Endogenous and exogenous hormone exposure and risk of cognitive impairment in Swedish twins: a preliminary study.

Purpose: To analyze the risk of cognitive impairment among female Swedish Twins with regard to endogenous and exogenous hormone exposure.

Design And Setting: A cross-sectional analysis of data from the HARMONY Study, a population-based cohort study of cognitive impairment in the Swedish Twin Registry.

Methods: Information regarding age at menarche and menopause, parity, and length and type of hormone therapy (HT) was collected via a telephone interview from 6604 women, aged 65-84.

Outcomes for women with co-occurring disorders and trauma: program and person-level effects.

Six-month outcomes are evaluated from a 9-site quasi-experimental study of women with mental health and substance use disorders who have experienced physical or sexual abuse who enrolled in either comprehensive, integrated, trauma-informed, and consumer/survivor/recovering person-involved services (N = 1023) or usual care (N = 983). Mental health, post-traumatic stress symptoms, and substance use outcomes are assessed with multilevel regression models, controlling for program and personal characteristics. Person-level variables predict outcomes independent of intervention condition and, to a small extent, moderate intervention and program effects.

Women, Co-occurring Disorders, and Violence Study: evaluation design and study population.

The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs.

Educating the brain to avoid dementia: can mental exercise prevent Alzheimer disease?

Physicians often recommend to older adults that they should engage in mentally stimulating activity to reduce the risk of dementia. But is this recommendation based on sound evidence?

Quantitative genetic analysis of latent growth curve models of cognitive abilities in adulthood.

Though many cognitive abilities exhibit marked decline over the adult years, individual differences in rates of change have been observed. In the current study, biometrical latent growth models were used to examine sources of variability for ability level (intercept) and change (linear and quadratic effects) for verbal, fluid, memory, and perceptual speed abilities in the Swedish Adoption/Twin Study of Aging. Genetic influences were more important for ability level at age 65 and quadratic change than for linear slope at age 65.

Age at onset of generalized anxiety disorder in older adults.

Objective: The authors explored the distribution and correlates of age-at-onset of late-life generalized anxiety disorder (GAD).

Methods: Authors examined the distribution of age at onset in a sample of 67 older adults with GAD recruited for a psychotherapy study. They compared those with an early onset of symptoms (before age 50) to those with a late onset (after 50) on demographic variables and measures of psychopathology and health-related quality of life.

Complete ascertainment of dementia in the Swedish Twin Registry: the HARMONY study.

The purpose of this report is to describe the Study of Dementia in Swedish Twins (known as HARMONY), including procedures for complete ascertainment of all cases of Alzheimer's disease (AD) and other dementias in 14,435 individuals aged 65 and older from the national Swedish twin registry. Telephone cognitive screening identified 11.5% as positive for cognitive dysfunction.

Risk and protective factors for Parkinson's disease: a study in Swedish twins.

Many studies have shown a protective effect of cigarette smoking on Parkinson's disease. However, criticism has been raised concerning confounding by genetic factors. We investigated the associations between Parkinson's disease and smoking, alcohol, coffee, area of living, and education in a co-twin control study.

A cladistic model of ACE sequence variation with implications for myocardial infarction, Alzheimer disease and obesity.

Sequence variation in ACE, which encodes angiotensin I converting enzyme, contributes to a large proportion of variability in plasma ACE levels, but the extent to which this impacts upon human disease is unresolved. Most efforts to associate ACE with other heritable traits have involved a single Alu insertion/deletion polymorphism, despite the probable existence of other functional sequence variants with effects that may not be consistently detectable by solely typing the Alu indel. Here, utilizing single nucleotide polymorphisms (SNPs) that differentiate major ACE clades in European populations, we demonstrate a number of significant phenotype associations across more than 4000 Swedish individuals.

Sensitivity and specificity of dementia coding in two Swedish disease registries.

The authors investigated the sensitivity and specificity of dementia identification in two Swedish disease registries by using clinical diagnoses from two population-based studies as gold standards. The probability of dementia detected by the Inpatient Discharge Registry was 55% for prevalent patients and 31% for incident patients and was higher than detection by the Cause of Death Registry. Specificity was 98% for the Inpatient Discharge Registry and 100% for the Cause of Death Registry.

No evidence for heritability of Parkinson disease in Swedish twins.

Background: Although several genes are implicated in Parkinson disease (PD), they explain only a small fraction of cases. The etiology of most cases is yet unknown.

Objective: To evaluate heritability of PD in same-sexed and opposite-sexed twin pairs in the Swedish Twin Registry (STR).

Gender differences in heritability of depressive symptoms in the elderly.

Background: The present study aimed to investigate the relative importance of genetic and environmental influences on depressive symptoms in the elderly.

Method: Depressive symptoms were assessed through the Center for Epidemiological Studies-Depression (CES-D) scale. The CES-D scale was administered to 959 twin pairs (123 female MZs, 90 male MZs, 207 same-sex female DZs, 109 same-sex male DZs and 430 opposite-sex DZs) aged 50 years or older (mean age 72 years).

Life review therapy using autobiographical retrieval practice for older adults with depressive symptomatology.

The aim of this study was to examine the efficacy of life review based on autobiographical retrieval practice for treating depressed older adults. Forty-three adults aged 65-93 with clinically significant depressive symptomatology and no dementia were randomly assigned to treatment or to no treatment. The results indicated significant differences between experimental and control groups after 4 weeks of autobiographical retrieval practice.

Genetic variants of ABCA1 modify Alzheimer disease risk and quantitative traits related to beta-amyloid metabolism.

