H85 H85 ext0204-1-1 Swedish National Data Service Svensk nationell datatjänst http://neurophys.gu.se/digitalAssets/1533/1533661_avhanbo6_is.pdf H85 H85 ext0204-1-1 Skoog, Ingmar Skoog, Ingmar Swedish National Data Service Svensk nationell datatjänst NEAR - National E-Infrastructure for Aging Research in Sweden The global increase in life expectancy is one of the greatest achievements of the last half century. However, the demographic development towards an older population poses tremendous societal and medical challenges globally, especially in developed countries such as Sweden. Promoting healthy ageing is therefore one of the most important commitments of the 21st century and to succeed, scientifically based knowledge of older individuals’ health- and care requirements are needed. To better understand the individual and population aging process, the National E-infrastructure for Aging Research (NEAR) was founded in 2018 to build and run a national infrastructure by integrating existing databases from the major population-based longitudinal studies on aging and health in Sweden. NEAR comprises 15 databases located at 8 different universities, which allows comparison, integration, and pooling of data from a large Swedish sample of 180 000 older adults aged 50+ years. NEAR includes information on clinical, biological, social, and environmental data that are assessed at the individual level by physicians, nurses, and psychologists on several occasions during a follow-up period ranging between 12 and 52 years. The creation of a national infrastructures, such as NEAR, is needed to achieve broad, multidisciplinary research perspectives that cannot be achieved by individual databases. Moreover, to address the increased health demands of an older population and enhance new opportunities for aging research, a critical mass of data is needed to increase sample sizes, variations, representativeness, and generalizability. Ultimately, this can lead to the identification of sustainable intervention strategies for better health and care for older persons in Sweden during the coming decades. Den globalt ökade livslängden är en av de senaste halvseklets största landvinningar. Men den demografiska utvecklingen mot en äldre befolkning innebär även enorma samhälleliga och medicinska utmaningar globalt och särskilt i utvecklade länder som Sverige. Att främja ett hälsosamt åldrande är därför en av 2000-talets viktigaste åtaganden och för att lyckas behövs vetenskapligt baserad kunskap om äldres hälsa och vårdbehov. För att bättre förstå åldrandet utifrån ett individuellt samt grupperspektiv grundades den nationella e-infrastrukturen för äldreforskning (NEAR) år 2018. Denna nationella infrastruktur har byggts upp och drivs genom att integrera befintliga databaser från de största populationsbaserade longitudinella studierna om åldrande och hälsa i Sverige. NEAR består av 15 databaser från 8 olika universitet vilket möjliggör jämförelse, integrering och sammanslagning av data från ett stort urval av 180 000 individer som är 50 år och äldre. NEAR tillhandahåller kliniska, biologiska, sociala och miljömässiga data som samlats in på individnivå av läkare, sjuksköterskor och psykologer vid upprepade tillfällen över en uppföljningsperiod som varierar mellan 12 och 52 år. En nationell infrastruktur som NEAR behövs för att uppnå multidisciplinära forskningsperspektiv som inte kan åstadkommas genom användandet av enskilda databaser. För att ta itu med de ökade hälsoutmaningarna som kommer med en åldrande befolkning, samt förbättra nya möjligheter till äldreforskning behövs dessutom en kritisk massa