Oral health & olfactory function : what can they tell us about cognitive ageing?

The objective of this thesis was to advance our understanding of whether oral health and olfactory function may predict accelerated cognitive ageing. Data from two Swedish study populations and one from the United States were applied to investigate the relationship of oral health and olfactory function with cognitive decline and brain ageing in late life. Study I examined the association of self-reported tooth loss with cognitive decline, and brain volume differences in older adults (n= 2715) from the Swedish National study of Aging and Care-Kungsholmen (SNAC-K). A subsample (n= 394) underwent magnetic resonance imaging (MRI). Tooth loss was associated with a steeper global cognitive decline (β: -0.18, 95% confidence interval [CI]: -0.24 to -0.11). Participants with complete or partial tooth loss had significantly lower total brain volume (β: -28.89, 95% CI: -49.33 to -8.45) and grey matter volume (β: -22.60, 95% CI: -38.26 to -6.94). Thus, tooth loss may be a risk factor for accelerated cognitive ageing. Study II Investigated the effect of poor masticatory ability on cognitive trajectories and dementia risk in 544 cognitively intact adults aged ≥50 from the Swedish Adoption/Twin Study of Aging (SATSA) with 22 years of follow-up. Masticatory ability was assessed using the Eichner Index and categorised according to the number of posterior occlusal zones: A (all four), B (3-1), and C (none). After the age of 65, participants in Eichner category B and C showed an accelerated decline in spatial/fluid abilities compared to those in category A (β: -0.16, 95% CI: -0.30 to -0.03 and β: -0.15, 95% CI: -0.28 to -0.02, respectively). Hence, poor masticatory ability is associated with an accelerated cognitive decline in fluid/spatial abilities. Study III examined whether impaired olfaction is associated with cognitive decline and indicators of neurodegeneration in 380 participants (mean age = 78 years) from the Memory and Aging Project (MAP). Participants with hyposmia (β = −0.03, 95% CI: −0.05 to −0.02) or anosmia (β = −0.13, 95% CI −0.16 to −0.09) had a faster global cognitive decline than those with normal olfaction. Impaired olfaction was related to smaller volumes of primarily the medial temporal cortex (β = −0.38, 95% CI −0.72 to −0.01). Olfactory deficits predict faster cognitive decline and indicate neurodegeneration in older adults. Study IV identified age-related trajectories in episodic memory and odour identification, as well as determinants of the trajectories. 1023 MAP participants were followed for up to 8 years with annual assessments. Three joint trajectories were identified; Class 1- stable performance in both functions; Class 2- stable episodic memory and declining odour identification; and Class 3- decline in both functions. Predictors of class membership were age, sex, APOE ε4 carrier status, cognitive activity, and BMI. Episodic memory and olfactory function often show similar trajectories in ageing, reflecting their shared vulnerability to changes in the medial-temporal lobes. Conclusions: Both poor oral health and olfactory deficits may predict cognitive decline and indicate neurodegeneration in the brain. Poor oral health is associated with accelerated cognitive decline and brain ageing, whereas, olfactory deficits may reflect loss of brain integrity in old age

The Metabolic Syndrome Is Associated With Lower Cognitive Performance and Reduced White Matter Integrity in Midlife: The CARDIA Study

BackgroundCardiovascular disease risk factors play a critical role in brain aging. The metabolic syndrome (MetS), a constellation of cardiovascular risk factors, has been associated with poorer cognition in old age; however, it is unclear if it is connected to brain health earlier in life.MethodsWe investigated the association of MetS (n = 534, 18.5%) vs. no MetS (n = 2,346, 81.5%) with cognition in midlife within the prospective study, Coronary Artery Risk Development in Young Adults (CARDIA). At midlife (mean age 50), MetS was defined using National Cholesterol Education Program guidelines. At the 5-year follow-up, a cognitive battery was administered including tests of processing speed (Digit Symbol Substitution Test, DSST), executive function (the Stroop Test), verbal memory (Rey Auditory Verbal Learning Test, RAVLT), verbal fluency (category and letter fluency), and global cognitive function (Montreal Cognitive Assessment, MoCA). A sub-sample (n = 453) underwent brain MRI.ResultsParticipants with MetS had worse performance on tests of verbal fluency, processing speed, executive function, and verbal memory (p < 0.05), but not on global cognition. MetS was also associated with lower frontal, parietal, temporal, and total white matter integrity (p < 0.05), as assessed with fractional anisotropy.ConclusionsMetS is associated with lower cognition and microstructural brain alterations already at midlife, suggesting that MetS should be targeted earlier in life in order to prevent adverse brain and cognitive outcomes

