The burden of caregivers of patients suffering from of Alzheimer type dementia (DAT) and vascular dementia (VD) was analysed at the critical time, the "breaking-point", when home care becomes insufficient and/or inadequate and the caregiver burden has probably reached its upper limit. Primary family caregivers of 39 DAT and 40 VD patients who were being considered for relocation into group-living units were studied. Total caregiving burden and different aspects of the burden: general strain, isolation, disappointment, and emotional involvement, were correlated with the patients' diagnoses, abilities, and symptoms. Closer kinship to the patient imposed a heavier burden. The caregiver's gender, social class, and previous institutionalization of the patient did not influence the caregiver burden. There was no significant correlation between the patients' ADL ability or cognition and the burden. A higher level of disappointment was found among the VD carers. Different symptomatology in patients of the two diagnostic groups was related to special aspects of the burden. Multiple regression analysis showed that the amount of caregiving time each week and impaired sense of own identity, misidentifications, clinical fluctuations, and nocturnal deterioration in the patients predicted the breaking-point.

The British Stroke Driver Screening Assessment (SDSA) is a set of four simple cognitive tests to evaluate driving fitness in stroke patients. To evaluate its usefulness in a Scandinavian context, we adapted the tests and assessed a group of 97 stroke patients from Sweden and Norway, using a driving test as the criterion. When results were calculated according to the original method, based on a discriminant function, less than 70% of the participants were correctly classified. To improve the predictive potential, a new discriminant analysis was performed, using the scores of a subsample of 49 patients, and validated on the remaining 48 participants. In total, 78% of the patients were correctly classified, but specificity was superior to sensitivity. We conclude that the Nordic version of the SDSA is a useful instrument, provided that test scores are interpreted in a balanced manner, taking into account the possibility of compensatory traffic behavior.

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The impact of occupational age-retirement on physical and mental health was investigated in 116 female municipal employees (age 62-64 years old) in Malmö. Interviews and physical examinations were made about six months prior to and five months after retirement. The women were asked about present state of subjective health, earlier and present diseases, various symptoms, medication, calls to physicians, smoking habits, physical activity and sleeping habits. The majority (n = 109.94%) felt healthy before retirement. At least one definable disease was noted in 41 (35%). A proportion of them had a low level of subjective health which, however, improved after retirement. The disease most commonly found was hypertension. After retirement the subjective health improved in 22% and got worse in 9%. Blood pressure diminished and particularly musculo-skeletal and psychiatric symptoms were less common. Calls to physicians diminished. Intake of drugs, smoking and sleeping habits and physical activity changed little. In general, occupational retirement due to age was associated with mostly positive influences on health.