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Jonsson, F., Olofsson, B., Söderberg, S. & Niklasson, J. (2024). Association between the COVID-19 pandemic and mental health in very old people in Sweden. PLOS ONE, 19(4), Article ID e0299098.
Open this publication in new window or tab >>Association between the COVID-19 pandemic and mental health in very old people in Sweden
2024 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 4, article id e0299098Article in journal (Refereed) Published
Abstract [en]

Background: During the COVID-19 pandemic, Sweden implemented social distancing measures to reduce infection rates. However, the recommendation meant to protect individuals particularly at risk may have had negative consequences. The aim of this study was to investigate the impact of the COVID-19 pandemic on very old Swedish peoples' mental health and factors associated with a decline in mental health.

Methods: We conducted a cross-sectional study among previous participants of the SilverMONICA (MONItoring of Trends and Determinants of CArdiovascular disease) study. Of 394 eligible participants, 257 (65.2%) agreed to participate. Of these, 250 individuals reported mental health impact from COVID-19. Structured telephone interviews were carried out during the spring of 2021. Data were analysed using the χ2 test, t-test, and binary logistic regression.

Results: Of 250 individuals (mean age: 85.5 ± 3.3 years, 54.0% women), 75 (30.0%) reported a negative impact on mental health, while 175 (70.0%) reported either a positive impact (n = 4) or no impact at all (n = 171). In the binary logistic regression model, factors associated with a decline in mental health included loneliness (odds ratio [95% confidence interval]) (3.87 [1.83-8.17]) and difficulty adhering to social distancing recommendations (5.10 [1.92-13.53]). High morale was associated with positive or no impact on mental health (0.37 [0.17-0.82]).

Conclusions: A high percentage of very old people reported a negative impact on mental health from the COVID-19 pandemic, primarily from loneliness and difficulty adhering to social distancing measures, while high morale seemed to be a protective factor.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2024
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-223268 (URN)10.1371/journal.pone.0299098 (DOI)38564616 (PubMedID)2-s2.0-85189507899 (Scopus ID)
Funder
Umeå University
Available from: 2024-04-17 Created: 2024-04-17 Last updated: 2024-04-17Bibliographically approved
Almevall, A., Dahlin Almevall, A., Öhlin, J., Gustafson, Y., Zingmark, K., Niklasson, J., . . . Olofsson, B. (2024). Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort. Archives of gerontology and geriatrics (Print), 122, Article ID 105392.
Open this publication in new window or tab >>Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort
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2024 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 122, article id 105392Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Aged 80 and over, Aging/psychology, Diagnostic self evaluation, Longitudinal studies, Population characteristics, Self-rated health, Survival analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-222682 (URN)10.1016/j.archger.2024.105392 (DOI)38492492 (PubMedID)2-s2.0-85187986768 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01074Swedish Research Council, K2014-99X-22610-01-6Visare NorrNorrbotten County CouncilRegion VästerbottenSwedish Dementia CentreFoundation for the Memory of Ragnhild and Einar LundströmSwedish Society of MedicineKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2024-04-09 Created: 2024-04-09 Last updated: 2024-04-09Bibliographically approved
Snellman, S., Hörnsten, C., Olofsson, B., Gustafson, Y., Lövheim, H. & Niklasson, J. (2024). Validity and test–retest reliability of the Swedish version of the Geriatric Depression Scale among very old adults. BMC Geriatrics, 24(1), Article ID 261.
Open this publication in new window or tab >>Validity and test–retest reliability of the Swedish version of the Geriatric Depression Scale among very old adults
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2024 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 24, no 1, article id 261Article in journal (Refereed) Published
Abstract [en]

Background: The Geriatric Depression Scale (GDS) has shown good validity and reliability, but few studies have examined the GDS among very old adults or the Swedish translation.

Objectives: Evaluate the validity and reliability of the Swedish version of GDS-15 among very old adults.

Methods: In the Umeå85 + /GErontological Regional DAtabase (GERDA) study, 387 participants were assessed with both the GDS-15 and the Montgomery-Åsberg Depression Rating Scale (MADRS). The mean age was 91 years. Concurrent validity between the scales was calculated using Spearman's correlation. We used the Diagnostic and Statistical Manual of Mental Disorders (DSM) V symptom criteria for depression based on MADRS item scores to define depression. We calculated the Area Under the Curve (AUC) and found an optimal cut-off. A convenience sample with 60 individuals was used to calculate test–retest reliability with Cohen’s kappa and Intraclass Correlation Coefficient (ICC).