av data för att öka urval, variation, representativitet och generaliserbarhet. I slutändan kan detta leda till utvecklandet av hållbara interventionsstrategier för bättre hälsa och omsorg av äldre i Sverige under de kommande decennierna. http://neurophys.gu.se/digitalAssets/1533/1533661_avhanbo6_is.pdf Aged Äldre Psychology Psykologi Physical Examination Hälsokontroll Dementia Demens Psychiatry Psykiatri Geriatric Psychiatry Äldrepsykiatri Geriatric Nursing Äldrevård Memory Minne Longitudinal Studies Longitudinella studier Risk Factors Riskfaktorer Mortality Dödlighet Health Hälsa HEALTH HÄLSA Elderly Äldre 'H85' is one of the longitudinal studies from Gothenburg where representative populations of older people has been followed over a long period (information about the studies H70, 95+ and Kvinnoundersökningen KVUS can be found under Related studies). This is a multidisciplinary study of representative samples of 85-year olds in Göteborg, which started in 1986. At the baseline examination during 1986/87 all 85-year-olds born between July 1, 1901 and June 30, 1902 and living in Gothenburg were invited to a health examination. Half of them were also examined by a psychiatrist (n=494). Participants were followed up at age 88, 90, 92, 95, 97, 99, 100, 101, 102, 103, 104 and 105. The study surveys have been conducted in 1986/87, 1989, 1991, 1993, 1996, 1998, 2000, 2001, 2002, 2003, 2004, 2005 and 2006. A second cohort of 85-year-olds born between July 1, 1923 and June 30, 1924 was invited to the study. At the baseline examination (2008-2010), 572 individuals participated, representing a response rate of 60 %. Participants were followed up at age 88 and 90. The study surveys have been conducted in 2008-2010, 2011, 2013 and 2018. Re-examinations are planned for 2021. Cohort three of 85-year-olds was included in 2015‒16, where 491 persons born 1930 were examined. Re-examinations are planned at ages 91 and 95. The examination procedures at each study have been retained as identical as possible to provide results that can be compared over time. The study comprises a psychiatric interview, physical examination, psychological tests, blood samples with extensive laboratory analysis and a close informant interview. It also includes collecting data related to socioeconomic status, marital status, living conditions, housing situation, education, religion, hobbies and life events. Neurobiological investigations in the form of computed tomography (CT) and magnetic resonance imaging (MRI) of the brain and spinal puncture and analysis of brain-spinal fluid are also carried out. Medical records from all major hospitals, geriatric and psychiatric institutions and outpatient clinics in Gothenburg are evaluated to find cases of psychiatric and somatic diseases. Dementia, depression, psychotic disorders, sleep disorders, anxiety disorders, and post-traumatic stress disorder (PTSD) are diagnosed according to DSM-III-R and DSM-IV. Somatic diseases are classified according to established criteria. The purpose is to investigate the frequency of, and which factors that are associated with psychiatric and somatic diseases in a population 85-years-old followed longitudinally. H85-studien är en av de longitudinella studierna från Göteborg där representativa populationer av äldre har följts över lång tid (information om studierna H70, 95+ och Kvinnoundersökningen finns under Relaterade studier). H85-studien koordineras gemensamt av flera forskargrupper men bedrivs huvudsakligen vid enheten för neuropsykiatrisk epidemiologi - EPINEP. Vid baslinjemätningens hälsoundersökning år 1986/87 inbjöds alla 