Flowchart of the study design.

<p>A random sample of 2000 of the participants from the North Karelia and FINMOCA study, originally investigated in either 1972, 1977, 1982 or 1987, were invited for a reinvestigation in 1998. For health reasons or other reasons, 551 (27%) did not accept the invitation. During the measurements, 40 persons dropped out, leaving 1409 to be included in this study.</p

Levels of hopelessness at baseline and follow-up for the different outcome groups.

<p>Changes in hopelessness scores from baseline until follow up for those who at follow-up were either without cognitive impairment or were diagnosed with any cognitive impairment, mild cognitive impairment or Alzheimer’s disease. No changes from baseline to follow-up were statistically significant within any of the outcome categories (Student t-test for independent samples). All differences between the non-impaired group and any of the cognitive impairment groups were statistically significant, both at baseline and at follow-up (* = p≤0.05, ** = p≤0.01, *** = p≤0.001 as indicated by Students t-test for paired samples). The graph is based on scores from participants with measurements of hopelessness both at baseline and follow-up (N = 1246).</p

Characteristics of participants with low and high levels of hopelessness in midlife.

<p>The two-tailed P-values were derived from Students t-test for continuous variables and χ2 for nominal variables.</p><p>Characteristics of participants with low and high levels of hopelessness in midlife.</p

Hopelessness and cognitive impairment for ApoE4 carriers and non-carriers.

<p>Odds ratios from logistic regressions after adjustments for age, education, gender, BMI, blood pressure, cholesterol, residence area, occupation, physical activity, smoking, marital status, and depression. The risk is in comparison to ApoE4 non-carriers with low levels of hopelessness at midlife (OR = 1). Stars indicate the level of statistical significance (three levels <0.05, <0.01, <0.001).</p

Association of Alzheimer’s disease with hip fractures.

a<p>Unadjusted.</p>b<p>Adjusted for cardiovascular diseases, cancer, diabetes, pernicious anemia and other disturbances in absorption of vitamin B₁₂, Parkinson’s disease, epilepsy, glaucoma and rheumatoid arthritis.</p>c<p>Adjusted for covariables in Model 2 plus use of bisphosphonate and psychotropic drugs in 2005.</p

Formation of study cohort.

<p>Formation of study cohort.</p

Association of Alzheimer’s disease with hip fractures in men and women.

a<p>Unadjusted.</p>b<p>Adjusted for cardiovascular diseases, cancer, diabetes, pernicious anemia and other disturbances in absorption of vitamin B₁₂, Parkinson’s disease, epilepsy, glaucoma, rheumatoid arthritis.</p>c<p>Adjusted for covariables in Model 2 plus use of bisphosphonate and psychotropic drugs in 2005.</p

Incident Hip Fractures among Community Dwelling Persons with Alzheimer’s Disease in a Finnish Nationwide Register-Based Cohort

<div><p>Background</p><p>Previous cohort studies have shown that persons with Alzheimer’s disease (AD) have a higher risk of hip fractures but recent data from large representative cohorts is scarce.</p> <p>Methods</p><p>We investigated the association between AD and prevalent and incident hip fractures in an exposure-matched cohort study conducted in Finland 2002–2009 (the Medication and Alzheimer’s disease in 2005 study; MEDALZ-2005). The study population included all community-dwelling persons with verified AD diagnosis in Finland on December 31, 2005 and one matched comparison person per AD case (N = 56,186, mean age 79.9 (SD 6.8) years, range 42–101 years). The diagnosis of AD was extracted from a special reimbursement register. Data on hip fractures during 2002–2009 was extracted from the Finnish National hospital discharge register. Analyses of incident hip fractures (n = 2,861) were restricted to years 2006–2009.</p> <p>Results</p><p>Persons with AD were twice as likely to have previous hip fracture in 2005 (odds ratio, 95% confidence interval 2.00, 1.82–2.20) than matched aged population without AD. They were also more likely to experience incident hip fracture during the four-year follow-up (hazard ratio, 95% confidence interval 2.57, 2.32–2.84, adjusted for health status, psychotropic drug and bisphosphonate use). The AD-associated risk increase decreased linearly across age groups. Although people with AD had higher risk of hip fractures regardless of sex, the risk increase was larger in men than women.</p> <p>Conclusion</p><p>Findings from our nationwide study are in line with previous studies showing that persons with AD, regardless of sex or age, have higher risk of hip fracture in comparison to general population. Although there was some suggestion of effect modification by age or sex, AD was consistently associated with doubling of the risk of incident hip fracture.</p> </div

Mean left hippocampus volumes and standard errors as a function of age (males and females) and gender (for all ages).

<p>Mean left hippocampus volumes and standard errors as a function of age (males and females) and gender (for all ages).</p

Feature groups used in the analysis, and the number of features after pre-selections.

<p>Feature groups used in the analysis, and the number of features after pre-selections.</p