Abstract
Objectives
To examine the effect of perceived loneliness on the development of dementia (all-cause), Alzheimer´s disease (AD), and vascular dementia (VaD).
Method
The study comprised 1,905 ...nondemented participants at baseline, drawn from the longitudinal Betula study in Sweden, with a follow-up time of up to 20 years (mean 11.1 years). Loneliness was measured with a single question: “Do you often feel lonely?”.
Results
During the follow-up, 428 developed dementia; 221 had AD, 157 had VaD, and 50 had dementia of other subtypes. The entire dementia group is denoted “all-cause dementia.” Cox regression models, adjusted for age, gender, and a baseline report of perceived loneliness, showed increased risk of all-cause dementia (hazard ratio HR = 1.46, 95% confidence interval CI 1.14–1.89), and AD (HR = 1.69, 95% CI 1.20–2.37), but not VaD (HR = 1.34, 95% CI 0.87–2.08). After adjusting for a range of potential confounders, and excluding participants with dementia onset within the first 5 years of baseline (to consider the possibility of reverse causality), the increased risk for the development of all-cause dementia and AD still remained significant (HR = 1.51, 95% CI 1.01–2.25 for all-cause dementia; HR = 2.50, 95% CI 1.44–4.36 for AD).
Discussion
The results suggest that perceived loneliness is an important risk factor for all-cause dementia and especially for AD, but not for VaD. These results underscore the importance of paying attention to subjective reports of loneliness among the elderly adults and identifying potential intervention strategies that can reduce loneliness.
The year 2022 marks the 40th anniversary of Olof Palme’s Independent Commission on Disarmament and Security Issues. The Commission presented its report in 1982, at the height of the Cold War. It ...developed the concept of common security – the idea that nations and peoples can only feel safe when their counterparts feel safe. By taking the concept of common security as its starting point, the Common Security 2022 initiative has analysed the world we live in and some of the great challenges facing humanity on the planet earth. At the time of 50th anniversary of the 1972 Stockholm Conference (Stockholm+50), the Common Security 2022 recommendations are indications, or steps forward for our shared future that would include addressing the climate change, a process of removing the threat of nuclear annihilation and turning around the ‘super tanker’ of war.
ObjectivesTo examine the association between marital status and dementia in a cohort of young-old (50–64) and middle-old (65–74) adults, and also whether this may differ by gender.DesignProspective ...population-based study with follow-up time of up to 10 years.SettingSwedish national register-based study.Participants2 288 489 individuals, aged 50–74 years, without prior dementia diagnosis at baseline. Dementia was identified using the Swedish National Patient Register and the Cause of Death Register.Outcome measuresThe influence of marital status on dementia was analysed using Cox proportional hazards models, adjusted stepwise for multiple covariates (model 1: adjusted for age and gender; and model 2: additionally adjusted for having adult children, education, income and prior cardiovascular disease).ResultsDuring follow-up, 31 572 individuals in the study were identified as demented. Cox regression showed each non-married subcategory to be associated with a significantly higher risk of dementia than the married group, with the highest risk observed among people in the young-old age group, especially among those who were divorced or single (HRs 1.79 vs 1.71, fully adjusted model). Analyses stratified by gender showed gender differences in the young-old group, with indications of divorced men having a higher relative risk compared with divorced women (HRs 2.1 vs 1.7, only-age adjusted model). However, in the fully adjusted model, these differences were attenuated and there was no longer any significant difference between male and female participants.ConclusionsOur results suggest that those living alone as non-marrieds may be at risk for early-onset and late-onset dementia. Although more research is needed to understand the underlying mechanism by which marital status is associated with dementia, this suggests that social relationships should be taken seriously as a risk factor for dementia and that social-based interventions may provide an opportunity to reduce the overall dementia risk.
Finding valid and reliable ways to assess complex clinical skills within psychology is a challenge. Recently, there have been some examples of applying Objective Structured Clinical Examinations ...(OSCEs) in psychology for making such assessments. The aim of this study was to examine students’ and examiners’ perceptions of a digital OSCE in psychology regarding quality and students’ feelings about the OSCE. Participants were 51 students enrolled in the Programme for Master of Science in Clinical Psychology during two semesters and nine examiners assessing each OSCE occasion, at Umeå University, Sweden. Web-based questionnaires were used for data collection. Psychometric analyses indicated that the subscales in the student questionnaire had adequate or close to adequate levels of item and scale reliability. Both students and examiners felt that the digital OSCE was realistic, valid and well-aligned with professional practice. Although students perceived the digital OSCE as stressful, the results showed that they were focused and concentrated and found the OSCE to be a positive learning experience, implying that the stress did not affect performance to any significant extent. Based on the examiners’ experiences, it can be concluded that there are both advantages and disadvantages which need to be considered when planning future digital OSCEs.
