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Externalizing Behaviors and Alzheimer's Disease and Any Dementia: A Multigeneration Cohort Study in Sweden
Örebro University, School of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0001-6656-8836
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Örebro University, School of Behavioural, Social and Legal Sciences.ORCID iD: 0000-0002-8163-6558
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2023 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 7, no 9, article id igad117Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: We examined the extent to which externalizing behaviors such as violent and nonviolent criminal behavior, and substance use disorders (SUD) are associate with the onset of Alzheimer's disease (AD) and any dementia in prior generations.

RESEARCH DESIGN AND METHODS: A nationwide cohort of 2,463,033 individuals born between 1973 and 1997 (index persons) were linked to their biological relatives (parents, grandparents, and uncles/aunts) using Swedish national registers. Cox regression models were used to examine the association between each measure of externalizing behaviors with AD and any dementia in each of the relative cohorts.

RESULTS: Parents of index persons with externalizing behaviors had an increased risk for AD compared with parents of index persons without externalizing behaviors-nonviolent criminal behavior: Hazard Ratio (HR) = 1.16, 95% Confidence Intervals (CI) 1.10-1.22; violent criminal behavior: HR = 1.32 (95% CI: 1.19-1.45); SUD: HR = 1.28 (95% CI: 1.17, 1.40). The associations attenuated with decreasing familial relatedness. Relatives of individuals with externalizing behaviors compared with relatives of individuals without, showed an increased risk of having both early-onset and late-onset AD but the strength of the associations was higher for early-onset AD than for late-onset AD. A similar pattern of results was observed for the association with any dementia.

DISCUSSION AND IMPLICATIONS: Externalizing behaviors are associated with AD and any dementia in prior generations. The associations were stronger for parents in comparison with grandparents and uncles/aunts, suggesting shared familial risks between conditions. This warrants further studies examining common genetic and family-wide environmental factors that may contribute to identifying common underlying mechanisms to the development of externalizing behaviors, AD, and any dementia.

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 7, no 9, article id igad117
Keywords [en]
Criminal behavior, Epidemiology, Family design, Major neurodegenerative disorders, Substance abuse
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:oru:diva-109961DOI: 10.1093/geroni/igad117ISI: 001106048000002PubMedID: 38024330Scopus ID: 2-s2.0-85178100452OAI: oai:DiVA.org:oru-109961DiVA, id: diva2:1815795
Funder
EU, Horizon 2020, 754285Swedish Research Council, 2018-02599; 2018-02213; 2021-06370The Swedish Brain Foundation, FO2021-0115Available from: 2023-11-30 Created: 2023-11-30 Last updated: 2024-02-26Bibliographically approved
In thesis
1. The impact of criminal and externalizing behaviors on aging: Long-term associations with health and dementia
Open this publication in new window or tab >>The impact of criminal and externalizing behaviors on aging: Long-term associations with health and dementia
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Previous studies have shown that criminal and other externalizing behaviors are associated with several adverse outcomes, but very little is known about the impact of these behaviors beyond middle adulthood. Few studies have explored how a life-course background of criminal and externalizing behaviors influence aging and more specifically, whether it is associated with the onset and development of different neurodegenerative, mental, and physical health disorders when aging. The overarching aim of this dissertation is to advance the knowledge about the long-term influence that criminal and other externalizing behaviors along the lifespan may have on health and neurodegeneration while individuals age. This aim was explored throughout three studies: Study I, a systematic review and meta-analysis performed to investigate the prevalence of several mental and physical health problems of older offenders; Study II, a Swedish population-based register study which examined how the severity of the criminal background associated with dementia and mild cognitive impairment (MCI), and how several life-course factors influenced these associations and; Study III, a multi-generation cohort study investigating whether externalizing behaviors and dementia co-aggregate in families. The main findings suggest that older adults with criminal and externalizing behavioral backgrounds, and overall, those with a severe criminal history, exhibit an increased liability to develop physical and mental health problems as well as MCI and dementia when aging. This increased risk is influenced by life-course health and psychosocial problems as well as genetic and familial environmental factors. In general, findings from this thesis point towards a better understanding of the aging process of individuals with this background, and to further the scientific knowledge about the influence of life-course adverse behaviors on aging. This knowledge may promote the development of preventive and interventive strategies for individuals with a criminal and externalizing behavioral background.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2024. p. 96
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 48
Keywords
Older adults, aging, criminal behavior, externalizing behaviors, violent crime, dementia, Alzheimer's diseases, mental health, physical health, epidemiology
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-111219 (URN)9789175295411 (ISBN)9789175295428 (ISBN)
Public defence
2024-03-22, Örebro universitet, Hörsal M, Musikhögskolan, Fakultetsgatan 1, Örebro, 09:15 (English)
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Supervisors
Available from: 2024-01-30 Created: 2024-01-30 Last updated: 2024-05-02Bibliographically approved

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Solares, CarmenAndershed, HenrikPersson, JonasLarsson, Henrik

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