Linkage studies have provided evidence that one or more loci on chromosome 9q influence Alzheimer disease (AD). The gene encoding the ATP-binding cassette A1 transporter (ABCA1) resides within proximity of previously identified linkage peaks and represents a plausible biological candidate for AD due to its central role in cellular lipid homeostasis. Several single nucleotide polymorphisms (SNPs) spanning ABCA1 have been genotyped and haplotype-based association analyses performed in four independent case-control samples, consisting of over 1,750 individuals from three European populations representing both early and late-onset AD.

Quality of life in geriatric generalized anxiety disorder: a preliminary investigation.

Objective: To examine the impact of late-life generalized anxiety disorder (GAD) on health-related quality of life.

Method: We compared quality of life in 75 treatment-seeking older adults with GAD, 39 of whom had psychiatric comorbidity, with 32 older adults without psychiatric illness. We examined predictors of quality of life in these samples.

Pathways to care for Alzheimer's disease among Korean Americans.

Little is known about how Korean Americans make decisions whether to seek help when, experiencing symptoms that might signal dementia. In Study 1, patient registry data for 60 Korean and 212 non-Korean Alzheimer's disease patients revealed that both groups waited 3-4 years before seeking help and sought help when memory decline was accompanied by other problems. Among Korean Americans, those living with family were more impaired than those living alone, suggesting greater, delay in seeking help.

Common variants of ACE contribute to variable age-at-onset of Alzheimer's disease.

Studies on the role that genetic variation may play in a complex human disease can be empowered by an assessment of both disease risk in case-control or family models and of quantitative traits that reflect elements of disease etiology. An excellent example of this can be found for the epsilon4 allele of APOE in relation to Alzheimer's disease (AD) for which association with both risk and age-at-onset (AAO) is evident. Following a recent demonstration that variants of the gene encoding angiotensin I converting enzyme ( ACE) contribute to AD risk, we have explored the potential influence of ACE upon AAO in AD.

How heritable is Alzheimer's disease late in life? Findings from Swedish twins.

Although genetic effects are known to be important for early onset Alzheimer's disease, little is known about the importance of genetic effects for late-onset disease. Furthermore, previous studies are based on prevalent cases. Our purpose was to characterize the relative importance of genetic and environmental factors for incident Alzheimer's disease late in life, and to test for differences in the importance of genetic effects at different ages.

Depressive symptoms and aging: the effects of illness and non-health-related events.

This study examined whether depressive symptoms increase with age longitudinally, and it evaluated two potential sources of influence-declining health and non-health-related negative life events. Adults aged 29-93 years from the Swedish Adoption/Twin Study of Aging completed the Center for Epidemiologic Studies-Depression scale three times at 3-year intervals. Analyses were performed on one twin (n = 877) and repeated on the second twin (n = 909) as a nonindependent replication.

The influence of mortality on twin models of change: addressing missingness through multiple imputation.

Twin analyses of phenotypes that are associated with mortality may provide biased heritability estimates if the models require that data from both members of a pair are available. This is particularly true when longitudinal analyses are applied to measures of cognition or biomarkers of aging. The effect of applying imputational techniques that include information on age at death was tested on longitudinal data from two twin studies of aging, each with up to four occasions of measurement.

Sex differences in genetic risk for dementia.

We used two Swedish twin samples to test whether women are at greater risk than men of developing dementia and whether there are sex differences in mechanisms underlying dementia and cognitive dysfunction. Dementia analyses found no sex differences in incidence of dementia or Alzheimer's disease among initially intact participants followed longitudinally. Twin analyses indicated a substantial genetic influence on liability to incident dementia.

Liquid chromatography-tandem mass spectrometric quantitative determination of the HIV protease inhibitor atazanavir (BMS-232632) in human peripheral blood mononuclear cells (PBMC): practical approaches to PBMC preparation and PBMC assay design for high-throughput analysis.

A selective, accurate, and reproducible LC/MS/MS assay was developed and validated for the determination of the HIV protease inhibitor atazanavir (BMS-232632) in human peripheral blood mononuclear cells (PBMC) samples. In addition to the details of the validated LC/MS/MS method, a practical procedure is described in great detail for the preparation of large supplies of control (blank) PBMC from units of blood (each unit of blood is about 500 ml) for making the calibration standards and quality control (QC) samples. The PBMC assay design, intended for high-throughput sample analysis, is also described in some detail in regards to the composition and concentration expressions of the calibration standards and QC samples, the lysing procedure of the PBMC samples, and the final analysis/quantitation procedure.

DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well.

This study compared 36 older adults with generalized anxiety disorder (GAD), 22 older adults with subsyndromal anxiety symptoms, and 32 normal controls on criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) for GAD. GAD patients reported more frequent and uncontrollable worry, somewhat different worry content, higher prevalence of most associated symptoms, and more distress or impairment than the subsyndromal group or normal controls.

Genetic variation in a haplotype block spanning IDE influences Alzheimer disease.

Linkage studies have identified a large (>60-Mb) region on chromosome 10q that segregates with Alzheimer Disease (AD). Within the region, the gene for insulin degrading enzyme (IDE) represents a notable biological candidate given that it degrades amyloid beta-protein (one of the major constituents of senile plaques) and the intracellular amyloid precursor protein (APP) domain released by gamma-secretase processing. We have used a single nucleotide polymorphism (SNP) genetic association strategy to investigate AD in relation to a 480-kb region encompassing IDE.

Does participation in leisure activities lead to reduced risk of Alzheimer's disease? A prospective study of Swedish twins.

This study examined whether participation in leisure activities during early and middle adulthood was associated with reduced risk of Alzheimer's disease. The sample consisted of 107 same-sex twin pairs discordant for dementia and for whom information on leisure activities was self-reported more than 20 years prior to clinical evaluation. A factor analysis of these activities yielded three activity factors: intellectual-cultural, self-improvement, and domestic activity.