Systemic α-synuclein injection triggers selective neuronal pathology as seen in patients with Parkinson’s disease

Abstract: Parkinson’s disease (PD) is an α-synucleinopathy characterized by the progressive loss of specific neuronal populations. Here, we develop a novel approach to transvascularly deliver proteins of complex quaternary structures, including α-synuclein preformed fibrils (pff). We show that a single systemic administration of α-synuclein pff triggers pathological transformation of endogenous α-synuclein in non-transgenic rats, which leads to neurodegeneration in discrete brain regions. Specifically, pff-exposed animals displayed a progressive deterioration in gastrointestinal and olfactory functions, which corresponded with the presence of cellular pathology in the central and enteric nervous systems. The α-synuclein pathology generated was both time dependent and region specific. Interestingly, the most significant neuropathological changes were observed in those brain regions affected in the early stages of PD. Our data therefore demonstrate for the first time that a single, transvascular administration of α-synuclein pff can lead to selective regional neuropathology resembling the premotor stage of idiopathic PD. Furthermore, this novel delivery approach could also be used to deliver a range of other pathogenic, as well as therapeutic, protein cargos transvascularly to the brain

Att ge information till patienter med bristande språkkunskaper : En litteraturstudie

The main aim of this study is to illuminate problems related to communication with immigrant patients with insufficient or no knowledge of the dominant languageSyftet med denna litteraturstudie är att belysa prblem som är kopplade till kommunikation med patienter som har utländsk härkomst och bristande språkkunskaper

Europa från två horizonter : En komparativ studie av två länders EU bevakning

Abstract The study examines the European Union coverage in a Swedish and a Romanian newspaper during three different weeks. The aim is to answer the question of how the different countries portray EU and what quality there is on the information the readers or users receive from the papers. How the media portrays the European Union is an important topic to study when it comes to democracy. The European Union makes a lot of national decisions and controls a lot of our daily politics so it is important that the people get relevant and good information. Sweden joined the European Union in 1995 after a referendum where only 52, 3 percent of the Swedish population wanted to join and then only if the European Union acknowledged Sweden’s wish to remain neutral. Romania’s on the other hand joined the European Union in 2007 after long negotiations. The country had to improve a lot of social and economical problems before they were aloud to join. When they finally did join the European Union together with Bulgaria they did so under the strict conditions that they would fight the corruption and other problems harder. The theories we used was: normative theory, media effect theories, framing, medialogic, gatekeeping and europeaness. The previous studies we were inspired by was Vanni Tjenströms “Europa Norrifrån” (2001), Ulf Wallin´s “ Vad vi fick veta” (1994) and Göran Palm´s “I marknadens och nationens namn” (2002). With this study we could discover that the Swedes view the European Union mostly like a profit organization and the economical part of the membership was very important. The view the Swedes had of themselves was a very positive one. They thought that their living standards were much better than that of other citizens in other countries in the EU. The Romanian people see the union more like a hope for the future but they see themselves as failures

