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  • 1.
    Fang, Fang
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
    Valdimarsdóttir, Unnur
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Centre of Public Health Sciences,University of Iceland, Reykjavik, Iceland.
    Fürst, Carl Johan
    Stockholms Sjukhem, Palliative Care Unit, Stockholm.
    Hultman, Christina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm; Department of Neuroscience, Psychiatry, Ulleråker,Uppsala University,Uppsala.
    Fall, Katja
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
    Sparén, Pär
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
    Ye, Weimin
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
    Suicide among patients with amyotrophic lateral sclerosis2008Inngår i: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 131, nr 10, s. 2729-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Studies on the suicide risk among patients with amyotrophic lateral sclerosis (ALS) in countries without legalized euthanasia or assisted suicide are important additions to data on the wish to die of these patients. We conducted a population-based cohort study in Sweden between 1965 and 2004, which comprised of 6,642 patients with incident ALS identified from the Swedish Inpatient Register. We calculated the standardized mortality ratios (SMRs) of suicide among the patients using the suicide rates of the general Swedish population as a reference. In total, 21 patients committed suicide during follow-up, compared to the predicted 3.6 suicides. Thus, we noted an almost 6-fold increased risk for suicide among ALS patients [SMR 5.8, 95% confidence interval (CI) 3.6-8.8]. Patients who committed suicide were, on average, around 7 years younger at the time of their first period of hospitalization than patients who did not commit suicide. The highest relative risk for suicide was observed within the first year after the patient's first period of hospitalization (SMR 11.2, 95% CI 5.8-19.6). After that, the relative risks decreased with time after hospitalization (P-value for trend = 0.006), but remained elevated 3 years later. The relative risks of suicide among ALS patients did not show a clear trend over time in contrast to the decreasing trend of relative risks for suicide among patients with cancer during the same period. Patients with ALS are at excess risk of suicide in Sweden and the relative risk is higher during the earlier stage of the disease.

  • 2.
    Vos, Stephanie J. B.
    et al.
    Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, The Netherlands.
    Verhey, Frans
    Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, The Netherlands.
    Frölich, Lutz
    Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany.
    Kornhuber, Johannes
    Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen, Erlangen, Germany.
    Wiltfang, Jens
    Department of Psychiatry and Psychotherapy, University Medical Centre (UMG), Georg-August-University, Göttingen, Germany.
    Maier, Wolfgang
    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany.
    Peters, Oliver
    Department of Psychiatry and Psychotherapy, Charité Berlin, Berlin, Germany.
    Rüther, Eckart
    Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany.
    Nobili, Flavio
    Clinical Neurophysiology Service, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy.
    Morbelli, Silvia
    Nuclear Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
    Frisoni, Giovanni B.
    IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy; University Hospitals and University of Geneva, Geneva, Switzerland.
    Drzezga, Alexander
    Department of Nuclear Medicine, University of Cologne, Cologne, Germany.
    Didic, Mira
    Service de Neurologie et Neuropsychologie, Pôle de neurosciences cliniques, AP-HM Timone, Aix Marseille Université, Marseille, France.
    van Berckel, Bart N. M.
    Department of Nuclear Medicine and PET Research, VU University Medical CentRE, Amsterdam, The Netherlands.
    Simmons, Andrew
    Department of Neuroimaging, Centre for Neuroimaging Science, King’s College London, Institute of Psychiatry, London, UK.
    Soininen, Hilkka
    Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland.
    Kłoszewska, Iwona
    Medical University of Lodz, Lodz, Poland.
    Mecocci, Patrizia
    Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy.
    Tsolaki, Magda
    Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, “G Papanicolaou” General Hospital, Thessaloniki, Greece.
    Vellas, Bruno
    UMR INSERM 1027, CHU Toulouse, Toulouse, France.
    Lovestone, Simon
    Department of Psychiatry, University of Oxford, Oxford, UK.
    Muscio, Cristina
    IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Fondazione Europea Ricerca Biomedica (FERB), Centro di Eccellenza Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
    Herukka, Sanna-Kaisa
    Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland; Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland.
    Salmon, Eric
    Memory Clinic, Department of Neurology, CHU Liège, Belgium; Cyclotron Research Centre, University of Liège, Liège, Belgium.
    Bastin, Christine
    Cyclotron Research Centre, University of Liège, Liège, Belgium.
    Wallin, Anders
    Department of Psychiatry and Neurochemistry, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nordlund, Arto
    Department of Psychiatry and Neurochemistry, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    de Mendonça, Alexandre
    Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal.
    Silva, Dina
    Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal.
    Santana, Isabel
    Department of Neurology, Coimbra University Hospital, Coimbra, Portugal.
    Lemos, Raquel
    Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Engelborghs, Sebastiaan
    Reference Centre for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Hospital Network Antwerp, Middelheim and Hoge Beuken, Antwerp, Belgium.
    Van der Mussele, Stefan
    Reference Centre for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium.
    Freund-Levi, Yvonne
    Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Wallin, Åsa K.
    Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden.
    Hampel, Harald
    Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France.
    van der Flier, Wiesje
    Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
    Scheltens, Philip
    Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
    Visser, Pieter Jelle
    Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Alzheimer Centre Limburg, Maastricht, The Netherlands; Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
    Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage2015Inngår i: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 138, nr 5, s. 1327-1338Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage according to these criteria. Subjects with mild cognitive impairment (n = 1607), 766 of whom had both amyloid and neuronal injury markers, were recruited from 13 cohorts. We used cognitive test performance and available biomarkers to classify subjects as prodromal Alzheimer's disease according to International Working Group-1 and International Working Group-2 criteria and in the high Alzheimer's disease likelihood group, conflicting biomarker groups (isolated amyloid pathology or suspected non-Alzheimer pathophysiology), and low Alzheimer's disease likelihood group according to the National Institute of Ageing-Alzheimer Association criteria. Outcome measures were the proportion of subjects with Alzheimer's disease at the mild cognitive impairment stage and progression to Alzheimer's disease-type dementia. We performed survival analyses using Cox proportional hazards models. According to the International Working Group-1 criteria, 850 (53%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 50% compared to 21% for subjects without prodromal Alzheimer's disease. According to the International Working Group-2 criteria, 308 (40%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 61% compared to 22% for subjects without prodromal Alzheimer's disease. According to the National Institute of Ageing-Alzheimer Association criteria, 353 (46%) subjects were in the high Alzheimer's disease likelihood group, 49 (6%) in the isolated amyloid pathology group, 220 (29%) in the suspected non-Alzheimer pathophysiology group, and 144 (19%) in the low Alzheimer's disease likelihood group. The 3-year progression rate to Alzheimer's disease-type dementia was 59% in the high Alzheimer's disease likelihood group, 22% in the isolated amyloid pathology group, 24% in the suspected non-Alzheimer pathophysiology group, and 5% in the low Alzheimer's disease likelihood group. Our findings support the use of the proposed research criteria to identify Alzheimer's disease at the mild cognitive impairment stage. In clinical settings, the use of both amyloid and neuronal injury markers as proposed by the National Institute of Ageing-Alzheimer Association criteria offers the most accurate prognosis. For clinical trials, selection of subjects in the National Institute of Ageing-Alzheimer Association high Alzheimer's disease likelihood group or the International Working Group-2 prodromal Alzheimer's disease group could be considered.

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