Domicile Preferences in Employment: The Case of Alaska Hire

Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations

Orthostatic intolerance predicts mild cognitive impairment: incidence of mild cognitive impairment and dementia from the Swedish general population cohort Good Aging in Skåne.

Contradictory results have been reported on the relationship between orthostatic hypotension (OH) and mild cognitive impairment (MCI)

Ambulatory recorded ST segment depression on ECG is associated with lower cognitive function in healthy elderly men

ST segment depression (STDE) has been found to be associated with cardiovascular disease in the elderly. Studies of the relation of ambulatory STDE to cognitive function in elderly persons aged 80 years or above is lacking

Differing pattern of ambulatory blood pressure in very elderly men expresses dynamics in atherosclerotic load in the senescence.

To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM) in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM. Results. At age 68, hypertension and high clinic blood pressure (CBP) did not predict ABPM level. Smoking and low ankle-brachial index (ABI) predicted higher ABPM variability and pulse pressure (PP), but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP. Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status

Separate physical tests of lower extremities and postural control are associated with cognitive impairment. Results from the general population study Good Aging in Skåne (GÅS-SNAC).

PURPOSE: To investigate whether separate physical tests of the lower extremities, that assess movement speed and postural control, were associated with cognitive impairment in older community-dwelling subjects. SUBJECTS AND METHODS: In this population-based, cross-sectional, cohort study, the following items were assessed: walking speed, walking 2 × 15 m, Timed Up and Go (TUG) at self-selected and fast speeds, one-leg standing, and performance in step- and five chair-stand tests. The study comprised 2115 subjects, aged 60-93 years, with values adjusted for demographics, health-related factors, and comorbidity. Global cognitive function was assessed using the Mini-Mental State Examination (MMSE), and cognitive impairment was defined by the three-word delayed recall task of the MMSE. Subjects who scored 0/3 on the three-word delayed recall task were defined as cases (n = 328), those who scored 1/3 were defined as intermediates (n = 457), and the others as controls (n = 1330). RESULTS: Physical tests performed rapidly were significantly associated with cognitive impairment; this was the case in increased time of five chair stands (P = 0.009, odds ratio [OR] = 1.03), TUG (P < 0.001, OR = 1.11) and walking 2 × 15 m (P < 0.001, OR = 1.05). Inability to stand on one leg for 10 seconds was associated with increased risk of being a case (P < 0.001, OR = 1.78), compared to those able to stand for 30 seconds or longer. More steps during the step test (P < 0.001, OR = 0.95) and higher fast walking speed (P < 0.001, OR = 0.51) were associated with lower risk of being a case. CONCLUSION: Slower movements and reduced postural control were related to an increased risk of being cognitively impaired. All tests that were performed rapidly were able to separate cases from controls. These findings suggest that physical tests that are related to lower extremity and postural control, emphasizing velocity, might be useful in investigating relationships between physical and cognitive function; furthermore, they can be used to complement cognitive impairment diagnoses

Residential mobility among foreign-born persons living in Sweden is associated with lower mortality

There have been few longitudinal studies on the effect of within-country mobility on patterns of mortality in deceased foreign-born individuals. The results have varied; some studies have found that individuals who move around within the same country have better health status than those who do not change their place of residence. Other studies have shown that changing one’s place of residence leads to more self-reported health problems and diseases. Our aim was to analyze the pattern of mortality in deceased foreign-born persons living in Sweden during the years 1970–1999 in relation to distance mobility. Data from Statistics Sweden and the National Board of Health and Welfare was used, and the study population consisted of 281,412 foreign-born persons aged 16 years and over who were registered as living in Sweden in 1970. Distance mobility did not have a negative effect on health. Total mortality was lower (OR 0.71; 95% CI 0.69–0.73) in foreign-born persons in Sweden who had changed their county of residence during the period 1970–1990. Higher death rates were observed, after adjustment for age, in three ICD diagnosis groups “Injury and poisoning”, “External causes of injury and poisoning”, and “Diseases of the digestive system” among persons who had changed county of residence

Cardiac ventricular dimensions predict cognitive decline and cerebral blood flow abnormalities in aging men.

The aims of this study are to examine possible associations between left cardiac ventricular measures in sixth decade and cognitive performance, both cross sectionally and longitudinally, and to examine if left cardiac ventricular measures could predict future changes in cerebral blood flow (CBF)

Both deterioration and improvement in activities of daily living are related to falls: a 6-year follow-up of the general elderly population study Good Aging in Skåne.

To determine the relationship between long-term change in activities of daily living (ADL) and falls in the elderly and to identify characteristics of groups at risk for falls

Family caregivers' assessment of symptoms in persons with dementia using the GBS-scale: differences in rating after psychosocial intervention - an 18-month follow-up study.

The purpose of this study was to examine if psychosocial intervention for family caregivers made any differences in describing symptoms of dementia in the persons they cared for. The study population comprised family caregivers of persons aged 70 years and older receiving social services and diagnosed with dementia disorders. A group of 129 family caregivers underwent psychosocial intervention including education, information, and provision of a support group, while 133 family caregivers did not and these formed the control group. Family caregivers were followed-up every 6 months for a total of 18 months. They rated intellectual, emotional, and activity of daily living (ADL) functions in persons with dementia using the Gottfries-Bråne-Steen scale (GBS-scale). Family caregivers who underwent psychosocial intervention rated the intellectual and emotional symptoms of dementia significantly higher 6 months later compared to controls and the effect was sustained during the 18-month follow-up irrespective of relationship and education. Most notably, decrease in function of recent memory, ability to increase tempo, long-windedness, distractibility, and blunting were better identified. Our findings suggest that the family caregivers who underwent psychosocial intervention achieved better understanding of different symptoms and the behaviors of dementia. These findings may explain earlier findings of positive effects after psychosocial intervention on family caregivers' sense of burden, satisfaction, and ability to delay nursing home placement