Subjective driving skill is commonly assessed with self-reports and many studies have found that drivers have overly positive beliefs in their own skill. The purpose of this review was to examine how ...subjective driving skill has been measured in different studies. Secondly, the aim was to discuss the methods used from a measurement perspective, i.e., to discuss the reliability and the validity of the measures and methods used. The findings from the review indicated that studies about subjective driving skills can be divided into three different domains with respect to the methodology used. In two of the domains, subjective driving skill is measured by comparing the individual’s own skill to internal criteria: the skill of the average driver and specific aspects of driving skill. In the third domain, the subjective skill is compared with an external criterion, i.e., the actual skill in order to determine if drivers have an accurate perception of their own skill. The conclusion of the review was that there are several methodological problems with the reference to the average driver that can result in biased assessments. Moreover, this methodology cannot be used to conclude whether drivers’ are overconfident or not. In order to obtain indicators of reliability and validity, the measurement of subjective driving skill should incorporate judgments of specific aspects of driving skills. By the use of this methodology, subjective driving skill can be validated through comparison with actual driving skill.
The aim of this study was to examine the psychometric properties of the Swedish version of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE‐OM) using classical test theory and item ...response theory (IRT). The CORE‐OM is a commonly used 34‐item self‐report instrument measuring psychological problems/distress covering four domains: subjective well‐being, problems/symptoms, functioning and risk. Despite its broad application, only a few studies have used IRT to examine the psychometric properties, and the properties of the Swedish version have only been examined in one initial study. The present study included 1,011 clients with mild to moderate symptoms of distress, applying for psychotherapy at an outpatient training clinic in Sweden. Clients' responses were subjected to classical item analyses as well as IRT (Rasch) analysis using the partial credit model. The classical analyses demonstrated high levels of internal consistency and acceptable levels of item discrimination for the majority of the items, although lower for some items, particularly in the Risk domain. IRT analyses showed that there was a rather good match between item and respondent locations and the measurement precision was high. Disordered step and average measures for some of the items in the Risk domain indicate that these items were problematic from a psychometric point of view and only applicable for a minority of the participants. Differential item functioning for gender in some of the items suggests that they might need to be revised to minimise potential gender bias.
Abstract Introduction The objective was to examine whether subjective memory impairment (SMI) predicts all-cause dementia or Alzheimer's disease (AD) in a population-based study with long-term ...follow-up (median = 10 years). Methods A total of 2043 initially dementia-free participants (≥ 60 years) made three memory ratings (“compared with others”, “compared with five years ago”, and “complaints from family/friends”) at baseline. During follow-up, 372 participants developed dementia (208 with AD). Results Cox regression revealed that subjective memory impairment ratings predicted all-cause dementia in models adjusting for age and sex (hazard ratio or HR from 2.04 to 3.94), with even higher values for AD (HR from 2.29 to 5.74). The result persisted in models including other covariates, including baseline episodic memory performance, and in analyses restricted to participants with long time to dementia diagnosis (≥ 5 years). Discussion The findings underscore the usefulness of subjective memory assessment in combination with other factors in identifying individuals at risk for developing dementia.
Objectives
The aim of this nationwide study was to examine the association between age at retirement and dementia risk, with a follow‐up period of up to 24 years.
Methods/design
This cohort study ...comprised Swedish citizens born in 1930 who were alive in the year 1990 (n = 63 505). The cohort was followed for incidents of dementia through data provided by the Swedish National Patient Register and the Cause of Death Register. Age at retirement and socioeconomic variables were retrieved from Statistics Sweden.
Results
During the follow‐up, 5181 individuals received a dementia diagnosis. Competing risk regression models, adjusted for sex, education, marital status, occupation, and previous history of cardiovascular diseases, showed that later‐than‐average retirement age was associated with decreased dementia risk.
Conclusions
The present results support the idea that individuals who retired at an older age have a decrease risk of dementia. However, as this was an observation study, unmeasured factors, such as premorbid cognitive level and genetic predisposition, may have influenced our findings and remains to be elucidated in future studies.
Abstract Retrieval practice is a learning strategy that has repeatedly been found to have positive effects on memory and learning. However, studies indicate that students rarely use retrieval ...practice on a voluntary basis. The objective of the present study was to examine students’ self-regulated use of retrieval practice, and to determine whether sex and individual differences in cognitive and non-cognitive aspects are related to optional use of practice testing. A classroom study was conducted with 146 upper-secondary school students taking courses in mathematics and Swedish. An ABAB design was used to compare students’ optional and non-optional use of retrieval practice (i.e., repeated online quizzing). Students performed cognitive tasks to assess working memory capacity and fluid intelligence and completed self-reports of non-cognitive factors related to school achievement, such as grit, need for cognition (NFC), conscientiousness and openness. Quiz use was then compared using paired- and independent-samples t-tests, and hierarchical linear regression analyses explored relations to individual differences. The results showed that students completed significantly fewer quizzes in the optional sections than in the non-optional sections, and that females completed significantly more optional quizzes than males in Swedish, but not in mathematics. Further, the results showed that conscientiousness predicted optional quiz use in mathematics, whereas sex, NFC, conscientiousness, and openness predicted quiz use in Swedish. To conclude, although the findings show a relatively low optional/self-regulated use of practice testing, in line with earlier research, they suggest that sex and non-cognitive factors, such as personality characteristics, can predict optional use of practice testing.
Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term ...exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: -0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.
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