Results: Spearman's correlation coefficients between total scores for GDS-15 and MADRS were 0.60. Cronbach's alpha for the whole scale was 0.73. The AUC was 0.90 for distinguishing major depression, and the recommended cut-off of ≥ 5 showed a sensitivity of 95.2% and specificity of 65.8%. The test–retest showed that Cohen’s kappa was substantial (0.71) and the ICC was excellent (0.95).

Conclusions: The Swedish version of the GDS-15 showed good validity and reliability among very old adults. The generally recommended cut-off of ≥ 5 seems reasonable to use with the Swedish version and among very old adults.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Aged 80 and over, Depression, Psychiatric status rating scales, Psychometrics, ROC curve
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-222888 (URN)10.1186/s12877-024-04869-7 (DOI)001187389700003 ()38500031 (PubMedID)2-s2.0-85188072998 (Scopus ID)
Funder
Swedish Research Council, K2014– 99X-22610–01–6Region VästerbottenNorrbotten County CouncilThe Dementia Association - The National Association for the Rights of the Demented
Available from: 2024-04-08 Created: 2024-04-08 Last updated: 2024-04-08Bibliographically approved
Johansson, S., Lövheim, H., Olofsson, B., Gustafson, Y. & Niklasson, J. (2022). A clinically feasible short version of the 15-item geriatric depression scale extracted using item response theory in a sample of adults aged 85 years and older. Aging & Mental Health, 26(2), 431-437
Open this publication in new window or tab >>A clinically feasible short version of the 15-item geriatric depression scale extracted using item response theory in a sample of adults aged 85 years and older
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2022 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 26, no 2, p. 431-437Article in journal (Refereed) Published
Abstract [en]

Objectives: To extract the items most suitable for a short version of the 15-item Geriatric Depression Scale (GDS-15) in a sample of adults aged ≥ 85 years using item response theory (IRT).

Method: This population-based cross-sectional study included 651 individuals aged ≥ 85 years from the Umeå 85+/GErontological Regional DAtabase (GERDA) study. Participants were either community dwelling (approximately 70%) or resided in institutional care (approximately 30%) in northern Sweden and western Finland in 2000–2002 and 2005–2007. The psychometric properties of GDS-15 items were investigated using an IRT-based approach to find items most closely corresponding to the GDS-15 cut off value of ≥5 points. Receiver operating characteristic curves were used to compare the performance of the proposed short version with that of previously proposed short GDS versions.

Results: GDS-15 items 3, 8, 12, and 13 best differentiated respondents’ levels of depressive symptoms corresponding to the GDS-15 cut off value of ≥5, regardless of age or sex, and thus comprise the proposed short version of the scale (GDS-4 GERDA). For the identification of individuals with depression (total GDS-15 score ≥ 5), the GDS-4 GERDA with a cut-off score of ≥2 had 92.9% sensitivity and 85.0% specificity.

Conclusion: The GDS-4 GERDA could be used as an optimized short version of the GDS-15 to screen for depression among adults aged ≥ 85 years.

Place, publisher, year, edition, pages
Routledge, 2022
Keywords
80 and over, Aged, depression, item response theory, psychiatric status rating scales, psychometrics, ROC curve
National Category
Other Health Sciences
Identifiers
urn:nbn:se:umu:diva-180763 (URN)10.1080/13607863.2021.1881759 (DOI)000616203400001 ()2-s2.0-85100803309 (Scopus ID)
Funder
Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseRegion VästerbottenNorrbotten County CouncilVisare NorrSwedish Research Council, K2014-99X-22610-01-6
Available from: 2021-02-25 Created: 2021-02-25 Last updated: 2023-03-24Bibliographically approved
Almevall, A. D., Wennberg, P., Zingmark, K., Öhlin, J., Söderberg, S., Olofsson, B., . . . Niklasson, J. (2022). Associations between everyday physical activity and morale in older adults. Geriatric Nursing, 48, 37-42
Open this publication in new window or tab >>Associations between everyday physical activity and morale in older adults
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2022 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 48, p. 37-42Article in journal (Refereed) Published
Abstract [en]

Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This study aimed to explore objectively measured everyday physical activity and sedentary behavior in relation to a morale measure specifically constructed for older adults. A total of 77 persons (42 women, 35 men) aged 80 years or older (84.3 ± 3.8) wore an accelerometer device for at least 5 days. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS scores were significantly positively associated with number of steps, time spent stepping, and time spent stepping at >75 steps per minute. Sedentary behavior did not associate with PGCMS. Promoting PA in the form of walking at any intensity–or even spending time in an upright position—and in any quantity may be important for morale, or vice versa, or the influence may be bidirectional.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
80 and over, Accelerometer, Aged, Morale, Physical activity, Well-being
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-199453 (URN)10.1016/j.gerinurse.2022.08.007 (DOI)000859439100006 ()2-s2.0-85137619883 (Scopus ID)
Available from: 2022-09-27 Created: 2022-09-27 Last updated: 2023-09-05Bibliographically approved
Öhlin, J., Toots, A., Dahlin Almevall, A., Littbrand, H., Conradsson, M., Hörnsten, C., . . . Söderberg, S. (2022). Concurrent validity of the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) - tested with accelerometer data from the SilverMONICA study. Gait & Posture, 92, 135-143
Open this publication in new window or tab >>Concurrent validity of the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) - tested with accelerometer data from the SilverMONICA study
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2022 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 92, p. 135-143Article in journal (Refereed) Published
Abstract [en]

Background: Physical activity and sedentary behavior vary across the life span, and in very old people activity behavior can vary considerably over 24 h. A physical activity questionnaire adapted for this age group is lacking. This study was conducted to validate such a newly developed questionnaire suitable for use in very old people.

Research question: Is the International Physical Activity Questionnaire adapted for adults aged ≥ 80 years (IPAQ-E 80 +) a valid measure of physical activity in very old people?

Methods: Seventy-six participants (55.3% women) with a mean age of 84.4 ± 3.8 years wore accelerometers for ≥ 5 consecutive days, and completed the IPAQ-E 80 +. Spearman's rho and Bland-Altman plots were used to analyze the validity of IPAQ-E 80 + against accelerometer measures. Analyses were conducted for the separate items sitting, laying down at daytime and nighttime, walking, moderate to vigorous (MV) walking, and moderate to vigorous physical activity (MVPA), and the summary measures: total inactive time, sedentary time (i.e. lying down at daytime + sitting), total active time, and total MVPA + MV walking.

Results: The IPAQ-E 80 + correlated with the accelerometer measures of total inactive- (r = 0.55, p < 0.001), sedentary- (r = 0.28, p = 0.015), walking- (r = 0.54 p < 0.001) and total active- (r = 0.60, p < 0.001) times, but not with measures of intensity of walking or physical activity; MV walking (r = 0.06, p = 0.58), MVPA (r = 0.17, p = 0.13).

Significance: In this study the IPAQ-E 80 + showed fair to substantial correlations with accelerometers, and it therefore seems able to rank very old people according to levels of PA (total inactive-, sedentary-, and total active time, and walking time). The IPAQ-E 80 + seems promising for use in studies investigating associations between activity behavior and health in this population. Further investigation is needed to determine whether the IPAQ-E 80 + can accurately measure PA intensity.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Validity, Physical activity questionnaire, Sedentary behavior, Very old people, Accelerometry
National Category
Physiotherapy Geriatrics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-187217 (URN)10.1016/j.gaitpost.2021.11.019 (DOI)000788079500011 ()34847411 (PubMedID)2-s2.0-85120962874 (Scopus ID)
Funder
Swedish Research Council Formas, 2016-01074Swedish Research Council, K2014-99X-22610-01-6
Note

Originally included in thesis in manuscript form.

Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2023-09-05Bibliographically approved
Almevall, A. D., Nordmark, S., Niklasson, J. & Zingmark, K. (2022). Experiences of home as an aspect of well-being in people over 80 years: a mixed method study. Journal of Advanced Nursing, 78(1), 252-263
Open this publication in new window or tab >>Experiences of home as an aspect of well-being in people over 80 years: a mixed method study
2022 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 78, no 1, p. 252-263Article in journal (Refereed) Published
Abstract [en]

Aims: To (1) describe experiences of home from a well-being perspective, (2) describe participant characteristics and well-being measures in relation to housing type (3) and how the aforementioned aspects may affect well-being in very old persons.

