Biomedical subjects

Y Forsell

Publications and source records attributed to Y Forsell.

32 records · Page 2Linked to original sources

PubMed1996

The influence of depressive symptomatology on episodic memory functioning among clinically nondepressed older adults.

The authors examined a community-based sample of 303 clinically nondepressed individuals aged 75 through 96 years on 4 recall tasks: free recall of rapidly presented random words, free recall of slowly presented random words, free recall of organizable words, and cued recall of organizable words. Using a classification taxonomy that identified mood- and motivation-related symptoms of depression, it was found that motivation-related symptoms had a negative effect on performance across all tasks, whereas mood-related symptoms had no effects. In addition, motivation-related symptoms negatively influenced the ability to benefit from more study time but had no effect on the ability to make use of item organization or category cues. An analysis of the specific motivation-related symptoms suggested that symptoms that may affect the ability to focus and sustain attention (e.g., concentration difficulties, lack of interest) were most strongly associated with performance deficits.

Affect↗

PubMed1996

Episodic remembering in a population-based sample of nonagenarians: does major depression exacerbate the memory deficits seen in Alzheimer's disease?

Population-based samples of normal old adults and people with major depression (MD), Alzheimer's disease (AD), and coexisting MD and AD (MD + AD) between 90 and 100 years of age were assessed in face recognition, word recall, and object recall. Results indicated a consistent pattern across tasks: no differences between the normal old and the MD participants or between the AD and MD + AD participants in any task, a clear performance decrement in the AD and MD + AD participants in all task variables reflecting long-term episodic memory, and no group differences in those variables reflecting short-term memory. These data suggest that depression in very old age may not exacerbate the episodic memory deficit that accompanies AD. Further, differences between normal old and MD participants in episodic memory tasks appear to be negligible among the oldest old. The general lack of effects of MD may be due to the fact that those symptoms of this disease that are most likely to affect memory functioning (e.g., loss of energy, concentration difficulties) are common in AD as well as in nondepressed people in the 10th decade of life.

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PubMed1996

Episodic memory deficit in elderly adults with suspected delusional disorder.

This study examined memory functions in two groups of elderly adults with and without suspected delusional disorder (SDD). The samples consisted of 66 normal elderly subjects and 33 elderly subjects with symptoms, as reported by close informants, of delusional disorder. Subjects were matched with regard to age, gender and education, and there were no differences between the two groups with regard to performance of visuo-spatial and primary memory tasks. Subjects were examined concerning a variety of episodic recall and recognition tasks. The results demonstrated that subjects with SDD performed at a lower level than controls for some episodic memory tasks (i.e. recall tasks). There were no group differences in measures of episodic recognition or in the primary memory tasks. In addition, the group of subjects with SDD was, to the same extent as the control group, able to utilize cognitive support in the form of organization, cues and previous knowledge in order to enhance episodic memory. In summary, it appears that elderly adults with SDD have a mild episodic memory deficit in the absence of other cognitive deficits.

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PubMed1995

Prevalence and correlates of depression in a population of nonagenarians.

BACKGROUND: Clinicians see many more nonagenarian patients now and there is a need for epidemiological data relating to this group. The aim of the present study was to investigate the prevalence of depressive symptoms and syndromes in this age group. METHOD: The DSM-IV and the ICD-10 criteria for depression were used and correlated with physical health, disability in daily life, gender, use of drugs, social circumstances and cognitive dysfunction. Data were derived from 329 persons aged 90 and over, registered in a parish of Stockholm, who had been extensively examined by physicians and nurses. RESULTS/CONCLUSIONS: The prevalence of Major Depressive Episode as defined in DSM-IV was 7.9%; and of mild, moderate and severe Depressive Episode (combined); as defined in ICD-10 9.1%. No gender difference was found. Disability in daily life and the use of psychotropic drugs were found to correlate with depressive symptoms and syndromes.

Activities of Daily Living↗

PubMed1994

Episodic memory functioning in a community-based sample of old adults with major depression: utilization of cognitive support.

