Is the association between late-life morbidity and disability attenuated over time? : Exploring the dynamic equilibrium of morbidity hypothesis

Context: There is evidence suggesting that the prevalence of disability in late life has declined over time while the prevalence of disabling chronic diseases has increased. The dynamic equilibrium of morbidity hypothesis suggests that these seemingly contradictory trends are due to the attenuation of the morbidity-disability link over time. The aim of this study was to empirically test this assumption.Methods: Data were drawn from three repeated cross-sections of SWEOLD, a population-based survey among the Swedish men and women ages 77 and older. Logistic regression models were fitted to assess the trends in the prevalence of Activities of Daily Living (ADL) disability, Instrumental ADL (IADL) disability, and selected groups of chronic conditions. The changes in the associations between chronic conditions and disabilities were examined in both multiplicative and additive models.Results: Between 1992 and 2011, the odds of ADL disability significantly declined among women whereas the odds of IADL disability significantly declined among men. During the same period, the prevalence of most chronic morbidities including multimorbidity went up. Significant attenuations of the morbidity-disability associations were found for cardiovascular diseases, metabolic disorders, poor lung function, psychological distress, and multimorbidity.Conclusion: In agreement with the dynamic equilibrium hypothesis, this study concludes that the associations between chronic conditions and disability among the Swedish older adults have largely waned over time.

Catalytic reactions with palladium supported on mesocellular foam : Applications in hydrogenation, isomerization, and C-C bond forming reactions

The major part of this thesis concerns the development of catalytic methodologies based on palladium nanoparticles immobilized on aminopropyl-functionalized siliceous mesocellular foam (Pd0-AmP-MCF). The catalytic activity of the precursor to the nanocatalyst, PdII-AmP-MCF is also covered by this work. In the first part the application of Pd0-AmP-MCF in Suzuki-Miyaura cross-coupling reactions and transfer hydrogenation of alkenes under microwave irradiation is described. Excellent reactivity was observed and a broad range of substrates were tolerated for both transformations. The Pd0-AmP-MCF exhibited high recyclability as well as low metal leaching in both cases. The aim of the second part was to evaluate the catalytic efficiency of the closely related PdII-AmP-MCF for cycloisomerization of various acetylenic acids. The catalyst was able to promote formation of lactones under mild conditions using catalyst loadings of 0.3 - 0.5 mol% at temperatures of up to 50 oC in the presence of Et3N. By adding 1,4-benzoquinone to the reaction, the catalyst could be recycled four times without any observable decrease in the activity. The selective arylation of indoles at the C-2 position using Pd-AmP-MCF and symmetric diaryliodonium salts is presented in the third part. These studies revealed that Pd0-AmP-MCF was more effective than PdII-AmP-MCF for this transformation. Variously substituted indoles as well as diaryliodonium salts were tolerated, giving arylated indoles in high yields within 15 h at 20 - 50 oC in H2O. Only very small amounts of Pd leaching were observed and in this case the catalyst exhibited moderate recyclability. The final part of the thesis describes the selective hydrogenation of the C=C in different α,β-unsaturated systems. The double bond was efficiently hydrogenated in high yields both under batch and continuous-flow conditions. High recyclability and low metal leaching were observed in both cases.