Beyond health and economy: resource interactions in retirement adjustment.

Objectives: The retirement transition is a multidimensional and dynamic process of adjustment to new life circumstances. Research has shown that individual differences in resource capability accounts for a substantial amount of the previously observed heterogeneity in retirement adjustment. The aim of the present study was to investigate interaction effects of self-esteem, autonomy, social support, self-rated physical health, self-rated cognitive ability, and basic financial resources on levels and changes in life satisfaction in the retirement transition. Method: Our sample included 1924 older adults from the longitudinal population-based HEalth, Ageing, and Retirement Transitions in Sweden (HEARTS) study. The participants were assessed annually over a three-year period, covering the transition from work to retirement (n = 614). Participants continuously working (n = 1310) were included as a reference group. Results: Results from latent growth curve models showed that the relationship between a particular resource and levels and changes in life satisfaction varied depending on other available resources, but also that these effects varied between retirees and workers. Autonomy moderated the effect of physical resources, and social support and perceived cognitive ability moderated the effect of financial resources. Discussion: Our findings add to the current knowledge on retirement adjustment and suggest that negative effects of poor health and lack of basic financial resources on retirees life satisfaction may be compensated for by higher levels of autonomy, social support, and perceived cognitive ability.

The Gothenburg H70 Birth cohort study 2014-16: design, methods and study population.

To improve health care for older persons, we need to learn more about ageing, e.g. identify protective factors and early markers for diseases. The Gothenburg H70 Birth Cohort Studies (the H70 studies) are multidisciplinary epidemiological studies examining representative birth cohorts of older populations in Gothenburg, Sweden. So far, six birth cohorts of 70-year-olds have been examined over time, and examinations have been virtually identical between studies. This paper describes the study procedures for the baseline examination of the Birth cohort 1944, conducted in 2014-16. In this study, all men and women born 1944 on specific dates, and registered as residents in Gothenburg, were eligible for participation (n = 1839). A total of 1203 (response rate 72.2%; 559 men and 644 women; mean age 70.5 years) agreed to participate in the study. The study comprised sampling of blood and cerebrospinal fluid, psychiatric, cognitive, and physical health examinations, examinations of genetics and family history, use of medications, social factors, functional ability and disability, physical fitness and activity, body composition, lung function, audiological and ophthalmological examinations, diet, brain imaging, as well as a close informant interview, and qualitative studies. As in previous examinations, data collection serves as a basis for future longitudinal follow-up examinations. The research gained from the H70 studies has clinical relevance in relation to prevention, early diagnosis, clinical course, experience of illness, understanding pathogenesis and prognosis. Results will increase our understanding of ageing and inform service development, which may lead to enhanced quality of care for older persons.

Neuropathologic assessment of dementia markers in identical and fraternal twins.

Twin studies are an incomparable source of investigation to shed light on genetic and non-genetic components of neurodegenerative diseases, as Alzheimer's disease (AD). Detailed clinicopathologic correlations using twin longitudinal data and post-mortem examinations are mostly missing. We describe clinical and pathologic findings of seven monozygotic (MZ) and dizygotic (DZ) twin pairs. Our findings show good agreement between clinical and pathologic diagnoses in the majority of the twin pairs, with greater neuropathologic concordance in MZ than DZ twins. Greater neuropathologic concordance was found for ß-amyloid than tau pathology within the pairs. ApoE4 was associated with higher ß-amyloid and earlier dementia onset, and importantly, higher frequency of other co-occurring brain pathologies, regardless of the zygosity. Dementia onset, dementia duration, difference between twins in age at dementia onset and at death, did not correlate with AD pathology. These clinicopathologic correlations of older identical and fraternal twins support the relevance of genetic factors in AD, but not their sufficiency to determine the pathology, and consequently the disease, even in monozygotic twins. It is the interaction among genetic and non-genetic risks which plays a major role in influencing, or probably determining, the degeneration of those brain circuits associated with pathology and cognitive deficits in AD.

Psychological needs when diagnosed with testicular cancer: findings from a population-based study with long-term follow-up.