Life satisfaction in old age

Life satisfaction in old age has generated several theories in philosophy and psychology. The most prominent is the successful aging theory, proclaiming that aging successfully entails maintaining a busy, physically active and independent life, in addition to avoiding chronic diseases. Harmonious aging is a newly formulated theory derived from East Asian philosophy, stressing the importance of balancing negative and positive life circumstances, and to be socially connected in old age. The aim of this thesis was to compare the two theories in how older people evaluate life satisfaction. Data was acquired from an established database in the Swedish National study on Aging and Care (SNAC)- Kungsholmen in Stockholm (n=1975, age= 60-104), through interviews, self-reported questionnaires and medical examinations. Life satisfaction was measured with the Life Satisfaction Index-A (LSI-A). The hypothesis was that harmonious aging factors (social network and activity, subjective health and feeling harmonious), rather than successful aging factors (number of chronic diseases, physical activity, exercise and independence) are associated with higher LSI-A score. The hypothesis was investigated using logistic regression analysis. The results are in support of the hypothesis in that high scores in harmonious aging factors were significantly (p<0.001) associated with higher odds of having an LSI-A score of medium (≥ 7 <14) and high (≥14) LSI-A score compared to a low score (<7). Successful aging factors were not significantly associated with LSI-A score. The conclusion is that compared to the successful aging theory, harmonious aging is a more valid theory of life satisfaction evaluation in old age

The Association Between Cognitive Reserve and Cognitive Trajectories Among Older Adults.

BACKGROUND AND OBJECTIVES: Prior studies on cognitive reserve (CR) and cognitive trajectories are limited and have had conflicting results. Furthermore, most studies have used a single measure of CR that may not reflect a comprehensive exposure. The objective of this study is to determine the impact of individual and composite CR measures on cognitive decline over a 6-year period. RESEARCH DESIGN AND METHODS: We studied 55,340 participants from 16 European countries, aged 50 and older, who participated in the Survey of Health, Aging, and Retirement in Europe. We used cognitive measures (including immediate memory, delayed memory, verbal fluency, and numeracy) and 3 CR factors (education, occupation, and cognitive activities) collected in 4 waves from 2011 to 2017. Structural equation modeling was used to construct the composite CR score, analyzed as tertile. Linear mixed-effect models were used to examine the study aims. RESULTS: At baseline, the highest composite CR tertile was associated with a higher cognition score than the middle and lowest CR tertiles (β: -0.28, 95% confidence interval [CI]: -0.29 to -0.26; β: -0.71, 95% CI: -0.72 to -0.70, respectively), as well as for all individual cognitive domains. At longitudinal results, compared with the lowest CR, the highest but not the middle CR tertile demonstrated a slower 6-year decline in global cognition (β: -0.02, 95 % CI: -0.03 to -0.01), as well as in all cognitive domains (p &lt; .05). DISCUSSION AND IMPLICATIONS: A composite CR could be a protective factor for cognitive performance and cognitive decline, and it is more sensitive and inclusive than an individual CR indicator alone

Association Between Sensory Impairment and Dementia: The Roles of Social Network and Leisure Activity.

BACKGROUND: Evidence suggests that sensory impairment is linked to dementia; however, the role of social network and leisure activity in this relationship is unclear. OBJECTIVE: Examine the association of hearing and visual impairment with dementia, and whether a rich social network and leisure activity moderates this association. METHODS: Dementia-free older adults from the Swedish National Study on Aging and Care in Kungsholmen (n = 2,579) were followed up for up for a median of 10 years (interquartile range = 6). Visual impairment was assessed with a reading acuity test, and hearing impairment was ascertained via self-report and medical records. Dementia was diagnosed following international criteria. Data on social network and leisure activity was collected via self-report. Hazard ratios (HRs) of dementia risk were derived from Cox regression models. RESULTS: Dual impairment, but not single impairment in hearing and vision was associated with a higher risk of dementia (HR: 1.62, 95% CI: 1.16 to 2.27). Compared to participants with no sensory impairment and a moderate-to-rich social network, those with dual impairment and low social network or leisure activity had higher dementia risk (HR: 2.08, 95% CI: 1.43 to 3.22; HR: 2.08, 95% CI: 1.43 to 3.22, respectively), whereas participants with dual impairment with a moderate-to-rich social network or leisure activity did not have significantly higher dementia risk (HR; 1.42, 95% CI: 0.87 to 2.33; HR; 1.42, 95% CI: 0.87 to 2.33, respectively). CONCLUSION: A richer social network and participation in stimulating activities may mitigate the higher dementia risk in older adults with dual impairment in vision and hearing