Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Showing posts with label sweden. Show all posts
Showing posts with label sweden. Show all posts

Saturday, March 21, 2026

High meat consumption linked to lower dementia risk in genetic risk group

 I'm sure your doctor won't approve but ASK FOR EXACT SPECIFICS ON WHY NOT!

High meat consumption linked to lower dementia risk in genetic risk group

High meat consumption linked to lower dementia risk in genetic risk group

Photo: Getty Images

Older people with a genetic risk of Alzheimer's disease did not experience the expected increase in cognitive decline and dementia risk if they consumed relatively large amounts of meat. This is shown in a new study from Karolinska Institutet published in JAMA Network Open. The results may contribute to the development of more individually tailored dietary advice.

APOE is a gene that affects the risk of Alzheimer's disease. In Sweden, approximately 30 per cent of the population are carriers of the gene combinations APOE 3/4 or APOE 4/4. Among people with Alzheimer's disease, those with these genotypes account for nearly 70 per cent.

When the Swedish Food Agency presented an overview of research on the link between diet and dementia last year, more research was requested to assess a possible link between meat consumption and the development of dementia.

Jakob Norgren. Foto: Ulf Sirborn

‘This study tested the hypothesis that people with APOE 3/4 and 4/4 would have a reduced risk of cognitive decline and dementia with higher meat intake, based on the fact that APOE4 is the evolutionarily oldest variant of the APOE gene and may have arisen during a period when our evolutionary ancestors ate a more animal-based diet,’ says first author Jakob Norgren, researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.

The study followed more than 2,100 participants in the Swedish National Study on Aging and Care, Kungsholmen (SNAC-K) for up to 15 years. All were aged 60 or older and had no diagnosis of dementia at the start of the study. The association between self-reported diet and cognitive health measures was analysed, adjusting for age, sex, education and lifestyle factors.

Twice the risk of dementia

At lower meat intake, the group with APOE 3/4 and 4/4 had more than twice the risk of dementia than people without these gene variants. However, the increased risk of cognitive decline and dementia in the risk groups was not seen in the fifth of participants who consumed the most meat. Their median consumption is estimated at approximately 870 grams of meat per week, standardised to a daily energy intake of 2,000 calories.

‘Those who ate more meat overall had significantly slower cognitive decline and a lower risk of dementia, but only if they had the APOE 3/4 or 4/4 gene variants,’ says Jakob Norgren. He continues: 

‘There is a lack of dietary research into brain health, and our findings suggest that conventional dietary advice may be unfavourable to a genetically defined subgroup of the population. For those who are aware that they belong to this genetic risk group, the findings offer hope; the risk may be modifiable through lifestyle changes. ‘

Portrait of the researcher Sara Garcia Ptacek.
Sara Garcia Ptacek. Foto: Privat

The study also shows that the type of meat is important.

‘A lower proportion of processed meat in total meat consumption was associated with a lower risk of dementia regardless of APOE genotype,’ says Sara Garcia-Ptacek, assistant professor at the same department, who together with senior lecturer Erika J Laukka is the study's last author.

The findings also extend beyond brain health. In a follow-up analysis, the researchers observed a significant reduction in all-cause-mortality in carriers of APOE 3/4 and 4/4 with higher consumption of unprocessed meat.

However, the study is observational and needs to be followed up with intervention studies that can better demonstrate causal relationships.

‘Clinical trials are now needed to develop dietary recommendations tailored to APOE genotype,’ says Jakob Norgren. He continues:

‘Since the prevalence of APOE4 is about twice as high in the Nordic countries as in the Mediterranean countries, we are particularly well suited to conduct research on tailored dietary recommendations for this risk group.’

The research was funded by, among others, the Swedish Alzheimer's Foundation, the Swedish Dementia Foundation, the Emil and Wera Cornell Foundation, the Leif Lundblad family and other philanthropists, the Swedish Research Council and FORTE. The researchers state that they have no related conflicts of interest.

Publication

”Meat Consumption and Cognitive Health by APOE Genotype”, Jakob Norgren, Adrián Carballo-Casla, Giulia Grande, Anne Börjesson-Hanson, Hong Xu, Maria Eriksdotter, Erika J Laukka, Sara Garcia-Ptacek, JAMA Network Open, online March 19, 2026, doi:10.1001/ jamanetworkopen.2026.6489

Facts:

Apolipoprotein E plays a central role in the transport of cholesterol and fats in the brain and blood. The protein is encoded by the APOE gene, which exists in three main variants: epsilon 2, 3 and 4. These variants affect the risk of developing Alzheimer's disease and cardiovascular disease. Each person inherits two APOE genes, one from each parent, giving six possible combinations (genotypes): 2/2, 2/3, 2/4, 3/3, 3/4 and 4/4.

Compared to the most common genotype 3/3, one 4 variant increases the risk of Alzheimer's disease by about three to four times and two 4 variants by about ten to fifteen times, while the 2 variant is associated with a lower risk. However, the increase in risk varies between different ethnic groups.

