSN 1873-7935, Vol. 61, p. 78-84Article in journal (Refereed) Published
Abstract [en]

The objective of the study was to examine determinants of midlife level and long-term changes in a general cog-nitive ability (g) factor. The data were from a Swedish sample of men (n=262;M=49.9years,SD=4.0)forwhich cognitive (conscript) test scores at age 18 were retrieved. In midlife the men completed a battery of cog-nitive tests that was re-administered atfive-year intervals up to 15 years after the baseline assessment. Second-order latent growth curve models were used to examine predictors of midlife level and longitudinal changes in agfactor reflecting four cognitive measures (WAIS-R Block Design, vocabulary, action recall, and wordfluency).The results showed education (years of schooling) to be related to ability level (intercept) before (β= 0.71),but not after (β= 0.09), adjustment of an early adult (age 18)gfactor (reflecting three different cognitive mea-sures)that washighly predictive of midlifeglevel (adjustedβ= 0.89). Neither education norgat age 18 (or mid-lifeglevel) was related to long-term changes ing, though. Conversely,baseline age, BMI, and pulse pressure wereunrelated to midlife ability level, but higher baseline age, higher BMI and higher pulse pressure in midlife werepredictive of cognitive decline. Thus, whereas higher levels of initial ability or educational attainment do not ap-pear to buffer against onset of age-related decline ingin midlife and young-old age, maintenance of lower levelsof pulse pressure and body weight could possibly have such an effect. However, further research is required toevaluate the mechanisms behind the observed relationships of the targeted variables and cognitive decline.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
g factor, Early cognitive ability, Midlife, Longitudinal, BMI, Pulse pressure
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:umu:diva-131941 (URN)10.1016/j.intell.2017.01.007 (DOI)000395606300012 ()
Funder
Swedish Research Council
Available from: 2017-02-24 Created: 2017-02-24 Last updated: 2018-06-09Bibliographically approved
Sörman Eriksson, D., Rönnlund, M., Sundström, A., Norberg, M. & Nilsson, L.-G. (2017). Social network size and cognitive functioning in middle-aged adults: cross-sectional and longitudinal associations. Journal of Adult Development, 24(2), 77-88
Open this publication in new window or tab >>Social network size and cognitive functioning in middle-aged adults: cross-sectional and longitudinal associations
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2017 (English)In: Journal of Adult Development, ISSN 1068-0667, E-ISSN 1573-3440, Vol. 24, no 2, p. 77-88Article in journal (Refereed) Published
Abstract [en]

The objective of the present study was to examine relations between social network size and three cognitive abilities (episodic memory, semantic memory, visuospatial ability) in middle-aged adults. We analyzed cross-sectional data on social network size and cognitive functioning that were available for 804 participants aged 40–60 years. In addition, we examined 5- and 10-year follow-up measurements of cognitive functioning that were available for 604 and 255 participants, respectively. Cross-sectional analyses revealed a positive association between social network size and each of the three cognitive abilities. Baseline network size was positively related to 5-year changes in semantic memory, and to 10-year changes in semantic as well as episodic memory, but was unrelated to changes in visuospatial performance. A minor portion of the sample (n = 131) had 10-year follow-up data on network size. Cross-lagged panel correlations revealed that baseline network size was associated with follow-up measurement in cognitive functioning (episodic memory, semantic memory), whereas baseline cognitive performance was unrelated to future network size. Together, the results demonstrate a small but positive relation between network size and declarative memory abilities, in line with models proposing a cognitive reserve built up by factors such as the increased cognitive stimulation associated with a more extensive social network.

Keywords
Cognition, Longitudinal, Cross-sectional, Social network, Cognitive reserve
National Category
Psychology Public Health, Global Health, Social Medicine and Epidemiology Sociology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-101832 (URN)10.1007/s10804-016-9248-3 (DOI)000399825300001 ()
Note

Originally published in manuscript form.

Available from: 2015-04-14 Created: 2015-04-14 Last updated: 2018-06-07Bibliographically approved
Sundström, A., Westerlund, O. & Kotyrlo, E. (2016). Marital status and risk of dementia: a nationwide population-based prospective study from Sweden. BMJ Open, 6(1), Article ID e008565.
Open this publication in new window or tab >>Marital status and risk of dementia: a nationwide population-based prospective study from Sweden
2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, article id e008565Article in journal (Refereed) Published
Abstract [en]

Objectives: To examine the association between marital status and dementia in a cohort of young-old (50-64) and middle-old (65-74) adults, and also whether this may differ by gender. Design: Prospective population-based study with follow-up time of up to 10 years. Setting: Swedish national register-based study. Participants: 2 288 489 individuals, aged 5074 years, without prior dementia diagnosis at baseline. Dementia was identified using the Swedish National Patient Register and the Cause of Death Register. Outcome measures: The influence of marital status on dementia was analysed using Cox proportional hazards models, adjusted stepwise for multiple covariates (model 1: adjusted for age and gender; and model 2: additionally adjusted for having adult children, education, income and prior cardiovascular disease). Results: During follow-up, 31 572 individuals in the study were identified as demented. Cox regression showed each non-married subcategory to be associated with a significantly higher risk of dementia than the married group, with the highest risk observed among people in the young-old age group, especially among those who were divorced or single (HRs 1.79 vs 1.71, fully adjusted model). Analyses stratified by gender showed gender differences in the young-old group, with indications of divorced men having a higher relative risk compared with divorced women (HRs 2.1 vs 1.7, only-age adjusted model). However, in the fully adjusted model, these differences were attenuated and there was no longer any significant difference between male and female participants. Conclusions: Our results suggest that those living alone as non-marrieds may be at risk for early-onset and late-onset dementia. Although more research is needed to understand the underlying mechanism by which marital status is associated with dementia, this suggests that social relationships should be taken seriously as a risk factor for dementia and that social-based interventions may provide an opportunity to reduce the overall dementia risk.

National Category
Psychology Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-117847 (URN)10.1136/bmjopen-2015-008565 (DOI)000369993900026 ()26729377 (PubMedID)
Projects
Ageing and Living Conditions ALC
Funder
Swedish Research Council, 2006-21576-36119-66Riksbankens Jubileumsfond, P11-0876:1
Available from: 2016-03-16 Created: 2016-03-04 Last updated: 2018-06-07Bibliographically approved
Sundström, A. & Adolfsson, R. (2016). Percieved loneliness and risk of dementia. In: Percieved loneliness and risk of dementia: . Paper presented at Gerontological Society of America (GSA) Annual Scientific Meeting.
Open this publication in new window or tab >>Percieved loneliness and risk of dementia
2016 (English)In: Percieved loneliness and risk of dementia, 2016Conference paper, Poster (with or without abstract) (Other academic)
National Category
Social Sciences
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-139906 (URN)
Conference
Gerontological Society of America (GSA) Annual Scientific Meeting
Available from: 2017-09-26 Created: 2017-09-26 Last updated: 2018-06-09
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