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Biomedical subjects

R Adolfsson

Publications and source records attributed to R Adolfsson.

At least 55 records · Page 3Linked to original sources
PubMed1995

Anticipation in Swedish families with schizophrenia.

Nineteen parent-offspring pairs obtained from 14 two-generation families with available medical records and diagnosis of schizophrenia were studied to compare the ages of onset of the parent generation with those of the offspring generation. The mean age of onset for the parent generation was 37.3 +/- 6.0 years and for the offspring generation was 20.8 +/- 4.4. The mean difference was thus 16.5 +/- 6.2, suggesting the occurrence of anticipation in schizophrenia (p < 0.001). Although some ascertainment biases (like reduced fertility in early-onset parents or early detection of symptoms in offsprings of affected parents) may partially contribute to the occurrence of anticipation, this study replicates recent reports of anticipation in several neuropsychiatric disorders, some of which have been shown to be associated with unstable expansions of trinucleotide repeats in the genomic DNA.

Adolescent↗
PubMed1995

Care for demented patients in different living conditions. Effects on cognitive function, ADL-capacity and behaviour.

OBJECTIVE: To assess if and how demented patients' living conditions affect their level of functioning. DESIGN: A prospective concurrent control-study. SETTING: Sundsvall, an industrial community in the middle of Sweden. PARTICIPANTS: Forty-six demented patients in group-living (GL-group) and 62 controls (C-group). MAIN OUTCOME MEASURE: Cognitive function, ADL-capacity and behaviour were measured every third month during one year. RESULTS: Both groups deteriorated, but the decline was significantly slower in the GL-group regarding some ADL-functions, e.g. dressing and motor functions, whereas some behavioural disturbances were significantly more frequent in the GL-group. No differences were observed regarding the level of cognitive function. CONCLUSION: The living condition has small effects on cognitive function and ADL-capacity. The behavioural disturbances observed in GL should be the focus of future research.

Activities of Daily Living↗
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

Anticipation in Swedish families with bipolar affective disorder.

Anticipation describes an inheritance pattern within a pedigree with an increase in disease severity or decrease in age at onset or both in successive generations. The phenomenon of anticipation has recently been shown to be correlated with the expansion of trinucleotide repeat sequences in different disorders. We have studied differences of age at onset and disease severity between two generations in 14 families with unilinear inheritance of bipolar affective disorder (BPAD). There was a significant difference in age at onset (p < 0.008), in episodes per year with (p < 0.006) and without (p < 0.03) lithium treatment, and in total episodes per year (p < 0.002) between generations I and II. Furthermore, there was a highly significant correlation (p < 0.001) in age at onset between generations I and II. No evidence for specific paternal or maternal inheritance was found. We found evidence of anticipation and could rule out ascertainment bias or some other artefact. Anticipation is thus an inheritance pattern in BPAD which suggests that the expansion of trinucleotide repeat sequences is a possible mode of inheritance in BPAD.

Adolescent↗
PubMed1994

[Morning care of patients with Alzheimer's dementia: a theoretical model based on direct observation].

Five hospitalized patients in different stages of Alzheimer-type dementia were monitored by unstructured, direct observations during morning care. Orem's model of nursing as a compensation for the patient's lack of self-care capabilities was used as a frame of reference for an analysis of the behaviours of patients and nurses during morning care. A 12-step classification system was developed to be used as a guide to understand and determine abilities essential for performance of morning care for demented patients. The quantitative assessment showed that none of the patients was able to manage morning care independently, but there was a wide variation in their highest level of performance.

Alzheimer Disease↗
PubMed1994

[Verbal communication and behavior during meals of 5 hospitalized patients with Alzheimer's disease].

Five institutionalized patients with Alzheimer-type dementia were observed (video-recorded) during meals. The aim was to assess their meal behaviour and social interaction. The results showed that when the patients ate without the participation of staff, the two least demented patients became 'caregivers' in the group and helped the three most demented patients to eat. When two mental health nurses joined the group, the patients dropped their roles as helpers. The conversation in the group could be characterized as incomplete, with short sentences and a lot of breaks. Sixty-three per cent of all comprehensible utterances concerned food and eating and almost all conversation concerned the present.

Alzheimer Disease↗
PubMed1993

Can changes in ward routines affect the severity of dementia? A controlled prospective study.

An extensive new caring program--including the introduction of Individual Care Plans and changes in ward organization, caring techniques, and caring philosophy--was introduced at two psychogeriatric wards with severely demented patients. The hypotheses were that the patients (n = 31) would improve in psychosocial capacity and orientation and the staff work load would decline in contrast to two other wards with a similar clientele (n = 31). After ten months the milieu was more "homelike," routines were more flexible, and the staff communicated more with the patients. However, the hypotheses were not proven. All patients in both groups deteriorated in ADL capacity, orientation, and behavior. The patients in the program wards became significantly more restless and disoriented and ate less than the patients in the contrast wards. The conclusion is that, despite optimal care, a humanistic approach, and support from staff, the progression of dementia symptoms is inevitable.

Activities of Daily Living↗
PubMed1993

Major depression in stroke patients. A 3-year longitudinal study.