Source: Belloy et al., JAMA Neurology, 2023


Saturday, January 17, 2026

Patient satisfaction with hospital-based outpatient rehabilitation after stroke in Sweden and its association with life satisfaction and health-related quality of life: a longitudinal national register study

You didn't factor out the tyranny of low expectations beat into survivors by their stroke medical 'professionals'! Without that brainwashing not getting to 100% recovery would be A COMPLETE FUCKING FAILURE!
Patient satisfaction with hospital-based outpatient rehabilitation after stroke in Sweden and its association with life satisfaction and health-related quality of life: a longitudinal national register study


Authors

  • Anna BråndalDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  • Britt-Marie StålnackeDepartment of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
  • Gudrun M. JohanssonDepartment of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Swedenhttps://orcid.org/0000-0003-1351-4425

DOI: 

https://doi.org/10.2340/jrm.v58.43966

Keywords: 

health, personal satisfaction, quality of life, stroke, outpatient rehabilitation

Abstract

Objective: To examine stroke survivors’ satisfaction with hospital-based outpatient rehabilitation and its association with life satisfaction and health-related quality of life (HRQoL), and whether sex and age affect possible associations. 

Design: A longitudinal national register study. 

Methods: Data from the Swedish national quality register were used and included 1,068 patients with stroke performing outpatient rehabilitation. Self-reported questionnaires collected on admission, discharge, and at 1-year follow-up were analysed. Regression analyses were used to assess possible associations between patient satisfaction and life satisfaction (Life Satisfaction Questionnaire, LiSat-11) and HRQoL (EuroQol Five Dimensions questionnaire, EQ-5D).

Results: Over 71% of the included patients were satisfied with their rehabilitation process on discharge.(Then you did the survey completely wrong! The only question to ask is: 'Did you get completely recovered?')) Satisfied patients also reported higher scores on global LiSat-11 and higher EQ-5D values. Older patients (> 58 years) satisfied with their rehabilitation process were more likely to be satisfied with global LiSat-11. Women dissatisfied with the rehabilitation process had lower EQ-5D values on discharge.

Conclusion: Patient satisfaction with hospreital-based outpatient rehabilitation was associated with life satisfaction and HRQoL. Potential differences linked to sex and age support the importance of individually tailored rehabilitation strategies. Evaluating self-reported outcomes and experiences over time is essential for improving long-term recovery and for further development of person-centred stroke rehabilitation.


Monday, January 5, 2026

Life after stroke in Sweden

This is the whole problem in stroke enumerated in one word; 'care'; NOT RECOVERY! 

Our non-existent stroke leadership should be demanding RECOVERY NOT 'CARE'!

My god, anyone in the business world would be fired immediately for managing or caring about something rather than delivering RESULTS. And this is why this is a complete fucking failure! This does nothing to guarantee recovery for survivors!

If your stroke medical 'professional'/hospital is touting 'care' it means they are a failure because they are delivering 'care'; NOT RECOVERY! I would never go to a failed hospital! Anytime I see the word 'care' associated with a stroke hospital; I immediately think fucking failure!

YOU have to get involved and change this failure mindset of 'care' to 100% RECOVERY! Survivors want RECOVERY, NOT 'CARE'!

I see nothing here that states going for 100% recovery! You need to create EXACT PROTOCOLS FOR THAT!

ASK SURVIVORS WHAT THEY WANT, THEY'LL NEVER RESPOND 'CARE'! This tyranny of low expectations has to be completely rooted out of any stroke conversation! I wouldn't go there because of such incompetency as not having 100% recovery protocols!

RECOVERY IS THE ONLY GOAL IN STROKE!

GET THERE!

Life after stroke in Sweden

Discover how Sweden has developed their life after stroke care(NOT RECOVERY!)Professors Bo Norrving and Mia von Euler will share insights into successes in organising and monitoring care(NOT RECOVERY!) nationally, while stroke survivors Annelie Heikenborn and Helen Palmqvist Novik will highlight the power of patient advocacy, follow-up and support in recovery. With the wrong goal; EVERYTHING HERE IS DOOMED TO FAILURE! Survivors want recovery, NOT 'CARE'! Have you never talked to a survivor without talking them down to your tyranny of low expectations?

Registrations are openEarly bird ends 16 February

Wednesday, November 20, 2024

Drinking non-fermented milk may increase the risk of heart disease in women

 Your competent? doctor will need to reconcile these conflicting research pieces. Do you really think your doctor can do that?

The latest here:

Drinking non-fermented milk may increase the risk of heart disease in women

Researchers analyzed data from over 100,000 Swedish adults over 33 years, though the study couldn't confirm a direct cause-and-effect link.

Study: Non-fermented and fermented milk intake in relation to risk of ischemic heart disease and to circulating cardiometabolic proteins in swedish women and men: Two prospective longitudinal cohort studies with 100,775 participants. Image Credit: Katarzyna Hurova/Shutterstock.com
Study: Non-fermented and fermented milk intake in relation to risk of ischemic heart disease and to circulating cardiometabolic proteins in swedish women and men: Two prospective longitudinal cohort studies with 100,775 participants. Image Credit: Katarzyna Hurova/Shutterstock.com

In a recent study published in BMC Medicine, Swedish researchers explored the link between fermented and non-fermented milk consumption and heart health, specifically ischemic heart disease and myocardial infarction risk. Using data from two large Swedish cohort studies, the study examined the association between milk consumption and cardiometabolic protein patterns in the blood.

Background

Ischemic heart disease results primarily from restricted blood flow to the heart and is a significant global health issue and a major cause of early mortality. Although research indicates that cardiovascular health is influenced by multiple factors, including diet, the role of dairy products, especially milk, remains ambiguous.

Furthermore, different types of milk products, such as non-fermented fresh milk or fermented milk products such as yogurt, may affect heart health in distinct ways, possibly due to variations in the microbial content or bioactive compounds formed during fermentation.