Community-based samples of old adults with current major depression (n = 17; mean age = 83.29 years) and healthy old adults (n = 51; mean age = 83.29 years) were examined on a variety of episodic recall and recognition tasks. Results indicate depression-related deficits in recall that were reduced, but not eliminated, in recognition. Control Ss were able to utilize cognitive support in the form of more study time and item organizability in free recall, whereas depressed Ss were not. However, both groups showed equal gains from the provision of category cues and beneficial effects of prior knowledge and more study time in recognition. Results suggest that depression results in deficits in effortful, elaborate processes at encoding and retrieval and that old age depression is associated with a reduced ability to utilize cognitive support to improve episodic memory. Depressed older adults appear to require cognitive support at both encoding and retrieval to demonstrate memory facilitation.

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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%).

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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↗

PubMed1993

Memory complaints of elderly people in a population survey: variation according to dementia stage and depression.

OBJECTIVE: To study the relationship between subjective memory complaints, cognitive functioning, and clinical diagnosis of dementia. DESIGN: Cross-sectional, total-population survey. MEASUREMENTS: A two-phase study was done. All 2368 were screened by Mini-Mental State Examination (MMSE). Then the 314 who screened positive and a sample of 354 who screened negative were examined clinically (by examining the subject and interviewing an informant) for DMS-III-R criteria for dementia, Clinical Dementia Rating (CDR) scale for severity of dementia and the presence of memory complaints or depressed mood. SETTING: An area in Stockholm, Sweden. PARTICIPANTS: All inhabitants of the area (2368) born in 1912 or before, living at home or in institutions. RESULTS: A greater percentage of informants reported marked memory impairment than did the subjects themselves. Neither the informants' nor the subject' reports differed according to the type of dementia, but they differed clearly according to the stage of dementia. Informants reported memory impairment more frequently as dementia severity increased, while the subjects' complaints of marked memory impairment were most common in mild-moderate dementia. Furthermore, non-demented subjects with marked complaints performed more poorly on the MMSE. Subjects with depressed mood were also more likely to complain about their memory, both in the demented and non-demented groups. CONCLUSION: Our data show the validity of the informants' reports about the subjects' memory deficits. Moreover, the study confirmed the clinical impression that the patient's own complaints should not be ignored, as subjects in the mild stage of dementia often have some insight into their own memory deficit. However, depressed individuals may underestimate their own memory, and individuals with moderate-severe dementia may overestimate theirs.

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PubMed1993

Application of DSM-III-R criteria for major depressive episode to elderly subjects with and without dementia.

OBJECTIVE: The aim of the present study was to see how DSM-III-R criteria for a major depressive episode functioned in a representative sample of elderly subjects with and without dementia. METHOD: Data were used from a population-based study of individuals 75 years old or older living in Stockholm. Subjects were screened for dementia by using the Mini-Mental State. Subjects with scores of 23 or lower as well as age- and sex-matched subjects with scores of 24 or higher were given a medical examination. Dementia was diagnosed according to DSM-III-R and staged for severity by using the Washington University Clinical Dementia Rating Scale. The Comprehensive Psychopathological Rating Scale was used to record symptoms of depression, which were then classified according to DSM-III-R criteria for a major depressive episode. Data on depressive symptoms were available for 643 individuals: 213 with and 430 without dementia. A principal component analysis was carried out on the nine symptoms from criterion. A for a major depressive episode. RESULTS: The depressive symptoms clustered into two groups: mood disturbance and motivation disturbance. The mood disturbance symptoms were most frequent in subjects with mild dementia and less frequent in those with more severe dementia; the subjects with the most severe dementia had the highest rates of motivation disturbance symptoms. CONCLUSIONS: The different manifestations of depression in elderly patients with and without dementia should be taken into account when making the diagnosis of major depression. Further research is needed on the manifestations of depressive symptoms in the elderly in order to validate the diagnostic criteria.

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PubMed1992

Clinical diagnosis of Alzheimer's disease and other dementias in a population survey. Agreement and causes of disagreement in applying Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, Criteria.

