Alzheimer’s & Dementia, 2024

Age of Alzheimer’s disease diagnosis in people with Down syndrome and associated factors: Results from the Horizon 21 European Down syndrome consortium

Abstract

Abstract

Introduction: People with Down syndrome (DS) have high risk of developing Alzheimer’s disease (AD). This study examined mean ages of AD diagnosis and associations with co-occurring conditions among adults with DS from five European countries.

Methods: Data from 1335 people with DS from the Horizon 21 European DS Consortium were used for the analysis.

Results: Mean ages of AD diagnosis ranged between 51.4 (SD 7.0) years (United Kingdom) and 55.6 (SD 6.8) years (France). Sleep-related and mental health problems were associated with earlier age of AD diagnosis. The higher number of co-occurring conditions the more likely the person with DS is diagnosed with AD at an earlier age.

Discussion: Mean age of AD diagnosis in DS was relatively consistent across countries. However, co-occurring conditions varied and impacted on age of diagnosis, suggesting that improvements can be made in diagnosing and managing these conditions to delay onset of AD in DS.

Highlights: Mean age of AD diagnosis was relatively consistent between countries Sleep problems and mental health problems were associated with earlier age of AD diagnosis APOE ε4 carriers were diagnosed with AD at an earlier age compared to non-carriers Number of co-occurring conditions was associated with earlier age of AD diagnosis No differences between level of intellectual disability and mean age of AD diagnosis.

Forfattere

Frode Kibsgaard Larsen, R. Asaad Baksh, Eimear McGlinchey, Ellen Melbye Langballe, Bessy Benejam, Jessica Beresford-Webb, Mary McCarron, Antonia Coppus, Segolene Falquero, Juan Fortea, Johannes Levin, Sandra V. Loosli, Ruth Mark, Anne-Sophie Rebillat, Shahid Zaman & Andre Strydom

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Nordic Studies on Alcohol and Drugs, 2024

The elephant in the room: Metaphors in women’s accounts of life with a family member with problematic substance use

Abstract

Abstract

Background: Research has shown that a family member’s problematic substance use has significant deleterious mental and physical health impacts on other members of the family. Women are more often affected than men. These negative health effects persist as the person with problematic substance use ages, and they vary according to the relationship status.

Aim: The aim of this study was to gain a deeper understanding of how women experience and are affected by their family member’s substance use problems.

Method: A metaphorical analysis of narrative interviews with 11 daughters and five wives of older adults (>65 years) with problematic substance use.

Results: We identified four areas of signification in which metaphors were employed: (1) experiences (chaos and crash and walking on eggshells); (2) strategies (complicity and silencing); (3) dilemmas (deceit or a disease and open or closed dilemmas); and (4) consequences (obtaining or retaining an identity, health and different types of help).

Conclusion: Family life with a parent or spouse with a substance use problem was described as chaotic, unsafe, uncertain and with no prospects of change. The study illustrates how metaphors are used to mediate experiences and worldviews pertaining to existential matters founded in deep negative emotions, deceit, shame and stigma. Metaphors make up a crucial material for communicating emotions and themes that are difficult to convey due to shame and stigma.

Forfattere

Aud Johannessen, Anne-Sofie Helvik, Kjerstin Tevik, Thomas Tjelta, and Kirsten Thorsen

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The Journal of Prevention of Alzheimer's Disease, 2024

Female Reproductive Factors and Risk of Mild Cognitive Impairment and Dementia: The HUNT Study

Abstract

Background: More women are living with dementia than men worldwide and there is a need to investigate causes for this female preponderance. While reproductive factors have been investigated as risk factors, the results are conflicting. We aim to clarify this using a large cohort with a long observation time, adjusting for multiple health and lifestyle variables and encompassing a wider range of cognitive impairment.

Objective: To study the association between menopause age, menarche age and risk of and risk of mild cognitive impairment (MCI) and dementia.

Setting: The Trøndelag Health study (HUNT), a longitudinal population health study in Norway (1984–2019).

Participants: Women who were ≥70 years in 2017–2019 were assessed for cognitive impairment.

Measurements: Data on menopause age and menarche age were obtained from questionnaires. Diagnosis of MCI or dementia was set using a standardised procedure by a diagnostic group of nine physicians. Multinomial logistic regression was used to study the association between menopause age, menarche age and risk of MCI and dementia with adjustment for birth year, education, smoking, ApoE4, number of children, diabetes, body mass index, alcohol use and physical inactivity.

Results: We evaluated 5314 women where 900 (16.9%) had dementia, and 1747 (32.8%) had MCI. Multiple adjusted relative risk ratio (RRR) and 95% confidence intervals (CI) for dementia were: 0.96(95%CI 0.95–0.98) (p<0.001) for menopause age, 0.97(95%CI 0.94–0.99) (p=0.007) for natural menopause age (excluding hysterectomy and/or oophorectomy<55 years) and 0.97(95%CI 0.95–0.99) (p<0.001) for reproductive span (menopause age minus menarche age). Menopause age <45years was associated with a 56% higher risk compared to mean menopause age 50 years. We found no significant associations between menarche age and dementia and no associations with MCI.

Conclusions: Older menopause age and longer reproductive span corresponding to longer oestrogen exposure were associated with a lower dementia risk. Future studies should explore therapeutical options to offset this risk in women.

Forfattere

Yehani Wedatilake, C. Myrstad, S. E. Tom, B. H. Strand, S. Bergh & G. Selbæk

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