Although milk is widely recommended as part of a balanced diet for its calcium, vitamin D, and protein content, studies on its cardiovascular impact have reported conflicting results. Some research suggests that high milk consumption might increase cardiovascular risks, while others find no link or even protective effects.

About the study

In the present study, the researchers aimed to clarify the impact of milk consumption on cardiovascular health, focusing on fermented and non-fermented milk intake and their potential effects on specific blood proteins related to heart disease. They analyzed data from two Swedish cohort studies, the Cohort of Swedish Men (COSM) and the Swedish Mammography Cohort (SMC), which cumulatively involved over 100,000 participants who were monitored for up to 33 years.

The participants were required to complete dietary and lifestyle questionnaires, which included details on milk consumption, categorized into non-fermented and fermented types. Additionally, blood samples were taken to assess cardiometabolic proteins. The researchers excluded participants who had a history of ischemic heart disease or cancer, and the final dataset consisted of over 40,000 men and close to 60,000 women.

Dietary intake was assessed through validated food frequency questionnaires, with milk intake specified by fat content (0.5%, 1.5%, or 3%) and type (non-fermented versus fermented). The total milk intake was calculated by combining the servings across types and fat contents. High-throughput immunoassays were used to measure the protein concentrations in blood, focusing on 276 proteins related to cardiometabolic health.

The study employed Cox proportional hazards regression models to evaluate the association between milk intake and the risk of ischemic heart disease or myocardial infarction, adjusting for factors such as age, physical activity, dietary habits, alcohol intake, and socioeconomic status. The analysis also assessed dose-response relationships for milk intake, with stratified analyses to explore potential modifiers like sex and lifestyle. Sensitivity analyses excluded the participants with comorbidities and assessed impacts across different intake levels and fat contents.

Results

The study found that increased consumption of non-fermented milk was associated with an elevated risk of ischemic heart disease and myocardial infarction in women but not in men. Specifically, women who consumed more than 300 mL of non-fermented milk (equating to 2 or more glasses) daily showed a significant increase in ischemic heart disease risk, with the hazard ratio increasing progressively with higher intake.

Furthermore, this association was consistent across all milk fat percentages (0.5%, 1.5%, and 3%) and was significant even after adjusting for lifestyle and dietary factors. In contrast, fermented milk intake was not linked to ischemic heart disease or myocardial infarction risk in either sex.

The study also found that women who consumed high amounts of non-fermented milk exhibited distinct patterns in cardiometabolic proteins. Higher intake of non-fermented milk was found to correlate with elevated levels of angiotensin-converting enzyme 2 (ACE-2), a protein that was associated with cardiovascular risks.

Additionally, the levels of fibroblast growth factor 21 (FGF21), a protein that is protective against cardiometabolic conditions, were found to be lower in women who consumed non-fermented milk in large amounts. These protein changes may reflect underlying biological pathways affected by non-fermented milk consumption, potentially explaining the higher ischemic heart disease risk observed in women.

Moreover, substitution analysis indicated that replacing non-fermented milk with fermented milk or fermented milk products such as yogurt could potentially lower the risk of ischemic heart disease, although further research is needed to confirm this possibility.

Conclusions

Overall, the study suggested that non-fermented milk, irrespective of fat content, may contribute to higher ischemic heart disease risk in women through pathways involving ACE-2 and FGF21.

The findings highlighted a potential sex-specific risk of ischemic heart disease associated with non-fermented milk intake, with a greater risk in women who consume large amounts of fresh milk. The study warranted further investigation into fermented milk products as a potentially safer dairy alternative.

Journal references:
  • Michaëlsson, K., Lemming, E. W., Larsson, S. C., Höijer, J., Melhus, H., Svennblad, B., Baron, J. A., Wolk, A., & Byberg, L. (2024). Non-fermented and fermented milk intake in relation to risk of ischemic heart disease and to circulating cardiometabolic proteins in swedish women and men: Two prospective longitudinal cohort studies with 100,775 participants. BMC Medicine, 22(1), 483. doi:10.1186/s12916024036511, https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03651-1

     

Saturday, October 5, 2024

New cardiovascular disease risk marker discovered in older women

 Didn't your competent? doctor test for this in men already and have protocols to address the problem? NO? So you don't have a functioning stroke doctor, do you?

New cardiovascular disease risk marker discovered in older women

Researchers at Karolinska Institutet have identified a new potential risk marker for cardiovascular disease in women. A new study shows an association between low levels of an anti-inflammatory antibody and the risk of heart attack and coronary heart disease. The study is published in the Journal of American College of Cardiology.

Cardiovascular disease is the leading cause of death for both women and men in Sweden. However, research on women's heart health has historically been neglected. Women are affected later in life and have more risk factors such as high blood pressure, diabetes, and heart failure. Now a new study shows how low levels of antibodies to the fatty substance phosphorylcholine, called anti-PC, may be a new independent risk marker for cardiovascular disease in older women. Previous studies have shown that this is the case in men.

"We can show that a low level of the natural antibody to phosphorylcholine can be used as a risk marker for cardiovascular disease also in women, independent of previously known risk factors. "We have previously shown that the antibody has an anti-inflammatory effect, which means that it protects against atherosclerosis, which is a chronic inflammation of the vessel wall," says Johan Frostegård, Professor of Medicine at the Institute of Environmental Medicine and Head of the Immunology and Chronic Disease Unit.