In a population survey aimed to detect cases of Alzheimer's disease and other dementias, two preliminary diagnoses were made independently with the purpose of using the concordant diagnoses as final diagnoses. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, diagnostic criteria were followed. The 668 subjects examined were selected from the population of an area in Stockholm, Sweden, aged 75 years or more, with the Mini-Mental State Examination used as a screening test. The agreement on dementia diagnosis was moderate (kappa = .54) and could be clearly improved (kappa = .70) with modifications to the diagnostic criteria, such as adding a category of questionable dementia and giving more guidelines in the definition of impairment of a function. The agreement on the diagnosis of Alzheimer's disease vs vascular dementia vs secondary dementia was substantial (kappa = .67) when the cases with concordant dementia diagnoses were examined.

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PubMed1992

Clinical staging of dementia in a population survey: comparison of DSM-III-R and the Washington University Clinical Dementia Rating Scale.

In a population survey in Stockholm, 224 dementia cases were staged using two scales: the Washington University Clinical Dementia Rating Scale and DSM III-R. Both scales had to be modified by adding additional specifications and, in the case of DSM III-R, a new category of questionable dementia. After modification, the comparison of the two scales showed good agreement when all stages were analyzed (kappa = 0.60), but moderate agreement on the questionable and mild stages (kappa = 0.47). These results confirm the staging of mild dementia as the most problematic issue. Finally, the scales both showed moderate agreement with the categorized Mini-Mental State Examination (MMSE) (0-17 for severe and moderate forms; 18-23 for mild cases). Our data suggest new cut-off points for the MMSE when used as a staging scale.

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PubMed1991

Prevalence of Alzheimer's disease and other dementias in an elderly urban population: relationship with age, sex, and education.

We studied the prevalence of different types of dementia in an elderly population in Stockholm, Sweden, in relation to age, sex, and education. The study confirmed Alzheimer's disease (AD) as the most frequent type of dementia and the positive association of dementias with age, even in the most advanced ages. In contrast to previously reported data, we found the same proportion of AD and vascular dementia in the different age strata, and no sex differences regarding the prevalence of different dementia types. Finally, less educated people had a higher prevalence of all dementias, due essentially to a higher prevalence of alcoholic dementia and unspecified type of dementia. The prevalence of AD was similar across different levels of education.

Age Factors↗

PubMedDate not supplied

Musculoskeletal pain and analgesic therapy in a very old population.

The aim of this study was to examine the prevalence of musculoskeletal pain and use of analgesic drugs in a population of very old people. The investigation is based on data from the Kungsholmen project. Of the 2638 inhabitants aged 75 or more in a parish of central Stockholm 1800 were examined. Of the subjects. 60% reported trouble with pain at musculoskeletal locations, while only 40% of the pain reporting subjects used analgesics, one third of which were non-prescription minor analgesics. Prescription analgesics (non-steroidal antiinflammatory drugs or centrally acting drugs) were used by one fourth of the pain reporting subjects, and taken on a regular basis in only half of the cases. Potent opioids were used by less than 1% of the population. There was no increase in pain with increasing age, but an increase in use of minor analgesics with age >85. Women more often reported pain and had a higher consumption of analgesics. Light opioids were more often used by subjects with multifocal pain. Subjects living in sheltered accommodation used more analgesics, particularly light opioids, than did those living in their own homes or in institutions. Subjects with low or intermediate educational status more often reported pain and used light opioids to a larger extent than did the highly educated. These results indicate that musculoskeletal pain is relatively common among the very old, but does not seem to be a severe problem for the majority, considering the low proportion of subjects using prescription analgesics regularly. However, the very low use of potent opioids indicates that some of the elderly suffering from cancer and other severe pain causing diseases might be undertreated.

Journal Article↗

PubMedDate not supplied

Variation in psychiatric and behavioural symptoms at different stages of dementia: data from physicians' examinations and informants' reports.

An investigation was carried out of psychiatric and behavioural symptoms in non-demented and demented subjects derived from a population study of the very elderly. Information on psychiatric and behavioural symptoms came from two independent sources: a physician's examination and an interview with an informant. The symptoms were grouped into clusters using principal-components analysis. Little agreement was found between the two sources of information on symptoms of anxiety, depression and psychosis. However, there was agreement about an increase in inactivity symptoms as the severity of dementia increased.

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