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Background: Elevated BMI and central adiposity increase the risk of cardiovascular disease, type 2 diabetes, and several cancers. Obesity has risen in recent decades, with Northern Sweden exceeding the national average. Anthropometric trends in the Northern Sweden MONICA study have not been updated since 2004.

Objective: To describe overweight and obesity trends in Northern Sweden from 1986 to 2022.

Methods: Eight population-based surveys were conducted between 1986 and 2022 within the Northern Sweden MONICA study. In each survey, 2000–2500 adults aged 25–74 years were invited; 12,950 participated (mean age 49.5 [SD 13.6]; 51% women), with a 68.2% response rate. Anthropometry was assessed using standardized protocols.

Results: Obesity increased by 15.7 percentage points in men and 12.1 percentage points in women. By 2022, obesity had doubled since 1986, reaching 26.6% in men and 26.3% in women. Abdominal obesity also increased: with waist circumference ≥ 102 cm in men and ≥ 88 cm in women rising by 21.5 and 4.9 percentage points, respectively.

Conclusions: General and abdominal obesity have substantially increased in Northern Sweden over the past four decades. These findings call for urgent, coordinated, and multi-level interventions, as continued increases in obesity pose serious long-term risks to population health and healthcare sustainability.

Background: Alcohol consumption at low to moderate levels has long been debated in relation to cardiovascular risk, with inconsistent findings. Multi-decade cohort data with repeated exposure assessments are rare, especially in a northern Scandinavian population. This study aims to investigate associations between alcohol consumption at age 40, 50, and 60 and markers of subclinical atherosclerosis [carotid plaque and intima-media thickness (IMT)] at age 60 in a healthy below-risk-threshold alcohol-consuming cohort in Northern Sweden.

Methods: Participants in the Visualisation of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention (VIPVIZA) trial, aged 60 and with alcohol data from the Västerbotten Intervention Programme (VIP) at 40, 50, and 60, with below-risk-threshold alcohol consumption (>0 to ≤100 g/week) (n = 1,014) were included. Alcohol intake data were collected via a food frequency questionnaire in VIP. Carotid plaque and IMT were assessed at age 60 at VIPVIZA baseline.

Results: Mean weekly alcohol consumption for the study period was 26 g (±21.4 g), higher in men (37.5 ± 23.8 g) than in women (19.2 ± 16.3 g) and increasing over time in both sexes. At age 60, 49.6% had carotid plaque, and mean IMT was 0.77 mm (±0.15). No indication of associations was found between midlife alcohol consumption and carotid plaque in the total cohort [odds ratio (OR): 1.00, 95% confidence interval (CI): 0.99–1.01], men (OR: 1.00, 95% CI: 0.99–1.01), or women (OR: 0.99, 95% CI: 0.99–1.00) per gram increase of weekly alcohol intake. No associations were observed across consumption groups (>25 to ≤50, >50 to ≤75, >75 to ≤100 vs. >0 to ≤25 g/week).

Conclusion: No association was found between self-reported midlife alcohol consumption and subclinical atherosclerosis at age 60 in the VIPVIZA baseline cohort. Results were consistent across sexes and intake levels, contributing to the evidence base used to guide primary prevention and public health recommendations.

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally and in Sweden. Effective primary prevention requires not only clinical risk assessment but also person-centred communication to promote a healthy lifestyle. Nurses play a key role in structured preventive dialogues, such as those in the Västerbotten Intervention Programme (VIP), one of the world’s largest prevention programmes. However, little is known about how nurses experience and navigate risk communication in real-world primary care. This study aimed to explore nurses’ experiences with cardiovascular risk communication and lifestyle counselling during preventive dialogues in primary care.

Methods: Semistructured interviews were conducted with 11 nurses delivering VIP health dialogues across primary care centres in Västerbotten County between December 2024 and April 2025. The interviews were audio-recorded and transcribed verbatim. Data were analysed via qualitative content analysis, identifying meaning units, codes, categories, and an overarching theme. Reporting followed COREQ.