The study was conducted using the Swedish Mammography Cohort (SMC) and followed 932 women with an average age of 66 years over 16 years. Of these, 113 women developed cardiovascular disease. The results show that women with a high level of the anti-PC antibody had a 25 percent lower risk of coronary heart disease and heart attack. However, the study cannot show which level is protective.

"We now need to go further to determine what level of anti-PC can be used as a risk level in a similar way to the levels found for high blood pressure, for example. We are now working on an even larger study that includes both men and women where we hope to establish such a level," says Johan Frostegård.

The researchers hope that the study can contribute to the development of a vaccine against atherosclerosis that can raise the level of anti-PC in those who show riskily low levels.

The research was funded by the Swedish Heart-Lung Foundation, the Swedish Science Fund, the King Gustaf V Foundation's 80th Anniversary Fund and the EU consortium CVDIMMUNE. Johan Frostegård is co-founder of Annexin Pharmaceuticals and also holds patents related to anti-PC.

Story Source:

Materials provided by Karolinska Institutet. Note: Content may be edited for style and length.

Tuesday, January 11, 2022

Death of a Child and the Risk of Stroke: A Binational Cohort Study From Denmark and Sweden

My brother died at age 11, I was 9. Dad lived to 91, dying from Parkinsons and dementia. Mom still going strong at 92, bought a brand new car 1.5 years ago.

Death of a Child and the Risk of Stroke: A Binational Cohort Study From Denmark and Sweden

Dang Wei, Jiong Li, Hua Chen, Fang Fang, Imre Janszky, Rickard Ljung, Krisztina D László

Abstract

Background and Objectives: The death of a child is an extreme life event with potentially long-term health consequences. Accumulating evidence suggests that parents who lost a child have increased risks of cardiovascular diseases, including ischemic heart disease and atrial fibrillation. Whether bereaved parents have an increased risk of stroke is unclear and was investigated in this study.

Methods: We conducted a population-based cohort study including parents who had a child born during 1973-2016 or 1973-2014 and recorded in the Danish and the Swedish Medical Birth Registers, respectively. We obtained information on child’s death, parent’s stroke and socioeconomic and health-related characteristics through linkage between several population-based registers. We used Poisson regression to examine the association between the death of a child and the risk of stroke.

Results: Of the 6,711,955 study participants, 128,744 (1.9%) experienced the death of a child and 141,840 (2.1%) had a stroke during the follow-up. Bereaved parents had an increased risk of stroke; the corresponding incidence rate ratio (95% confidence intervals) was 1.23 (1.19-1.27). The association was present for all analyzed categories of causes of child death (cardiovascular, other natural and unnatural death), did not differ substantially according to the age of the deceased child, but was stronger if the parent had no or ≥3 than 1-2 live children at the time of the loss. The association was similar for ischemic and hemorrhagic stroke. The risk for hemorrhagic stroke was highest immediately after the death of a child and decreased afterwards. In contrast, there was no clear pattern over time in case of ischemic stroke.

Discussion: The death of a child was associated with a modestly increased risk of stroke. The finding that an association was observed in case of unnatural deaths is suggestive of the explanation that bereavement-related stress may contribute to the development of stroke. Though the death of a child can often not be avoided, an understanding of its health-related consequences may highlight the need for improved support and attention from family members and healthcare professionals.

  • Received August 17, 2021.
  • Accepted in final form December 14, 2021.
 

Tuesday, December 14, 2021

Dementia Tied to Resting Heart Rate

 My rate now runs in the low 60's although 3 years after stroke I had it down to 54 at age 53.

Dementia Tied to Resting Heart Rate

Findings persist even after accounting for cardiovascular disease

An illustration of a heartbeat over a silhouette of a senior woman.

Higher resting heart rate (RHR) was linked to greater dementia risk and faster cognitive decline independent of cardiovascular disease in a study of more than 2,000 older adults in Sweden.

People with RHR of 80 bpm or higher had a 55% increased risk of developing dementia compared with people whose RHR was 60-69 bpm (adjusted HR 1.55, 95% CI 1.06-2.27), reported Yume Imahori, MD, PhD, of the Karolinska Institutet in Stockholm, and co-authors.

The association remained significant after excluding people with prevalent and incident cardiovascular disease. Cognitive function scores fell over time in all RHR groups, but people with RHR of 80 bpm or higher declined more quickly than people with RHR of 60-69 bpm, Imahori and co-authors wrote in Alzheimer's & Dementia.

Previously, the Atherosclerosis Risk in Communities (ARIC) study showed that an RHR of 80 bpm or more in midlife raised the risk of cognitive decline and incident dementia as people aged.

"Our study showed that this finding was also applicable in RHR measured in late life," Imahori told MedPage Today. "It further revealed that this association was not due to underlying cardiovascular diseases such as atrial fibrillation and heart failure."

"This study is important because RHR might be used to identify older people with a potentially high risk of cognitive decline in a wide variety of settings," Imahori added.

"If cognitive function in patients with elevated RHR is followed carefully and early intervention is made, the onset of dementia might be delayed, which can have a substantial impact on patients' quality of life," she said. "If further studies show that this association is causal, reducing RHR might be considered as a target of intervention."

Imahori and colleagues followed 2,147 older adults (62.1% women) in the Swedish National Aging and Care in Kungsholmen (SNAC-K) population-based study with a mean baseline age about 71. All participants were dementia-free at baseline and followed regularly from 2001-2004 until 2013-2016. Cognition and dementia status were assessed at multiple timepoints. Baseline mean Mini Mental State Examination (MMSE) score was 29.0 and was similar across RHR groups.