BACKGROUND AND PURPOSE: This prospective study was designed to examine the contributions of neurobiological, functional, and psychosocial factors to major depression after stroke. In addition, the prevalence and longitudinal course of major depression were studied. METHODS: Major depression, functional ability, and social network were assessed repeatedly for a period of 3 years in a population-based cohort of 80 patients with acute stroke (mean age, 73 years). Cerebral atrophy and brain lesion parameters were determined from computed tomographic scans performed acutely and after 3 years. RESULTS: The prevalence of major depression was 25% at the acute stage and approximately the same at 3 months (31%). It decreased to 16% at 12 months, was 19% at 2 years, and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in activities of daily living was the most important predictor at 3 months. From 12 months on, the patient's having few social contacts outside the immediate family contributed most to depression, and at 3 years cerebral atrophy also contributed. At 1 year, 60% of the patients with early depression (0 to 3 months) had recovered; those not recovered at this follow-up had a high risk of development of chronic depression. CONCLUSIONS: The study has provided evidence of a differentiation of factors likely to be implicated in the development of depression after stroke based or the period of time since the stroke event.

Activities of Daily Living↗
PubMed1993

Dementia day care and its effects on symptoms and institutionalization--a controlled Swedish study.

OBJECTIVE: To examine the effects of Day Care (DC) on demented patients. DESIGN: A prospective non-randomized concurrent-control study. PARTICIPANTS: 55 demented patients in DC and 44 controls. SETTING: Sundsvall, an industrial community in northern Sweden. MAIN OUTCOME MEASURE: Cognition, ADL-functions, behaviour and institutionalization. RESULTS: Measurements of cognition, ADL-functions, and behaviour showed no or only small differences between the groups. After one year, 24% of the patients in the DC-group were institutionalized, compared with 44% of the controls. In the control group, the exhaustion of spouse and supervision need were highly correlated to institutionalization (p < 0.001), while high physical nursing load was correlated to institutionalization in the DC-group (p < 0.01). CONCLUSION: DC postpones institutionalization, probably because of less exhaustion of spouses and decreased supervision need.

Activities of Daily Living↗
PubMed1991

Cue utilization following different forms of encoding in mildly, moderately, and severely demented patients with Alzheimer's disease.

The ability of patients with Alzheimer's disease (AD) to utilize semantic category cues in order to improve memory performance was examined. Categorizable lists of words or objects were presented under five different encoding conditions: (a) nouns, (b) objects, (c) objects with a semantic orienting question, (d) objects with self-generated motoric acts, and (e) objects with experimenter-instructed motoric acts. Subjects were asked to memorize the items for a free recall test, and were subsequently provided with the category names in a cued recall test. Mildly, moderately, and severely demented AD patients, and a group of normal older adults participated in the study. Results showed that normal older adults and mildly demented AD subjects were able to utilize cues to improve memory performance in all conditions. Moderately demented patients utilized cues in all conditions except in the verbal condition (condition [a]), whereas severely demented patients utilized cues only in the motoric condition (condition [e]). These results suggest that the ability to utilize category cues following a motoric encoding is preserved later in AD than the ability to utilize cues after a semantic encoding.

Aged↗
PubMed1991

The sucking behaviour of two patients in the final stage of dementia of the Alzheimer type.

Two patients in the final stage of dementia of the Alzheimer type (DAT), who could no longer be given nutrition by assisted feeding, were given fluids by means of the sucking ability they still retained. They sucked more slowly under nutritive than under non-nutritive sucking conditions. The sucking efficiency of one of them improved during training. The status of the patients in the final stage of their dementia differed from one another, which might explain the difference in outcome. It is therefore suggested, that the use of the patients' sucking ability could serve as a complement and/or an alternative feeding technique when assisted spoon-feeding becomes extremely difficult or impossible. It is considered to be more gentle and natural than the present feeding techniques.

Aged↗
PubMed1991

CSF monoamine metabolites, cholinesterases and lactate in the adult hydrocephalus syndrome (normal pressure hydrocephalus) related to CSF hydrodynamic parameters.

Monoamine metabolites, cholinesterases and lactic acid in lumbar cerebrospinal fluid (CSF) were investigated on patients with the adult hydrocephalus syndrome (idiopathic normal pressure syndrome; AHS, n = 15), Alzheimer's disease (AD, n = 14), multi-infarct dementia (MID, n = 13) and controls (n = 21). Patients had clinical and CSF hydrodynamic investigations. Monoamine concentrations were determined by reversed-phase liquid chromatography, cholinesterases and lactate were determined photometrically. In the AHS patients, CSF monoamine concentrations were not significantly different compared with controls, AD or MID patients. AHS and AD patients showed a similar reduction of CSF acetylcholinesterase activity compared with controls. Positive correlations were found in concentrations of CSF homovanillic acid, CSF 5-hydroxyindoleacetic acid and CSF lactic acid versus CSF outflow conductance (that is, resistance against CSF outflow) in the AHS patients. A similar pattern was observed in a subgroup of MID patients characterised by dilated ventricles and disturbed CSF hydrodynamics. These data suggest that a low CSF outflow conductance may facilitate the clearance of acidic substances from the arachnoid space at the probenecid sensitive active transport site. Alternative explanations would be that a pathologically low CSF outflow conductance is accompanied by an inverse caudorostral flow of CSF or a compromised trans-ependymal diffusion.

Aged↗