85-åringar i Göteborg födda 1 juli 1901 till 30 juni 1902 till en hälsoundersökning, hälften av dessa undersöktes av psykiatriker (n=494). Deltagarna har följts upp vid 88-, 90-, 92-, 95-, 97, 99-, 100-, 101, 102- 103- , 104- och 105-års ålder. Svarsfrekvensen har omfattat omkring 65-80%. Studiens undersökningar har genomförts år 1986/87, 1989, 1991, 1993, 1996, 1998, 2000, 2001, 2002, 2003, 2004, 2005, och år 2006. En andra kohort av 85-åringar födda mellan 1 juli 1923 till och med 30 juni 1924 bjöds in till att delta i studien. Baslinjemätningens undersökning genomfördes under 2008-2010. Antalet deltagare vid baslinjemätningen var 572, vilket motsvarade en svarsfrekvens på omkring 60 %. Deltagarna har därefter följts upp vid 88- och 90 års ålder. Studiens undersökningar har genomförts år 2008-2010, 2011, 2013 samt 2018. Deltagarna planeras att följas upp 2021. En tredje kohort av 85-åringar födda 1930 inkluderades 2015-16 då 491 individer undersöktes. Deltagarna har följts upp vid 88 års ålder och planeras att undersökas 2021. Undersökningen omfattar psykiatrisk intervju, somatiska undersökningar, tester av sjukgymnast, psykologtest, blodprov med omfattande laboratorieanalyser samt anhörigintervju. Vidare samlas data in relaterad till socioekonomisk status, civilstånd, levnadsvillkor, bostadssituation, utbildning, religiositet, hobbys och livshändelser. Slutligen ingår neurobiologisk undersökning i form av datortomografi (CT) och magnetröntgen (MR) av hjärnan samt lumbalpunktion och analys av hjärn-ryggmärgsvätska. Journaler från alla större sjukhus, geriatriska och psykiatriska institutioner samt polikliniska mottagningar i Göteborg granskas för att finna fall av psykiska och somatiska sjukdomar. Demens, depression, psykotiska sjukdomar, sömnproblem, ångestsjukdomar, och post-traumatiskt stresssyndrom (PTSS) diagnostiseras enligt DSM-III-R och DSM-IV. Somatiska sjukdomar klassificeras enligt etablerade kriterier. Syftet är att undersöka frekvens av, samt vilka faktorer som är av betydelse för utveckling av psykisk- och somatisk sjukdom i en population som har följts longitudinellt från 85 års ålder. Sweden Sverige IndividualIndividual IndividIndivid The population originally consisted of a representative sample of 85-year-old men and women born in 1901/1902 and living in Gothenburg 1986/1987. Den ursprungliga populationen bestod av ett representativt urval av 85-åriga män och kvinnor födda 1901/1902 och boende i Göteborg 1986/1987, som sedan följts longitudinellt. Fler kohorter av 85-åringar har inkluderats i studien. Numeric Longitudinal: Cohort/Event-basedLongitudinal: Cohort/Event-based Longitudinell: Kohort/HändelsebaseradLongitudinell: Kohort/Händelsebaserad The study participants were mainly drawn as a representative, systematic sample from the population register.The study participants were mainly drawn as a representative, systematic sample from the population register. Deltagarna har huvudsakligen valts ut genom ett representativt, systematiskt urval från befolkningsregistret.Deltagarna har huvudsakligen valts ut genom ett representativt, systematiskt urval från befolkningsregistret. Probability: Systematic randomProbability: Systematic random Sannolikhetsurval: systematiskt slumpmässigt urvalSannolikhetsurval: systematiskt slumpmässigt urval InterviewInterview IntervjuIntervju Access to data through an external actor. Access to data is restricted. Åtkomst till data via extern aktör. Tillgång till data är begränsad. restrictedAccess Liebetrau M, Steen B, Skoog I. Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds. Stroke 2008;39:1960-1965. Liebetrau M, Steen B, Skoog I. Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds. Stroke 2008;39:1960-1965. 2008 Aevarsson O, Svanborg A, Skoog I. Seven-year survival after age 85 years. Relation to Alzheimer disease and vascular dementia. Arch Neurol 1998;55:1226-1232. Aevarsson O, Svanborg A, Skoog I. Seven-year survival after age 85 years. Relation to Alzheimer disease and vascular dementia. Arch Neurol 1998;55:1226-1232. 1998 Skoog I, Vanmechelen E, Andreasson L-A, Palmertz B, Davidsson P, Hesse C, Blennow K. A population-based study of tau protein and ubiquitin in cerebrospinal fluid in 85-year-olds: relation to severity of dementia and cerebral atrophy, but not to the apolipoprotein E4 allele. Neurodegeneration 1995;4:433-442. Skoog I, Vanmechelen E, Andreasson L-A, Palmertz B, Davidsson P, Hesse C, Blennow K. A population-based study of tau protein and ubiquitin in cerebrospinal fluid in 85-year-olds: relation to severity of dementia and cerebral atrophy, but not to the apolipoprotein E4 allele. Neurodegeneration 1995;4:433-442. 1995 Skoog I, Hesse C, Fredman P, Andreasson L-A, Palmertz B, Blennow K. Apolipoprotein E in cerebrospinal fluid in 85-year-olds. Relation to dementia, apolipoprotein E polymorphism, cerebral atrophy, and white-matter lesions. Arch Neurol 1997; 54: 267-272. Skoog I, Hesse C, Fredman P, Andreasson L-A, Palmertz B, Blennow K. Apolipoprotein E in cerebrospinal fluid in 85-year-olds. Relation to dementia, apolipoprotein E polymorphism, cerebral atrophy, and white-matter lesions. Arch Neurol 1997; 54: 267-272. 1997 Skoog I, Steen B, Persson G, Nilsson L, Aevarsson O, Larsson L, Östling S. A 15-year longitudinal cross-sectional population study on sleep in the elderly. Facts and research in gerontology 1993;7:137-146. Skoog I, Steen B, Persson G, Nilsson L, Aevarsson O, Larsson L, Östling S. A 15-year longitudinal cross-sectional population study on sleep in the elderly. Facts and research in gerontology 1993;7:137-146. 1993 Skoog I, Nilsson L, Landahl S, Steen B. Mental disorders and the use of psychotropic drugs in an 85-year-old urban population. Int Psychogeriatrics 1993;5:33-48. Skoog I, Nilsson L, Landahl S, Steen B. Mental disorders and the use of psychotropic drugs in an 85-year-old urban population. Int Psychogeriatrics 1993;5:33-48. 1993 Skoog I, Andreasson L-A, Palmertz B, Lernfeldt B, Landahl S, Steen B, Svanborg A. Vascular factors and dementia in 85-year-olds. In: Bergener M, Brocklehurst JC, Finkel SI (eds). Aging, Health, and Healing. New York: Springer Publishing Company Inc 1995; 49-55. Skoog I, Andreasson L-A, Palmertz B, Lernfeldt B, Landahl S, Steen B, Svanborg A. Vascular factors and dementia in 85-year-olds. In: Bergener M, Brocklehurst JC, Finkel SI (eds). Aging, Health, and Healing. New York: Springer Publishing Company Inc 1995; 49-55. 1995 Skoog I, Nilsson L, Svanborg A. The authors reply: A population-based study of dementia in 85-year-olds. N Engl J Med 1993;329:363. Skoog I, Nilsson L, Svanborg A. The authors reply: A population-based study of dementia in 85-year-olds. N Engl J Med 1993;329:363. 1993 Skoog I, Palmertz B, Andreasson L-A. The prevalence of white matter lesions on computed tomography of the brain in demented and non-demented 85-year-olds. J Geriatr Psychiatry Neurol 1994;7:169-175. Skoog I, Palmertz B, Andreasson L-A. The prevalence of white matter lesions on computed tomography of the brain in demented and non-demented 85-year-olds. J Geriatr Psychiatry Neurol 1994;7:169-175. 