OBJECTIVE: To investigate the psychological needs of patients diagnosed with testicular cancer. PATIENTS AND METHODS: We identified 1192 eligible men diagnosed with non-seminomatous testicular cancer, treated according to the bi-national cancer-care programmes SWENOTECA I-IV between 1981 and 2004. Using a study-specific questionnaire we asked the survivors if they had experienced some kind of crisis attributable to their cancer diagnosis. We also asked if they were and, if not, if they wish they had been offered information about crisis and stress reactions and professional counselling. RESULTS: We obtained information from 974/1192 (82%) testicular cancer survivors diagnosed at a mean of 11 years before follow-up. Sixty-three percent reported that they had experienced a crisis owing to their diagnosis. For most men (76%) the crisis was at its worst at the time of diagnosis and treatment. Between 1981 and 2004, 145 men (15%) reported that they received information about common stress and crisis reactions and 348 (36%) reported that they were offered counselling. Of the men not informed about stress and crisis reactions and not offered counselling, 353/514 (69%) and 251/403 (62%), respectively, wish they had been. The percentage who reported that they wish that they had been informed or offered counselling did not differ significantly depending on civil status, age at diagnosis or stage of disease. CONCLUSIONS: The vast majority of Swedish testicular cancer survivors reported that they experienced a crisis because of their cancer diagnosis. Moreover, regardless of stage of disease, most men reported a need for psychological support at the time of diagnosis and treatment that was not satisfactorily met by the healthcare provision.

Classification models for early identification of persons at risk for dementia in primary care: an evaluation in a sample aged 80 years and older.

AIM: To evaluate previously developed classification models to make implementation in primary care possible and aid early identification of persons at risk for dementia. METHODS: Data were drawn from the OCTO-Twin study. At baseline, 521 persons >or= 80 years of age were nondemented, and for 387 a blood sample was available. Predictors of dementia were collected and analyzed in initially nondemented persons using generalized estimating equations and Cox survival analyses. RESULTS: In the basic model using predictors already known or easily obtained (basic set), the mean 2-year predictive value increased from 6.9 to 28.8% in persons with memory complaints and an MMSE score

Oral health in a population-based sample of the oldest-old: findings in twins 80 years and older in Sweden.

The aim of the study was to provide overall information on oral health markers and dental history in individuals aged 80 and older. The sample was drawn from the population-based Swedish Twin Registry and comprised monozygotic and same-sex dizygotic twins. The present analyses comprised a total of 357 individuals: 176 were edentulous and were interviewed by licensed nurses about their dental history, 181 were dentate and their dental records were reviewed. The dentate individuals had on average 13.9 teeth. Nearly a quarter (24%) had 20 or more natural teeth. Of the tooth surfaces, 9.3% were carious and 62.2% were filled or carious (DFS). Thirty-eight per cent of the individuals had fixed prostheses in the maxilla and 24% in the mandible. The fixed prostheses had on average 5 units. Twenty-two percent had removable partial dentures in the maxilla and 23% in the mandible. Fifty-one percent of the individuals had severe marginal bone loss. Periodontal treatment need was probably underdiagnosed since probing pocket depths were rarely recorded. Based on patient records from the last dental visit, the oral health of 30% was rated as bad while it was evaluated as good or satisfactory for 70%. Almost two-thirds (66%) of the dentate individuals made regular dental visits in the 1990s. The oral health of 134 individuals could be followed retrospectively up to 20 years. The oral health of 32%-41% of the patients was good or satisfactory and unchanged throughout the period while an appreciable deterioration was found in 17-21%. Interventions by a dental hygienist had been made only to a small extent. Advanced age in itself does not necessarily imply compromised oral health. The oral health of many individuals was stable and satisfactory for many years. Many remaining natural teeth and a great deal of prosthetic reconstructions indicate that among oldest-old individuals there is a significant potential for preserved oral health. In conjunction with the finding of extensive marginal bone loss this indicates, however, a need and demand for dental care as well as prophylactic support to maintain oral health despite age.