Lina Rydén

Background/Objectives: Hearing assessment may be challenging in individuals of very advanced age when cognitive or physical limitations restrict participation in behavioural testing or access to clinic-based hearing care. This study evaluated the suitability of auditory steady-state responses (ASSRs) as a clinical method for assessing peripheral hearing in individuals of very advanced age by examining its agreement with pure-tone audiometry (PTA) thresholds and its feasibility in a home setting among individuals aged 88–95 years. Methods: Home visits were conducted for 91 individuals, of whom 71 completed the behavioural and electrophysiological test protocol and were included in the analyses. ASSR thresholds at 0.5, 1, 2, and 4 kHz were compared with corresponding PTA thresholds for the right and left ears. Agreement was assessed using Bland–Altman analyses, with differences within ±15 dB considered clinically acceptable. Reasons for unobtained ASSR thresholds were systematically recorded. The Mini-Mental State Examination (MMSE) was administered, and PTA–ASSR threshold differences were compared using a cut-off score of ≤26 for cognitive impairment. Results: ASSR thresholds were within ±15 dB of the corresponding PTA thresholds in 92% of right ears and 85% of left ears. Mean differences were close to 0 dB at most frequencies, although greater differences were observed at 0.5 and 1 kHz in the left ear. The mean ASSR test duration was 21.5 min. ASSR thresholds were unobtainable in 31% of PTA–ASSR comparisons, most commonly because of high rejection rates related to EEG and/or myogenic activity and participant discomfort. PTA–ASSR threshold differences did not differ significantly between MMSE groups (≤26 vs. >26). Conclusions: ASSR offers a promising alternative for hearing assessment in individuals of very advanced age who may have difficulty participating in behavioural testing. Furthermore, the results suggest that ASSR can be performed in home settings, including nursing homes and residential care facilities. Participant comfort and positioning are important for reducing muscular artefacts and improving measurement feasibility.

Population-based studies on the relation between polygenic longevity scores (PGLSs) and specific brain regions on magnetic resonance imaging (MRI) are few. We aimed to investigate this relationship in a population of 70-year-olds from Gothenburg, Sweden ( N = 675). We constructed two PGLSs (one with and one without the APOE locus) using longevity GWAS summary statistics. MRI outcomes included total grey matter, white matter (WM), WM hyperintensities (WMHs), subcortical volumes, small vessel disease (SVD) score, cortical thicknesses, and fractional anisotropy (FA) fibre tracts. We adjusted for sex, age, principal components, and sex interactions, and corrected for multiple comparisons. We found no associations in the total sample. In males, both PGLSs were associated with smaller WMHs volume and lower SVD burden, and a thicker cortex of pars triangularis, pars opercularis, and insula. Our findings suggest a possible link between genetic propensity for longevity and lower cerebrovascular burden and certain cortical grey matter areas in males.

As societies age, a deeper understanding of ageing-related factors that contribute to longevity is needed. We therefore investigated possible longevity factors (social, medical, and biological) in relation to parental longevity (PL) and polygenic longevity scores (PGLSs). We examined 1126 70-year-olds from the Swedish population–based Gothenburg H70 Birth Cohort study in 2014–2016 (response rate 72%), with follow-up in 2019–2022 (response rate 77.6%). Comprehensive examinations included self-reported information on parents’ ages, socioeconomic factors, mental, cardiovascular, and neurological health, anthropometry, laboratory data, and genotyping to construct two continuous PGLSs variables (with and without the APOE locus). PL groups were categorised as high if both parents survived to age 85 (17.2%); medium if one parent had survived (43.3%), and low if neither parent had survived to age 85 (39.4%). Higher PL and higher PGLSs were related to less hypertension, higher educational level, better childhood, and current socioeconomic status. In addition, higher PL was associated with higher MMSE score, total cholesterol, HDL-cholesterol (HDL-c) and LDL-cholesterol (LDL-c), lower BMI, homocysteine and inflammatory markers (IL-6, CRP) levels, and less smoking, whereas higher PGLSs was related to less myocardial infarction. At follow-up, high-PL was associated with less increase in plasma pTau217. PGLSs were mainly related to socioeconomic and cardiovascular factors, while individuals with long-lived parents, in addition, had several other characteristics of longevity, such as less inflammation, homocysteine, and markers of dementia. PL may be a proxy for biological ageing and used as a screening for ageing-related disorders in the context of prevention. Graphical Abstract