Mean RHR, obtained from a standard 12-lead ECG at baseline, was 65.7 bpm. Participants in higher RHR groups were older (mean age about 72), less educated, and were more likely to be current smokers, physically inactive, and hypertensive. Prevalence of cardiovascular disease -- ischemic heart disease, atrial fibrillation, heart failure, or stroke -- at baseline was not significantly different among RHR groups.

Over a median followup of 11.4 years, 289 people were diagnosed with dementia. High RHR remained associated with dementia after excluding people with baseline cardiovascular disease and those who developed cardiovascular disease during followup.

MMSE scores fell faster for people who had high RHR. Compared with a resting rate of 60-69, RHR of 80 or more was associated with annual declines in MMSE score (adjusted β -0.13, 95% CI -0.21 to -0.04); results were similar after excluding prevalent and incident cardiovascular disease. RHR 70-79 also was linked to accelerated drops in MMSE score (adjusted β -0.10, 95% CI -0.17 to -0.04).

The relationship between elevated RHR and cognition might in part reflect pathophysiological pathways independent from vascular risk factors, Imahori and colleagues observed. "Nevertheless, we cannot rule out the possibility that subclinical or undiagnosed cardiovascular diseases may contribute to this association," they wrote.

"This population-based cohort study suggests higher resting heart rate is associated with increased risk for dementia and faster cognitive decline, further adding to the growing body of research showing the health of the heart and brain are closely connected," noted Claire Sexton, DPhil, director of scientific programs and outreach at the Alzheimer's Association in Chicago, who wasn't involved with the research.

"However, this study only shows a correlation between resting heart rate and cognition, not causation," Sexton cautioned. "More research is needed."

Imahori added that caution is needed when generalizing findings to other populations "because our study included mainly Caucasians who had relatively high socioeconomic status."

Unmeasured confounders and selective survival bias might also have influenced associations in the SNAC-K cohort, the researchers acknowledged.

  • Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

SNAC-K is supported by the Swedish Ministry of Health and Social Affairs and the participating county councils and municipalities, along with additional grants from the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare.

Imahori had no disclosures. Other researchers reported relationships with AFA-Insurance, Carl Bennet AB, FORMAS, FORTEO, Strategic Research Area Epidemiology Karolinska Institute, and the International Society for Environmental Epidemiology.

 

Wednesday, December 8, 2021

Dementia Tied to Resting Heart Rate

 It is completely your doctor's responsibility to get you 100% recovered so you can get cardiovascularly fit.

Dementia Tied to Resting Heart Rate

Findings persist even after accounting for cardiovascular disease

An illustration of a heartbeat over a silhouette of a senior woman.

Higher resting heart rate (RHR) was linked to greater dementia risk and faster cognitive decline independent of cardiovascular disease in a study of more than 2,000 older adults in Sweden.

People with RHR of 80 bpm or higher had a 55% increased risk of developing dementia compared with people whose RHR was 60-69 bpm (adjusted HR 1.55, 95% CI 1.06-2.27), reported Yume Imahori, MD, PhD, of the Karolinska Institutet in Stockholm, and co-authors.

The association remained significant after excluding people with prevalent and incident cardiovascular disease. Cognitive function scores fell over time in all RHR groups, but people with RHR of 80 bpm or higher declined more quickly than people with RHR of 60-69 bpm, Imahori and co-authors wrote in Alzheimer's & Dementia.

Previously, the Atherosclerosis Risk in Communities (ARIC) study showed that an RHR of 80 bpm or more in midlife raised the risk of cognitive decline and incident dementia as people aged.

"Our study showed that this finding was also applicable in RHR measured in late life," Imahori told MedPage Today. "It further revealed that this association was not due to underlying cardiovascular diseases such as atrial fibrillation and heart failure."

"This study is important because RHR might be used to identify older people with a potentially high risk of cognitive decline in a wide variety of settings," Imahori added.

"If cognitive function in patients with elevated RHR is followed carefully and early intervention is made, the onset of dementia might be delayed, which can have a substantial impact on patients' quality of life," she said. "If further studies show that this association is causal, reducing RHR might be considered as a target of intervention."

Imahori and colleagues followed 2,147 older adults (62.1% women) in the Swedish National Aging and Care in Kungsholmen (SNAC-K) population-based study with a mean baseline age about 71. All participants were dementia-free at baseline and followed regularly from 2001-2004 until 2013-2016. Cognition and dementia status were assessed at multiple timepoints. Baseline mean Mini Mental State Examination (MMSE) score was 29.0 and was similar across RHR groups.

Mean RHR, obtained from a standard 12-lead ECG at baseline, was 65.7 bpm. Participants in higher RHR groups were older (mean age about 72), less educated, and were more likely to be current smokers, physically inactive, and hypertensive. Prevalence of cardiovascular disease -- ischemic heart disease, atrial fibrillation, heart failure, or stroke -- at baseline was not significantly different among RHR groups.

Over a median followup of 11.4 years, 289 people were diagnosed with dementia. High RHR remained associated with dementia after excluding people with baseline cardiovascular disease and those who developed cardiovascular disease during followup.

MMSE scores fell faster for people who had high RHR. Compared with a resting rate of 60-69, RHR of 80 or more was associated with annual declines in MMSE score (adjusted β -0.13, 95% CI -0.21 to -0.04); results were similar after excluding prevalent and incident cardiovascular disease. RHR 70-79 also was linked to accelerated drops in MMSE score (adjusted β -0.10, 95% CI -0.17 to -0.04).

