Læknablaðið : fylgirit - 01.08.2003, Blaðsíða 8

I ABSTRACTS / 27TH NORDIC PSYCHIATRIC CONGRESS
H70-study started 1971, the Women's Health Study started 1968,
the 95+-study started 1996. Completed suicides in individuals above
age 70 are also studied. Dementia are the most important predictor
of death and institutionalization in old age. Vascular factors (in-
farcts, white matter lesions, hypertension), childhood factors and
female sex after age 90 are related to risk of Alzheimer's disease.
Life time prevalence of depression was 45% in women and 23% in
men. The prevalence of depression was 9% both at age 70 and 95.
The incidence of first-onset depression increased from age 70 to age
85. Female sex and neuroticism increased the incidence of depres-
sion. The proportion of 70-year-old depressed who were treated
with antidepressants increased from 10% in 1971 to 56% in 2000.
Current depression was related to poor performance on cognitive
testing, but not to organic brain changes on brain imaging. Psych-
otic symptoms were found in 10% of non-demented 85-year-olds,
and were related to cardiovascular disorders, increased mortality
and increased incidence of dementia. However, only a minority of
those with psychotic symptoms developed dementia during follow-
up. Suicide after age 70 was strongly associated with depression,
and the majority were diagnosed and treated for depression within
6 months before the suicide. Life weariness and other suicidal
thoughts were rare in the mentally healthy elderly, and were related
to an increased mortality in women independently from comorbid
physical disorders.
N - 8 Wednesday 13/8,15:50-17:00
A population study of dementia after age 95
Anne Börjesson Hanson, MD, Psychiatry Section, Inst. of Clinical Neuroscience,
Sahlgrenska University Hospital, Blá str 15, SU/Sahlgrenska, SE-413 45 GÖTEBORG,
Sweden. Þorsteinn Gíslason, Eva Edin, Ingmar Skoog
anne. borjesson@neuro.gu.se
Objective: To study demenlia in extreme old age.
Design: Longitudinal population study.
Materials and Methods: Tlte 95+ study includes more than 700
comprehensive neuropsychiatric examinations of individuals from
age 95 to 101 years. Dementia and its severity were diagnosed
according to the DSM-III-R criteria, Alzheimer’s disease (AD)
according to the NINCDS-ADRDA criteria and vascular dementia
(VaD) according to criteria proposed by Erkinjuntti.
Results: The prevalence of dementia was 51% at age 95 (N=338)
and increased to 58% at age 97 (N=167). At age 95, the prevalence
was 36% for AD, 15% for VaD, including mixed dementia. The
incidence of dementia between age 95 and 97 was 173/1000 person
years at risk. The proportion of mild dementia was 5%. Institutio-
nalization rate was 26% for non-demented and 85% for demented
at age 95 and increased to 30% for non-demented and 95% for
demented at age 97.
Conclusions: The prevalence of dementia continues to increase
after age 95. The incidence rate of dementia was higher between
age 95-97 than between age 85-88 (90/1000 person years at risk). In
line with several other studies the proportion of mild dementia
decreased from 28% at age 85,19% at age 88 to 5% at age 95. One
reason may be that DSM-III-R severity criteria are based on the
need for assistance in daily living. Therefore, the higher frequency
of physical co-morbidity in the extremely old will give a lower pro-
portion of mild dementia. When a physically impaired individual
reaches the threshold for dementia, the degree of severity will thus
be higher than for a physically unaffected individual. Another ex-
planation could be that the brains of extremely old individuals may
be more fragile. When this is superimposed by Alzheimer encepha-
lopathy the decline into more severe dementia may be faster than in
younger groups.
N - 9 Wednesday 13/8,15:50-17:00
Preclinical stages of Alzheimer’s disease and vascular
dementia: A three year follow-up of 85 years olds - the H
70 study
Simona Sacuiu1, Magnus Sjögren1, Boo Johansson2, Ingmar Skoog1
1 Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University
Hospital and 2Institute of Psychology, Gothenburg University, Gothenburg, Sweden
Background: Most studies on cognition and early dementia use
neuropsychiatric examination or psychometric tests. The impor-
tance of self-reports and key-informant interviews in the early
stages of dementia is controversial. Moreover, memory problems
are often mentioned as predictor of dementia, but are they suffi-
cient to predict dementia?
Aim: Evaluate the predictive value of four sources of information
(self-report, key-informant report, neuropsychiatric examination,
standard psychometric tests) on cognition (memory, language,
visuospatial, executive function) in non-demented 85 year-olds that
developed dementia within three years.
Mcthod: The cognitive performance was recorded in a representa-
tive population sample of non-demented 85 year-olds (N=313)
from Gothenburg, Sweden that was thereafter followed for three
years for incident dementia. We evaluated the contribution of diffe-
rent clinical sources and cognitive domains at the prediction of de-
mentia using logistic regression analyses with total dementia
(N=58), vascular dementia (N=27), Alzheimer’s disease (N=24) as
outcomes.
Kcsults: The neuropsychiatric examination independently predicted
AD, whereas the psychometric tests independently predicted VaD.
VaD and AD were independently predicted by poor memory (all
sources, except self-reported memory predicted AD, but not VaD)
and language (neuropsychiatric examination, psychometric tests).
Conclusion: Multiple sources of information covering multiple cog-
nitive domains are necessary to predict the development of AD or
VaD.
N - 10 Wednesday 13/8, 15:50-17:00
Sexual activity and attitudes to sex in 70-year-olds
Bcckman N, Institute of Clinical Neuroscience, Section of Psychiatry, Sahlgrenska
University Hospital, SE-413 45 Göteborg, Sweden. Skoog I
nils. beckman@neuro.gu.se
Objective: To study birth cohort differences in sexual attitudes and
prevalence of sexual activity in 70-year old non-demented men and
women.
8 LÆKNABLAÐIÐ / FYLGIRIT 48 2003/89