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Background Lifestyle modification plays a key role in prevention of cardiovascular disease (CVD), but often fails due to non-adherence to lifestyle recommendations. Previous research has highlighted the importance of psychosocial factors in non-adherence, though focused on secondary rather than primary prevention. The aim of this scoping review was to provide an overview of the moderating role of psychosocial factors on the effect of lifestyle interventions in primary CVD prevention. Methods A literature search of scientific databases was performed to identify studies published in peer-reviewed journals, that evaluated lifestyle interventions in primary prevention in adult populations (18 years and older), with a composite CVD risk score or a CVD risk factor (diet, physical activity, smoking or alcohol) as outcome, and assessed the moderating effect of a psychosocial factor. Results Thirty-five studies published between 2000 and 2025 were included in this review. Most were randomized controlled trials (RCT), included middle-aged participants, and investigated samples in which women were in majority. The outcomes differed, with fourteen studies reporting on physical activity, eleven on diet, six on body weight, two on smoking and one on alcohol. One study used a CVD risk score as the outcome. The studies included a broad array of psychological factors that were grouped into five categories: self-efficacy or motivation ( n  = 11), social support or relationship quality ( n  = 8), mental health ( n  = 6), personality or emotions ( n  = 6), and cognitive factors ( n  = 4). Sixteen (44%) of the studies did not use validated instruments in the assessment of the psychosocial factor. Conclusions This review highlights the potential role of psychosocial factors on the effectiveness of lifestyle interventions. However, our ability to draw detailed conclusions or identify any general trends were limited by the heterogeneity amongst the studies in terms of study design, assessment of outcomes and moderators, and populations. Still, we identified a lack of RCTs (1) with long follow-up time, (2) with sufficient sample size, (3) using validated instruments to assess the psychosocial moderator, and (4) using interaction analyses to assess moderating effect. Trial registration This scoping review was registered at Open Science Framework (osf.io) under https://doi.org/10.17605/OSF.IO/VEADK on December 19, 2023.

ObjectivesTo examine the association between marital status and dementia in a cohort of young-old (50–64) and middle-old (65–74) adults, and also whether this may differ by gender.DesignProspective population-based study with follow-up time of up to 10 years.SettingSwedish national register-based study.Participants2 288 489 individuals, aged 50–74 years, without prior dementia diagnosis at baseline. Dementia was identified using the Swedish National Patient Register and the Cause of Death Register.Outcome measuresThe influence of marital status on dementia was analysed using Cox proportional hazards models, adjusted stepwise for multiple covariates (model 1: adjusted for age and gender; and model 2: additionally adjusted for having adult children, education, income and prior cardiovascular disease).ResultsDuring follow-up, 31 572 individuals in the study were identified as demented. Cox regression showed each non-married subcategory to be associated with a significantly higher risk of dementia than the married group, with the highest risk observed among people in the young-old age group, especially among those who were divorced or single (HRs 1.79 vs 1.71, fully adjusted model). Analyses stratified by gender showed gender differences in the young-old group, with indications of divorced men having a higher relative risk compared with divorced women (HRs 2.1 vs 1.7, only-age adjusted model). However, in the fully adjusted model, these differences were attenuated and there was no longer any significant difference between male and female participants.ConclusionsOur results suggest that those living alone as non-marrieds may be at risk for early-onset and late-onset dementia. Although more research is needed to understand the underlying mechanism by which marital status is associated with dementia, this suggests that social relationships should be taken seriously as a risk factor for dementia and that social-based interventions may provide an opportunity to reduce the overall dementia risk.