The relationship between elevated RHR and cognition might in part reflect pathophysiological pathways independent from vascular risk factors, Imahori and colleagues observed. "Nevertheless, we cannot rule out the possibility that subclinical or undiagnosed cardiovascular diseases may contribute to this association," they wrote.

"This population-based cohort study suggests higher resting heart rate is associated with increased risk for dementia and faster cognitive decline, further adding to the growing body of research showing the health of the heart and brain are closely connected," noted Claire Sexton, DPhil, director of scientific programs and outreach at the Alzheimer's Association in Chicago, who wasn't involved with the research.

"However, this study only shows a correlation between resting heart rate and cognition, not causation," Sexton cautioned. "More research is needed."

Imahori added that caution is needed when generalizing findings to other populations "because our study included mainly Caucasians who had relatively high socioeconomic status."

Unmeasured confounders and selective survival bias might also have influenced associations in the SNAC-K cohort, the researchers acknowledged.

  • Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

SNAC-K is supported by the Swedish Ministry of Health and Social Affairs and the participating county councils and municipalities, along with additional grants from the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare.

Imahori had no disclosures. Other researchers reported relationships with AFA-Insurance, Carl Bennet AB, FORMAS, FORTEO, Strategic Research Area Epidemiology Karolinska Institute, and the International Society for Environmental Epidemiology.

 

Wednesday, September 29, 2021

Biomarkers of dairy fat intake, incident cardiovascular disease, and all-cause mortality: A cohort study, systematic review, and meta-analysis

Is this enough to get your doctors and stroke hospital to have their dieticians to create a diet protocol on this?  I started using whole milk when this research first started coming out. I would like to know the EXACT AMOUNTS AND TIMING for this.

 

Biomarkers of dairy fat intake, incident cardiovascular disease, and all-cause mortality: A cohort study, systematic review, and meta-analysis

 



Abstract

Background

We aimed to investigate the association of serum pentadecanoic acid (15:0), a biomarker of dairy fat intake, with incident cardiovascular disease (CVD) and all-cause mortality in a Swedish cohort study. We also systematically reviewed studies of the association of dairy fat biomarkers (circulating or adipose tissue levels of 15:0, heptadecanoic acid [17:0], and trans-palmitoleic acid [t16:1n-7]) with CVD outcomes or all-cause mortality.

Methods and findings

We measured 15:0 in serum cholesterol esters at baseline in 4,150 Swedish adults (51% female, median age 60.5 years). During a median follow-up of 16.6 years, 578 incident CVD events and 676 deaths were identified using Swedish registers. In multivariable-adjusted models, higher 15:0 was associated with lower incident CVD risk in a linear dose–response manner (hazard ratio 0.75 per interquintile range; 95% confidence interval 0.61, 0.93, P = 0.009) and nonlinearly with all-cause mortality (P for nonlinearity = 0.03), with a nadir of mortality risk around median 15:0. In meta-analyses including our Swedish cohort and 17 cohort, case–cohort, or nested case–control studies, higher 15:0 and 17:0 but not t16:1n-7 were inversely associated with total CVD, with the relative risk of highest versus lowest tertile being 0.88 (0.78, 0.99), 0.86 (0.79, 0.93), and 1.01 (0.91, 1.12), respectively. Dairy fat biomarkers were not associated with all-cause mortality in meta-analyses, although there were ≤3 studies for each biomarker. Study limitations include the inability of the biomarkers to distinguish different types of dairy foods and that most studies in the meta-analyses (including our novel cohort study) only assessed biomarkers at baseline, which may increase the risk of misclassification of exposure levels.

Conclusions

In a meta-analysis of 18 observational studies including our new cohort study, higher levels of 15:0 and 17:0 were associated with lower CVD risk. Our findings support the need for clinical and experimental studies to elucidate the causality of these relationships and relevant biological mechanisms.

Author summary

Why was this study done?

  • Many dietary guidelines recommend limiting dairy fat consumption in order to lower saturated fat intake and cardiovascular disease (CVD) risk.
  • However, increasing evidence suggests that the health impact of dairy foods is more dependent on the type (e.g., cheese, yoghurt, milk, and butter) rather than the fat content, which has raised doubts if avoidance of dairy fats is beneficial for cardiovascular health.
  • Dairy foods are a major source of nutrients, and their consumption is increasing worldwide; thus, it is important to advance our understanding of the impact of dairy fat on CVD risk.

What did the researchers do and find?

  • We measured dairy fat consumption using an objective biomarker, serum pentadecanoic acid (15:0), in 4,150 Swedish 60-year-olds and collected information about CVD events and deaths during a median follow-up of 16.6 years.
  • When we accounted for known risk factors including demographics, lifestyle, and disease prevalence, the CVD risk was lowest for those with high levels of the dairy fat biomarker 15:0, while those with biomarker levels around the median had the lowest risk of all-cause mortality.
  • We also conducted a systematic review and meta-analysis, and the combined evidence from 18 studies also showed higher levels of 2 dairy fat biomarkers (15:0 and heptadecanoic acid 17:0) were linked with lower risk of CVD, but not with all-cause mortality.

What do these findings mean?

  • The findings from our study using fatty acid biomarkers suggest that higher intake of dairy fat were associated with lower CVD risk in diverse populations including Sweden (a country with high dairy intake), though more trials are needed to understand if and how dairy foods protect cardiovascular health.