Design: Cross-sectional, convergent parallel-results mixed method design with semi-structured interviews analysed by qualitative content analysis, in relation to descriptive statistics and specific well-being outcome measures related to home.

Methods: A total of 50 persons 80 years or older living in ordinary housing were interviewed (July 2017 to November 2018) about home in relation to well-being, along with collection of participant characteristics and well-being measures related to home.

Results: Participants described how home had become increasingly important as it provided autonomy and acted as a social and occupational hub. However, autonomy was not unconditional, and home could also be perceived as a place of inactive solitude. Results were interpreted as relating to being in the margins of home and had a major impact on well-being. Housing type seemed of importance with higher measures of well-being for participants in single-living housing compared with those living in apartment.

Conclusion: Home is increasingly central to well-being in old age; however, very old persons also have to relate to being physically and mentally in the margins of being able to remain in the home. These aspects of home potentially have a major impact on well-being.

Impact: As very old persons living in ordinary housing will constitute a larger segment of society in coming years, aspects of home can potentially have a considerable impact on well-being for this age-group. This study describes aspects of home that contribute to, or has adverse impact on well-being. These aspects need thorough consideration in policy-making and planning of health care that can affect experiences of home.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
80 and over, aged, aging in place, independent living, nursing, ordinary housing, qualitative approaches, well-being
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-190013 (URN)10.1111/jan.15093 (DOI)000721418500001 ()34812517 (PubMedID)2-s2.0-85119698611 (Scopus ID)
Funder
The Dementia Association - The National Association for the Rights of the DementedForte, Swedish Research Council for Health, Working Life and Welfare, 2016-01074Konung Gustaf V:s och Drottning Victorias FrimurarestiftelseNorrbotten County CouncilRegion VästerbottenVisare Norr
Available from: 2021-12-01 Created: 2021-12-01 Last updated: 2023-03-24Bibliographically approved
Öhlin, J., Toots, A., Littbrand, H., Wennberg, P., Olofsson, B., Gustafson, Y., . . . Söderberg, S. (2022). Physical activity in late middle- to older-aged people and dementia, cognitive, and physical function two decades later. Dementia and Geriatric Cognitive Disorders, 51, 135-141
Open this publication in new window or tab >>Physical activity in late middle- to older-aged people and dementia, cognitive, and physical function two decades later
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2022 (English)In: Dementia and Geriatric Cognitive Disorders, ISSN 1420-8008, E-ISSN 1421-9824, Vol. 51, p. 135-141Article in journal (Refereed) Published
Abstract [en]

Introduction: Low physical activity (PA) is a potential risk factor for dementia and cognitive impairment. However, few studies have focused on very old people (aged ≥80 years), the age group with highest prevalence of dementia. The aim was to investigate if PA associated with subsequent dementia, cognitive function, and gait speed (GS), in very old people.

Methods: A population-based survey was conducted in 1999 and followed-up between 2016 and 2019 in participants ≥80 years. Altogether 541 individuals (56.2% women), 64.9 ± 4.2 years of age at baseline participated. Self-rated baseline PA was categorized into low, medium, or high. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), executive function with the Frontal Assessment Battery (FAB), and GS (in meters/second) was measured over 2.4 m at follow-up.

Results: During a mean of 19.0 ± 1.1 years, 175 (32.3%) developed dementia. Low or medium PA compared to high PA did not associate with subsequent dementia, and PA did not associate with future cognitive function (MMSE). PA associated with executive function (FAB) (unstandardized beta [95% confidence interval]) (0.67 [0.07–1.27]), but not after adjustments. PA associated with subsequent GS in the unadjusted model and after adjustment for age, sex, smoking, and education (0.06 [0.02–0.09], and 0.04 [0.01–0.08], respectively), but not after adding adjustment for hypertension, obesity, and glucose intolerance.