The aim of this study was to investigate how self-rated health (SRH) reflects ongoing ill-health and how SRH is associated with previous ill-health and/or predicts future ill-health such as burnout, disturbed sleep, and somatic symptoms. The study used two waves from the population-based Västerbotten Environmental and Health Study in which 2 336 adult persons participated by answering a questionnaire at two time points three years apart. Hierarchical and logistic regression analyses were conducted, thus treating all variables both continuously (degree) and categorically (case). The analyses were performed both cross-sectionally and longitudinally. The results showed bidirectionality between suboptimal SRH and burnout, disturbed sleep and somatic severity caseness. Moreover, degree of poor SRH was more likely to occur simultaneously to high degrees of burnout and somatic severity than to degree of poor sleep quality. Also, caseness of burnout, disturbed sleep and somatic severity increased the risk of simultaneous suboptimal SRH. Finally, the results showed that degree of burnout three years earlier, predicted degree of poor SRH, and that degree of poor SRH predicted degree of sleep three years later. In conclusion, in a population-based, normal adult sample there is a bidirectional relationship between suboptimal SRH and caseness of burnout, disturbed sleep quality and somatic symptoms, but not between degree of these symptoms. The results can have implications for health care meeting patients complaining about poor general health.

The year 2022 marks the 40th anniversary of Olof Palme’s Independent Commission on Disarmament and Security Issues. The Commission presented its report in 1982, at the height of the Cold War. It developed the concept of common security – the idea that nations and peoples can only feel safe when their counterparts feel safe. By taking the concept of common security as its starting point, the Common Security 2022 initiative has analysed the world we live in and some of the great challenges facing humanity on the planet earth. At the time of 50th anniversary of the 1972 Stockholm Conference (Stockholm+50), the Common Security 2022 recommendations are indications, or steps forward for our shared future that would include addressing the climate change, a process of removing the threat of nuclear annihilation and turning around the ‘super tanker’ of war.

ABSTRACTObjectivesProspective studies suggest that memory deficits are detectable decades before clinical symptoms of dementia emerge. However, individual differences in long-term memory trajectories prior to diagnosis need to be further elucidated. The aim of the current study was to investigate long-term dementia and mortality risk for individuals with different memory trajectory profiles in a well-characterized population-based sample. Methods1062 adults (aged 45–80 years) who were non-demented at baseline were followed over 23–28 years. Dementia and mortality risk were studied for three previously classified episodic memory trajectory groups: maintained high performance (Maintainers; 26%), average decline (Averages; 64%), and accelerated decline (Decliners; 12%), using multistate modeling to characterize individuals’ transitions from an initial non-demented state, possibly to a state of dementia and/or death. ResultsThe memory groups showed considerable intergroup variability in memory profiles, starting 10–15 years prior to dementia diagnosis, and prior to death. A strong relationship between memory trajectory group and dementia risk was found. Specifically, Decliners had more than a fourfold risk of developing dementia compared to Averages. In contrast, Maintainers had a 2.6 times decreased dementia risk compared to Averages, and in addition showed no detectable memory decline prior to dementia diagnosis. A similar pattern of association was found for the memory groups and mortality risk, although only among non-demented. ConclusionThere was a strong relationship between accelerated memory decline and dementia, further supporting the prognostic value of memory decline. The intergroup differences, however, suggest that mechanisms involved in successful memory aging may delay symptom onset.

Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: −0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.

Purpose Assessment of complex clinical skills and abilities is a challenge in mental health education. In the present study, an objective structured clinical examination (OSCE) was adapted to psychology and implemented in a Master in Psychology program. The purpose of the present study was to examine aspects of validity of this OSCE. Design/methodology/approach A total of 55 students enrolled in the Master in the Psychology program at Umeå University, Sweden, participated in two OSCE occasions. In addition to OSCE data, questionnaires were administered immediately after the OSCE to students (n = 18) and examiners (n = 13) to examine their perceptions of the OSCE. Findings The results provided support for different aspects of validity. The level of internal consistency was close to acceptable, and there was a good correspondence between global ratings and checklist scores for many stations. However, adding an additional category to the global rating scale and reviewing some of the station checklists might improve the assessment further. The present cut-score of the OSCE was comparable to a cut-score set by the borderline regression model. In general, students and examiners perceived the OSCE as a high-quality examination, although examiners raised some issues that could improve the OSCE further. Originality/value In conclusion, OSCE is a promising assessment in psychology, both from a psychometric perspective and from a test-taker and examiner perspective. The present study is an important contribution to the field as there are only a few examples where OSCE has been used in clinical psychology, and to the best of the authors’ knowledge, this paper is the first to evaluate the validity of such an assessment.