1994 Östling S, Johansson B, Skoog I. Cognitive test performance in relation to psychotic symptoms and paranoid ideation in non-demented 85-year-olds. Psychol Med 2004;34:443-450. Östling S, Johansson B, Skoog I. Cognitive test performance in relation to psychotic symptoms and paranoid ideation in non-demented 85-year-olds. Psychol Med 2004;34:443-450. 2004 Sacuiu S, Sjögren M, Gustafson D, Skoog I. Prodromal cognitive signs of dementia in 85-year-olds using four sources of information. Neurology 2005;65:1894-1900. Sacuiu S, Sjögren M, Gustafson D, Skoog I. Prodromal cognitive signs of dementia in 85-year-olds using four sources of information. Neurology 2005;65:1894-1900. 2005 Palsson S, Aevarsson O, Skoog I. Depression, cerebral atrophy, cognitive performance and incidence of dementia. Population study of 85-year-olds. Brit J Psychiatr 1999;174:249-253. Palsson S, Aevarsson O, Skoog I. Depression, cerebral atrophy, cognitive performance and incidence of dementia. Population study of 85-year-olds. Brit J Psychiatr 1999;174:249-253. 1999 Östling S, Gustafson D, Blennow K, Börjesson-Hanson A, Waern M. Psychotic symptoms in a population-based sample of 85-year-old individuals with dementia. J Geriatr Psychiatry Neurol. 2011 Mar;24(1):3-8. Östling S, Gustafson D, Blennow K, Börjesson-Hanson A, Waern M. Psychotic symptoms in a population-based sample of 85-year-old individuals with dementia. J Geriatr Psychiatry Neurol. 2011 Mar;24(1):3-8. 2011 Nilsson L, Persson G, Skoog I. Unik Svensk undersökning i Göteborg 85-åringar positiva till sexundersökningar. Ottar 1988;113-118. Nilsson L, Persson G, Skoog I. Unik Svensk undersökning i Göteborg 85-åringar positiva till sexundersökningar. Ottar 1988;113-118. 1988 Hellström L, Milsom I, Ekelund P, Skoog I. The influence of dementia on the prevalence of urinary and faecal incontinence in 85-year old men and women. Archives of Gerontology and Geriatrics 1994;19:11-20. Hellström L, Milsom I, Ekelund P, Skoog I. The influence of dementia on the prevalence of urinary and faecal incontinence in 85-year old men and women. Archives of Gerontology and Geriatrics 1994;19:11-20. 1994 Skoog I. Sex and Swedish 85-year-olds. N Engl J Med 1996;334:1140-1141. Skoog I. Sex and Swedish 85-year-olds. N Engl J Med 1996;334:1140-1141. 1996 Palsson S, Johansson B, Berg S, Skoog I. A population study on the influence of depression on neuropsychological functioning in 85-year-olds. Acta Psychiatr Scand 2000;101:185-193. Palsson S, Johansson B, Berg S, Skoog I. A population study on the influence of depression on neuropsychological functioning in 85-year-olds. Acta Psychiatr Scand 2000;101:185-193. 2000 Olesen PJ, Guo X, Gustafson D, Börjesson-Hanson A, Sacuíu S, Eckerström C, Bigler ED, Skoog I. A population-based study on the influence of brain atrophy on 20-year survival after age 85. Neurology 2011;76(10):879-86 Olesen PJ, Guo X, Gustafson D, Börjesson-Hanson A, Sacuíu S, Eckerström C, Bigler ED, Skoog I. A population-based study on the influence of brain atrophy on 20-year survival after age 85. Neurology 2011;76(10):879-86 2011 Liebetrau M, Steen B, Hamann GF, Skoog I. Silent and symptomatic infarcts on cranial computerized tomography in relation to dementia and mortality. A populationbased study in 85-year-olds. Stroke 2004;35:1816-1820. Liebetrau M, Steen B, Hamann GF, Skoog I. Silent and symptomatic infarcts on cranial computerized tomography in relation to dementia and mortality. A populationbased study in 85-year-olds. Stroke 2004;35:1816-1820. 