The Stockholm Stroke Triage Project: Outcomes of Endovascular Thrombectomy Before and After Triage Implementation

 Since they didn't report on 100% recovery,  I'd have to say this was a failure. But look over here: arterial puncture time reduction by 69 minutes. Using the tyranny of low expectations to declare success where none exists.

The Stockholm Stroke Triage Project: Outcomes of Endovascular Thrombectomy Before and After Triage Implementation

 
Originally publishedhttps://doi.org/10.1161/STROKEAHA.121.034195Stroke. ;0:STROKEAHA.121.034195

Background and Purpose:

The Stockholm Stroke Triage System (SSTS) is a prehospital algorithm for detection of endovascular thrombectomy (EVT)-eligible patients, combining symptom severity assessment and ambulance-to-hospital teleconsultation, leading to a decision on primary stroke center bypass. In the Stockholm Region (6 primary stroke centers, 1 EVT center), SSTS implementation in October 2017 reduced onset-to-EVT time by 69 minutes. We compared clinical outcomes before and after implementation of SSTS in an observational study.

Methods:

We prospectively recruited patients transported by Code Stroke ambulance within the Stockholm region under the SSTS, treated with EVT during October 2017 to October 2019, and compared to EVT patients from 2 previous years. Outcomes: shift in modified Rankin Scale (mRS) scores, mRS score 0 to 1, mRS score 0 to 2, and death (all 3 months), National Institutes of Health Stroke Scale (NIHSS) score change 24-hour post-EVT, recanalization (Thrombolysis in Cerebral Infarction 2b-3), and symptomatic intracranial hemorrhage. mRS outcomes were adjusted for age and baseline NIHSS.

Results:

Patients with EVT in the SSTS group (n=244) were older and had higher baseline NIHSS versus historical controls (n=187): median age 74 (interquartile range, 63–81) versus 71 (61–78); NIHSS score 17 (11.5–21) versus 15 (10–20). During SSTS, median onset-to-puncture time was 136 versus 205 minutes (P<0.001). Adjusted common odds ratio for lower mRS in SSTS patients was 1.7 (95% CI, 1.2–2.3) versus controls. During SSTS, 83/240 (34.6%) versus 44/186 (23.7%) reached 3-month mRS score 0 to 1 (P=0.014), adjusted common odds ratio 2.3 (95% CI, 1.4–3.6). Median NIHSS change 24-hour post-EVT was 6 versus 4 (P=0.005). Differences in Thrombolysis in Cerebral Infarction, symptomatic intracranial hemorrhage, and death were nonsignificant.

Conclusions:

With an onset to arterial puncture time reduction by 69 minutes, outcomes in thrombectomy-treated patients improved significantly after region-wide large artery occlusion triage system implementation. These results warrant replication studies in other geographic and organizational circumstances.

Sunday, April 11, 2021

Common Alzheimer's Medications Slow Cognitive Decline

This already proved value for stroke 4 months ago. Has your stroke hospital incompetently done nothing with this? If nothing, your stroke hospital board of directors IS DIRECTLY TO BLAME. Have them replaced with survivors.

Effect of acetylcholinesterase inhibitors on post-stroke cognitive impairment and vascular dementia: A meta-analysis December 2020

 

Common Alzheimer's Medications Slow Cognitive Decline 

TREATMENT: SWEDISH RESEARCHERS find that cholinesterase inhibitors provide cognitive benefits and reduce mortality for up to five years after an Alzheimer's diagnosis. One medication significantly reduced the risk of developing severe dementia. Find out more.



Cholinesterase inhibitors are a group of drugs recommended for the treatment of Alzheimer's disease, but their effects on cognition have been debated and few studies have investigated their long-term effects.

Researchers from Karolinska Institutet in Sweden found in their study, published in the journal Neurology, persisting cognitive benefits and reduced mortality for up to five years after diagnosis.


Alzheimer's disease is a cognitive brain disease that affects millions of patients around the world. Some 100,000 people in Sweden live with the diagnosis, which has a profound impact on the lives of both them and their families. Most of those who receive a diagnosis are over 65, but there are some patients who are diagnosed in their 50s.

The current cost of care and treatment for people with dementia is approximately SEK 60 billion a year in Sweden. This is on a par with the cost of care and treatment of cardiovascular diseases and is twice as high as cancer care.

Three Drugs That Work

In Alzheimer's disease changes to several chemical neurotransmitters in the brain are found, and thus to the ability of the neurons to communicate with each other. Acetylcholine is one such substance and plays a key role in cognitive functions such as memory, attention and concentration.

There are three drugs that work as cholinesterase inhibitors and that are used in the treatment of Alzheimer's disease: galantamine, donepezil and rivastigmine.

The effects of cholinesterase inhibitors have, however, been debated, partly because there are relatively few longitudinal clinical studies. Researchers at Karolinska Institutet and Umeå University have now conducted a registry study of patients with Alzheimer's disease over a period of five years from point of diagnosis.

Findings

The study is based on data from SveDem (the Swedish Dementia Registry) on 11,652 patients treated with cholinesterase inhibitors and a matched control group of 5,826 untreated patients.

The results showed that treatment with cholinesterase inhibitors was associated with slower cognitive decline over five years, and 27 per cent lower mortality in patients with Alzheimer's disease compared with the controls.

"Of all three drugs, galantamine had the strongest effect on cognition, which may bedue to its effect on nicotine receptors and its inhibiting effect on the enzyme acetylcholinesterase, which breaks down the neurotransmitter acetylcholine," says the study's first author Hong Xu, postdoctoral researcher at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.