Results: The analysis generated two main categories. The first, Meeting the person professionally while taking a step back, captured how nurses described exploring each patient’s unique situation, needs, motivations, and attitudes. The second, Continuously adapting approaches in self-management support, captured nurses’ accounts of using flexible strategies, such as gradual goal setting, visual tools, and practical daily habit suggestions, to support patients in understanding and working with lifestyle change. Together, these categories formed the overarching theme Shifting between leading and following, illustrating how nurses experienced balancing individualised adaptation with professional guidance while navigating structural and contextual challenges.

Conclusions: Nurses described translating cardiovascular risk into person-centred, relational dialogue by flexibly combining structure, responsiveness, and motivational strategies. Understanding preventive dialogues as interactive, person-centred processes, supported by the sensitive use of visualisation tools, may inform the continued development of cardiovascular prevention in primary care and warrants further evaluation.

Objectives: Fear of falling (FoF) is a common problem among older adults. It can lead to reduced quality of life and less physical activity, which increases fall risk. Earlier work has shown that FoF can be a manifestation of executive dysfunction in adults over 50 years, but studies on people over age 75 years are lacking. Executive functions (EFs) are cognitive functions associated with the frontal lobes and the prefrontal cortex. The aim of this study was to assess associations of EFs and FoF among people aged 80 years or older.

Methods: This cross-sectional study was based on data from the Northern Sweden Silver-MONICA study and included 434 participants aged 80 years or older. EFs were assessed with the Frontal Assessment Battery (FAB) and FoF with the Falls Self-Efficacy Scale–International (FES-I). Multivariable linear regression analysis was used to examine associations among EF, FoF, and a comprehensive set of adjustment factors. Pearson correlation analysis was used to evaluate associations of FES-I and the subitems of the FAB.

Results: EFs as measured by FAB were inversely associated with FoF (β = -0.23; 95% confidence interval, -0.42 to -0.03; p = 0.021), even after comprehensive adjustments. The FAB subitems measuring lexical fluency, inhibitory control, sustained attention, self-organization, motor programming, and planning also were inversely associated with FoF.

Conclusions: Lower EF is associated with higher FoF among people aged 80 years or older. This information is important for treating and preventing FoF in this population.

Aims: To investigate the association between dietary patterns at Ages 40, 50, and 60 and subclinical carotid atherosclerosis at Age 60.

Methods and results: Participants who were 60 years of age at the Swedish VIPVIZA (VisualiZation of asymptomatic Atherosclerotic disease) trial baseline (2013-16) with retrospective VIP (Västerbotten Intervention Programme) dietary data at Ages 40, 50, and 60 (n = 1034) were included. Dietary patterns were assessed using the Mediterranean diet score (MDS) and healthy diet score, while carotid ultrasound was used to measure carotid artery intima-media thickness (CIMT) and carotid plaque (CP). Multivariable regressions and mediation analysis investigated associations, sex differences and potential mediating factors. High [odds ratio (OR): 0.72, 95% confidence interval (CI): 0.52-0.98] or midrange (OR: 0.74, 95% CI: 0.55-0.99) cumulative MDS for Ages 40, 50, and 60, as compared with low, was associated with lower CP presence at Age 60. Initial sex-stratified analysis yielded similar, though non-significant, point estimates. Further analysis revealed that the relationship between plaque and MDS seem driven more by women (OR: 0.41, 95% CI: 0.237-0.703) while a significant association between CIMT and MDS was only present in men (P < 0.05). Healthy diet score during midlife did not show any significant associations with CP or CIMT at Age 60.

Conclusion: Findings underscore associations of midlife Mediterranean-style diet and lower presence of subclinical carotid atherosclerosis at Age 60 and confirm the significance of dietary interventions as potential means for cardiovascular disease prevention. The study enhances understanding of long-term dietary patterns and their link to subclinical atherosclerosis, supporting future interventions and further research.Keywords: Carotid intima media thickness; Carotid plaque; Dietary patterns; Healthy diet score; Mediterranean diet score; Subclinical atherosclerosis.

Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.

Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.

Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.

Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).

Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.