The global population aged 60 years and older is projected to grow from 1 billion in 2020 to 1.4 billion by 2030, and to double by 2050 (United Nations 2021). As life expectancy increases, the prev...

INTRODUCTION: High‐risk plasma p‐tau217 levels predict amyloid‐β pathology in Alzheimer's disease, but little is known about the prevalence and temporal dynamics in the general population. METHODS: Participants from the Gothenburg H70 Birth Cohort Study in Sweden were examined ( n = 1157) and re‐examined after 5–7 years ( n = 771). Prevalence and 5–7 year transition of high‐risk plasma p‐tau217 status was determined among community‐dwelling 70‐year‐olds. RESULTS: High‐risk plasma p‐tau217 prevalence was 3.6% at age 70 and 7.0% at age 75–77 years. Eighty‐nine percent remained low‐risk and 4% converted to high‐risk at follow‐up. Prevalence of dementia at follow‐up was 1.7% if remaining in the low‐risk group and 21.4% if transitioning to the high‐risk group. Prevalence of dementia among participants staying in the high‐risk group was 16.7% at follow‐up. DISCUSSION: Individuals with low‐risk plasma p‐tau217 were unlikely to transition over 5–7 years. However, transitioning to a higher risk‐category was associated with a higher prevalence of cognitive disability.

Background: Women face greater vulnerability to dementia and Alzheimer’s disease (AD), potentially due to estrogen fluctuations across the lifespan. However, its role in vascular brain health is unclear. We investigated associations between lifelong estrogen exposure—endogenous (reproductive span) and exogenous (oral contraceptives [OC], menopausal hormone therapy [MHT])—and late-life vascular brain injury, AD-related atrophy, and APOE -ε4 modification. Methods and findings: We included 352 cognitively unimpaired 70-years-old women from the Gothenburg H70-1944 Birth Cohort with brain MRI and 5-year follow-up. Reproductive lifespan was calculated as age at menopause or oophorectomy minus age at menarche. OC and MHT use were self-reported. Outcomes included cerebral small vessel disease (SVD), AD-related cortical thickness, and white-matter integrity (fractional anisotropy). Linear and multinomial regression and mixed-effects models were adjusted for confounders and stratified by APOE -ε4. Longer reproductive span (OR=0.90 [95%CI 0.83–0.98]) and MHT use (OR=0.43 [95% CI 0.20–0.92]) were linked to lower SVD burden, particularly fewer perivascular spaces and microbleeds. OC and MHT were associated with greater white matter integrity, with additive use throughout life showing the highest fractional anisotropy (OR=0.45 [95% CI 0.12–0.78]). MHT use was associated with greater thickness in areas often affected in AD among APOE -ε4 carriers (β=0.38 [95% CI 0.01–0.76]) but not in non-carriers. Longer estrogen exposure was linked to stable cortical thickness and WMH trajectories over time. Conclusions: Extended estrogen exposure throughout life—both endogenous and exogenous—appear to support late-life cerebrovascular health in women, with potential genotype-specific neuroprotective effects. Given the current absence of sex-specific prevention guidelines for cognitive disorders, future research should clarify estrogen’s long-term impact on brain health and cognition to inform personalized medicine.