Conclusion: No support was found for the hypothesis that low PA is a potential risk factor for dementia in very high age. However, PA and executive function were associated in unadjusted analyses which indicate that PA may be important for at least one aspect of cognitive function. The association between PA and GS around 2 decades later seems attenuated by cardiometabolic risk factors. Future investigations regarding PA, dementia, and cognitive decline may consider cardiometabolic risk factors such as hypertension, obesity, and glucose intolerance, and include repeated measures of PA over the life course.

Place, publisher, year, edition, pages
S. Karger, 2022
Keywords
cognitive function, dementia, executive function, gait speed, physical activity, very old people
National Category
Physiotherapy Geriatrics
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-187213 (URN)10.1159/000523726 (DOI)000779096600001 ()2-s2.0-85128538079 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-01074Swedish Research Council, K2014-99X22610-01-6The Dementia Association - The National Association for the Rights of the DementedKonung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Note

Originally included in thesis in manuscript form.

Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2023-05-26Bibliographically approved
Almevall, A. D., Zingmark, K., Nordmark, S., Forslund, A.-S. & Niklasson, J. (2021). Accepting the inevitable: A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study. Archives of gerontology and geriatrics (Print), 92, Article ID 104275.
Open this publication in new window or tab >>Accepting the inevitable: A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study
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2021 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 92, article id 104275Article in journal (Refereed) Published
Abstract [en]

Background: As the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS).

Method: In a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach.

Results: Quantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas.

Conclusion: When using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Well-being, Quality of life, Oldest old, Subjective well-being, Life satisfaction
National Category
Nursing Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-179070 (URN)10.1016/j.archger.2020.104275 (DOI)000600899700010 ()33032185 (PubMedID)2-s2.0-85092063262 (Scopus ID)
Available from: 2021-01-26 Created: 2021-01-26 Last updated: 2023-03-24Bibliographically approved
Ballin, M., Nordström, P., Niklasson, J. & Nordström, A. (2021). Associations of visceral adipose tissue and skeletal muscle density with incident stroke, myocardial infarction, and all-cause mortality in community-dwelling 70-year-old individuals: A prospective cohort study. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 10(9), Article ID e020065.
Open this publication in new window or tab >>Associations of visceral adipose tissue and skeletal muscle density with incident stroke, myocardial infarction, and all-cause mortality in community-dwelling 70-year-old individuals: A prospective cohort study
2021 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 10, no 9, article id e020065Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Aging leads to increased visceral adipose tissue (VAT) and reduced skeletal muscle density. To which extent these are associated with the risk of stroke, myocardial infarction (MI), and all-cause mortality in older adults is unknown.

METHODS AND RESULTS: A total of 3294 70-year-old individuals (49.6% women) underwent a health examination in Umeå, Sweden, during 2012 to 2018. VAT and muscle density were measured using dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Cases of stroke, MI, and all-cause mortality were collected through national registers. Cox regressions were used to calculate hazard ratios (HRs) and 95% CIs per SD greater VAT and per SD lower muscle density. During a mean follow-up of 3.6 years, there were 108 cases of stroke or MI, and 97 deaths. Greater VAT (adjusted HR [aHR], 1.56; 95% CI, 1.09– 2.22), but not lower muscle density (aHR, 1.14; 95% CI, 0.97–1.34), was associated with increased risk of stroke or MI. Neither VAT (aHR, 0.95; 95% CI, 0.65–1.41) nor muscle density (aHR, 1.11; 95% CI, 0.92–1.34) was associated with all-cause mortality. The association of VAT with stroke or MI was only significant in men (aHR, 1.86; 95% CI, 1.19– 2.91) but not women (aHR, 0.60; 95% CI, 0.25–1.42) (Pinteraction =0.038).

CONCLUSIONS: With the limitation of being an observational study, these findings suggest that VAT is an important obesity-related predictor of cardiovascular risk in 70-year-old men, and by implication, that decreasing VAT may potentially reduce their risk of cardiovascular disease.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
Body composition, Cardiovascular disease, Ectopic fat, Obesity
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-186217 (URN)10.1161/JAHA.120.020065 (DOI)000646630200018 ()33870709 (PubMedID)2-s2.0-85104300482 (Scopus ID)
Funder
Swedish Research Council, 2016-02589
Available from: 2021-07-16 Created: 2021-07-16 Last updated: 2023-04-25Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5050-3720

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