2003 Skoog I, Hesse C, Aevarsson O, Landahl S, Wahlström J, Fredman P, Blennow K. A population study of Apo E genotype at the age of 85: relation to dementia, cerebrovascular disease and mortality. J Neurol Neurosur Psychiatr 1998;64:37-43. Skoog I, Hesse C, Aevarsson O, Landahl S, Wahlström J, Fredman P, Blennow K. A population study of Apo E genotype at the age of 85: relation to dementia, cerebrovascular disease and mortality. J Neurol Neurosur Psychiatr 1998;64:37-43. 1998 Skoog I, Berg S, Johansson B, Palmertz B, Andreasson L-A. The influence of white matter lesions on neuropsychological functioning in demented and non-demented 85-year-olds. Acta Neurol Scand 1996;93:142-148. Skoog I, Berg S, Johansson B, Palmertz B, Andreasson L-A. The influence of white matter lesions on neuropsychological functioning in demented and non-demented 85-year-olds. Acta Neurol Scand 1996;93:142-148. 1996 Skoog I, Aevarsson O, Beskow J, Larsson L, Palsson S, Waern M, Landahl S, Östling, S. Suicidal feelings in a population sample of non-demented 85-year-olds. Am J Psychiatry 1996;153:1015-1020. Skoog I, Aevarsson O, Beskow J, Larsson L, Palsson S, Waern M, Landahl S, Östling, S. Suicidal feelings in a population sample of non-demented 85-year-olds. Am J Psychiatry 1996;153:1015-1020. 1996 Liebetrau M, Steen B, Skoog I. Stroke in 85-year-olds. Prevalence, incidence, risk factors and relation to mortality and dementia. Stroke 2003;34:2617-2622. Liebetrau M, Steen B, Skoog I. Stroke in 85-year-olds. Prevalence, incidence, risk factors and relation to mortality and dementia. Stroke 2003;34:2617-2622. 2003 Skoog I. The prevalence of psychotic, depressive and anxiety syndromes in demented and non-demented 85-year-olds. Int J Geriatric Psychiatry 1993;8:247-253. Skoog I. The prevalence of psychotic, depressive and anxiety syndromes in demented and non-demented 85-year-olds. Int J Geriatric Psychiatry 1993;8:247-253. 1993 Johansson C, Skoog I. A population-based study on the association between dementia and hip fractures in 85-year-olds. Aging Clin Exp Res 1996;8:189-196. Johansson C, Skoog I. A population-based study on the association between dementia and hip fractures in 85-year-olds. Aging Clin Exp Res 1996;8:189-196. 1996 Skoog I. Andresson L-A, Palmertz B, Landahl S, Lernfelt B. A population-based study on blood pressure and brain atrophy in 85-year-olds. Hypertension 1998; 32: 404-409. Skoog I. Andresson L-A, Palmertz B, Landahl S, Lernfelt B. A population-based study on blood pressure and brain atrophy in 85-year-olds. Hypertension 1998; 32: 404-409. 1998 Skoog I, Davidsson P, Aevarsson O, Vanderstichele H, Vammechelen E, Blennow K. Cerebrospinal Fluid Beta-Amyloid 42 Is Reduced before the Onset of Sporadic Dementia: A Population-Based Study in 85-Year-Olds. Dement geriatr Cogn Disord 2003;15:169-176. Skoog I, Davidsson P, Aevarsson O, Vanderstichele H, Vammechelen E, Blennow K. Cerebrospinal Fluid Beta-Amyloid 42 Is Reduced before the Onset of Sporadic Dementia: A Population-Based Study in 85-Year-Olds. Dement geriatr Cogn Disord 2003;15:169-176. 2003 Skoog I, Nilsson L, Palmertz B, Andreasson L-A, Svanborg A. A population-based study of dementia in 85-year-olds. N Engl J Med 1993; 328:153-158 Skoog I, Nilsson L, Palmertz B, Andreasson L-A, Svanborg A. A population-based study of dementia in 85-year-olds. N Engl J Med 1993; 328:153-158 1993 Skoog I, Wallin A, Fredman P, Hesse C, Aevarsson O, Karlsson I, Gottfries CG, Blennow K. A population-study on blood-brain barrier function in 85-year-olds. Relation to Alzheimer’s disease and vascular dementia. Neurology 1998;50:966-971. Skoog I, Wallin A, Fredman P, Hesse C, Aevarsson O, Karlsson I, Gottfries CG, Blennow K. A population-study on blood-brain barrier function in 85-year-olds. Relation to Alzheimer’s disease and vascular dementia. Neurology 1998;50:966-971. 1998