Background: Ageing involves heterogeneous brain grey matter (GM) patterns that may overlap with dementia-related changes. We evaluated cognitively unimpaired older adults to identify specific GM patterns, their clinical and cognitive profiles, and longitudinal trajectories. Methods: We analysed 746 participants from the Gothenburg H70 study using random forest cross-sectional clustering based on MRI measures of cortical thickness and subcortical volume across 41 regions. Using regression-based models, we examined associations with clinical, MRI variables, biochemical, and CSF Alzheimer biomarkers ( n = 286) and assessed 5-year longitudinal cognitive and brain trajectories. Results: Five clusters emerged, mainly differing in frontoparietal regions. Compared to Cluster 1 (reference), Cluster 2 showed diffuse GM loss, higher odds of diabetes ( OR = 2.54, 95% CI [1.27–5.06]) and at-risk alcohol consumption ( OR = 1.83, 95% CI [1.13–2.97]), poorer episodic memory ( β = − 0.19, p = 0.014) and visuospatial abilities ( β = − 0.21, p = 0.044), and greater longitudinal decline in MMSE ( β _slope = − 0.45, p = 0.035) and increase in white matter hyperintensity volume ( β _slope = 1.84, p = 0.004). Cluster 3 showed thicker GM and lower BMI ( OR = 0.57, 95% CI [0.35–0.94]). Cluster 4 had preserved GM, lower smoking habits ( OR = 0.62, 95% CI [0.40–0.95]), triglyceride levels ( OR = 0.55, 95% CI [0.32–0.95]) and depression ( OR = 0.17, 95% CI [0.05–0.56]), higher education ( OR = 2.52, 95% CI [1.08–5.87]), and better cognition in multiple domains. Cluster 5 had a mixed GM pattern and higher odds of heart disease ( OR = 3.44, 95% CI [1.48–8.01]). Conclusions: Cardiovascular and psychosocial factors influence GM integrity, which in turn relates to cognition. Targeting these risk factors may preserve brain health in late life.

Background: The EAT-Lancet Commission has proposed a global reference diet aimed at promoting both human health and environmental sustainability. While adherence to this dietary pattern has been associated with reduced risks of chronic disease and lower environmental impact, concerns remain about its ability to meet nutritional requirements - particularly among older adults. The aim was to explore the association between adherence to the EAT-Lancet diet and nutrient intake and adequacy among 70-year-old adults in Gothenburg, Sweden. Methods: This cross-sectional study included 861 participants from the Swedish population-based Gothenburg H70 Birth Cohort Study (mean age 70.5 years, 55% women). Dietary intake was assessed using a validated diet history interview, and adherence to the EAT-Lancet diet was scored based on 14 food components. Nutrient intake was evaluated against age- and sex-specific recommended intake (RI) levels. Cardiometabolic risk markers and biomarkers of nutritional status, including homocysteine and haemoglobin, were measured. Linear and logistic regression models were used to examine trends across sex-specific tertiles of diet adherence, with sensitivity analyses adjusting for energy intake and comparing adequacy based on average requirement (AR) thresholds. Results: Higher adherence to the EAT-Lancet diet was linked to higher intake of fibre and polyunsaturated fats, and lower intake of saturated fat and alcohol. Mean protein intake per kilogram body weight/day was similar across adherence tertiles. Intake of beta-carotene, folate, vitamin C, magnesium, potassium, and iron was higher with greater adherence, while retinol equivalents, vitamin B12, niacin equivalents was lower– patterns that remained consistent after energy adjustment. Despite lower B12 intake, homocysteine levels were lowest in the group with highest adherence, and anaemia prevalence did not differ. Micronutrient adequacy improved with higher adherence for vitamin E, folate, vitamin C, magnesium, potassium, and iron. Similar results were observed using average requirement (AR) thresholds in sensitivity analyses. Conclusions: Adherence to the EAT-Lancet diet was associated with a more favourable nutrient profile in this cohort of older adults, without evidence of widespread micronutrient inadequacy. These findings suggest that environmentally sustainable diets can support adequate nutrition when well-balanced, even in nutritionally vulnerable populations such as older adults.