Burnout is an increasing public health problem. Although research indicate that cognitive and affective factors are related to burnout, there is a lack of knowledge about the extent to which specific cognitive and affective symptoms are related to burnout, and whether there are sex-related differences. An aim of this study was to identify specific self-reported cognitive and affective symptoms that are particularly associated with burnout, both in the population in general and in men and women separately. Another aim was to examine the risk of burnout for specific symptoms and total number of symptoms in the general population and in men and women separately. Cross-sectional data were used from a large population-based questionnaire study consisting of 3406 participants (18-79 years) randomly selected from a general population in northern Sweden. Eleven cognitive and affective symptoms were assessed with a subsection of the Environmental Hypersensitivity Symptom Inventory, and the 22-item Shirom-Melamed Burnout Questionnaire (SMBQ) was used to assess burnout. The findings suggest that burnout is associated with a rather large number of cognitive and affective symptoms, in particular feeling tired/lethargic, having concentration difficulties, sleep disturbance, feeling depressed and being absent minded. Women with burnout (SMBQ score ≥ 4) reported higher prevalence of feeling tired/lethargic and sleep disturbance. The results add to the understanding of affective and cognitive symptomatology in burnout, which might have implications for early identification and prevention of burnout and exhaustion disorder.

This study examines the association between marital and parental status and their individual and combined effect on risk of dementia diseases in a population-based longitudinal study while controlling for a range of potential confounders, including social networks and exposure to stressful negative life events. A total of 1,609 participants without dementia, aged 65 years and over, were followed for an average period of 8.6 years (SD = 4.8). During follow-up, 354 participants were diagnosed with dementia. Cox regression was used to investigate the effect of marital and parental status on risk of dementia. In univariate Cox regression models (adjusted for age as time scale), widowed (hazard ratio (HR) 1.42, 95% confidence interval (CI) = 1.13–1.78), and not having children (HR 1.54, 95% CI = 1.15–2.06) were significantly associated with incident dementia. In multivariate analyses that included simultaneously marital and parental status and covariates that were found to be significant in univariate models (p < 0.10), the HR was 1.30 (95% CI = 1.01–1.66) for widowed, and 1.51 (95% CI = 1.08–2.10) for those not having children. Finally, a group of four combined factors was constructed: married parents (reference), married without children, widowed parents, and widowed without children. The combined effect revealed a 1.3 times higher risk (95% CI = 1.03–1.76) of dementia in widow parents, and a 2.2 times higher risk (95% CI = 1.36–3.60) in widowed persons without children, in relation to married parents. No significant difference was observed for those being married and without children. Our findings suggest that marital- and parental status are important risk factors for developing dementia, with especially increased risk in those being both widowed and without children.

Patients with type 1 diabetes (T1D) have an increased risk of cognitive dysfunction. The cognitive decrement is believed to depend on macro- and microvascular complications and long disease duration. Some patients do not develop these complications, but still report cognitive symptoms. We examined if long-standing T1D without complications is associated with lower cognitive performance. A group of patients (n=43) with long-standing T1D (>30years) without micro- or macro vascular complications was compared with a non-diabetic control group (n=86) on six cognitive tests which probed episodic memory, semantic memory, episodic short-term memory, visual attention and psychomotor speed. Each patient was matched with two controls regarding age, gender and education. A linear mixed effect model was used to analyze the data. The mean age was 57years and mean duration was 41years. Patients with diabetes had lower diastolic blood pressure but BMI, waist circumference, systolic blood pressure and smoking did not differ between groups. Patients had lower results than non-diabetic controls in episodic short-term memory (p<0.001) and also lower values on a test that mirrors visual attention and psychomotor speed (p=0.019). Long-standing T1D was associated with lower cognitive performance, regardless of other diabetes-related complications.