"Our results provide strong support for current recommendations to treat people with Alzheimer's disease with cholinesterase inhibitors, but also shows that the therapeutic effect lasts for a long time," says the study's last author and initiator Maria Eriksdotter, professor at the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.


SOURCE: REFERENCE:
  • Hong Xu, Sara Garcia-Ptacek, Linus Jönsson, Wimo Anders, Peter Nordström, Maria Eriksdotter. Long Term Effects of Cholinesterase Inhibitors on Cognitive Decline and Mortality. Neurology, 2021; 10.1212/WNL.0000000000011832 DOI: 10.1212/WNL.0000000000011832
 

Saturday, July 11, 2020

CardioPulse discovers how patient power is keeping cardiac care on its toes in Sweden

Now if we can just get stroke leaders to listen to us(100% recovery is the only goal) or depose them as extinct leaders.  But stroke leaders will hang onto power until we overthrow them for incompetence.

CardioPulse discovers how patient power is keeping cardiac care on its toes in Sweden



Mark Nicholls speaks to Professor Joep Perk and colleagues about the healthcare role heart patients are playing in Sweden.
With increased patient involvement defined by the European Society of Cardiology as a strategic priority, the role patients can play in helping shape cardiac care with their input, first-person expertise, and feedback was high on the agenda at ESC 2019 in Paris. Members of the new patient forum took an active role in the conference; but just how can patients influence cardiovascular medicine, the treatment offered, help maintain high standards of care at a hospital or across a region, and what impact can they have?
A striking example has recently emerged in Sweden—underpinned by the nationwide SWEDEHEART registry—demonstrating the power, influence, and input patients can have and their critical role in maintaining and driving up standards and holding healthcare providers to account. Formed in 2005, the SWEDEHEART registry includes a range of quality indicators for patients with cardiovascular disease in Sweden, including data on secondary prevention outcomes for patients after myocardial infarction (MI).
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With almost all hospitals in Sweden contributing to the SWEDEHEART registry and an annual report providing hospitals with important quality information—participating cardiac rehabilitation (CR) centres can use the continuously updated performance data online and compare results with national averages and with other centres. Five central CR quality measures are: attendance in CR, percentage of smoking patients who are abstinent post-MI, patient targets for blood pressure and LDL cholesterol, and percentage participating in physical exercise training. However, patients do not often access, or act upon, the data.
The Swedish Heart and Lung Association (RHL), a non-governmental patient organization with 37 000 registered members and 146 local branches and a core objective to improve living conditions for those with heart and lung diseases, collaborates regularly with the Swedish Cardiac Society and national government and participates in regional training courses on secondary prevention. And members are actively referring to and monitoring the data.
At the latest conference, in November 2019 in Linköping, a presentation by patient Anders Nordqvist from the local RHL branch, demonstrated the true impact of patient power and how patient organizations can influence healthcare, using quality indicators from a national database. In 2015, they celebrated the success of Köping hospital, when it reached first place in the SWEDEHEART quality index, congratulating the cardiac team with flowers, cake, and a positive article in the local newspaper.
Yet the following year, Köping hospital had dropped 23 places and fell further a year later, and below a neighbouring rival hospital. ‘This could simply not be accepted,’ said Mr Nordqvist.
Armed with SWEDEHEART quality data, they contacted the hospital and regional health authorities seeking explanations. It emerged that staff shortages caused a loss of focus on secondary prevention. In response, the department head promised to explore ways to improve the situation with RHL members invited to meet the board of the regional health authority. The initiative from the local patients group did result in influencing and improving the quality of care.
According to online data from SWEDEHEART in 2019, it appears there is a positive change in the secondary preventive results at this hospital’s CR centre: more patients attend CR and reach target values for blood pressure and lipids. Preliminary data now indicate that Köping hospital may once again end up with a Top 10 ranking. Mr Nordqvist added: ‘The association’s review of the SWEDEHEART results and the contact with healthcare staff and politicians have been received well and we can see that our efforts have aided in the development of cardiac care for the better’. Köping hospital staff have welcomed the action of their local patient group, and see it as contributing to a ‘new’ start of their care for patients after MI.
Pelle Johansson, senior project manager at RHL Sweden said: ‘As a large patient organization we have shown that we can influence both public opinion and health care politicians to strengthen the quality of cardiac rehabilitation programmes’. The outcome illustrates the role and impact of patient engagement and collaboration with health workers, in line with the ethos and recent activities of the ESC Patient Forum and underlines the importance of unity in optimizing secondary prevention.
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Associate Professor Margrét Leósdóttir from Lund University and co-ordinator of SWEDEHEARTS’s secondary prevention sub-register, added: ‘In our Perfect-CR study, a nationwide register study on the practice of cardiac rehabilitation, we have seen that there is still ample room for improvement. We welcome the support from heart patients in our endeavour to optimize cardiac care’.
Professor Joep Perk, from the Department of Health and Caring Sciences at Linnaeus University and Prevention & Public Health Lead of the ESC Advocacy Committee, stated: ‘After years of experience of joining hands with heart patients in the Swedish Heart and Lung Patients Association, I am particularly pleased that the ESC has acknowledged the important role patients can play in cooperating with cardiologists and other health workers for the benefit of heart patients around Europe. We know it works’.
In Sweden, added Professor Perk, the hope is that patients ‘will continue observing and using the data’.
Conflict of interest: none declared.
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This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)