Publications
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Mathiesen, Liv; Blix, Hege Salvesen; Molden, Espen; Kersten, Hege; Trapnes, Elin & Bergan, Stein
[Show all 7 contributors for this article]
(2024).
Erfaringsbasert master i klinisk farmasi – en kartleggingsstudie.
Norsk Farmaceutisk Tidsskrift.
ISSN 0029-1935.
p. 32–36.
Show summary
Hensikt
Kartlegge bakgrunn for farmasøyter som har gjennomført minst halve det erfaringsbaserte masterprogrammet i klinisk farmasi ved Farmasøytisk institutt, Universitetet i Oslo. Kartlegge i hvilken grad arbeidsoppgavene har endret seg for de som har fullført utdanningen.
Materiale og metode
Deskriptiv nettbasert spørreskjemaundersøkelse med spørsmål knyttet til demografi, grunnutdanningen i farmasi, det erfaringsbaserte masterprogrammet og arbeidsoppgaver. Farmasøyter som hadde fullført minst tre av seks emner i masterprogrammet, kunne inkluderes, og 92 farmasøyter ble invitert til å delta.
Resultater
82 farmasøyter (88 %) besvarte undersøkelsen, hvorav 53 hadde gjennomført hele utdanningen, og 29 farmasøyter hadde gjennomført minst halve utdanningen. Blant respondentene som hadde fullført masterprogrammet, hadde en signifikant høyere andel 5-årig farmasiutdanning (master i farmasi eller cand.pharm.) (p < 0,01) og jobbet i sykehus med klinisk farmasøytiske oppgaver før de startet på masterprogrammet (p = 0,04), sammenliknet med de som var underveis i utdanningen. Blant de som hadde fullført masterprogrammet, svarte 93 % at de hadde jobbet med klinisk farmasøytiske oppgaver etter utdanningen. Det var 70 % som for tiden utførte klinisk farmasøytiske arbeidsoppgaver, sammenliknet med 62 % før oppstart. 43 % hadde vært involvert i kliniske forskningsprosjekter etter endt utdanning.
Konklusjon
Blant de som var i ferd med å gjennomføre videreutdanningen var det flere med bachelorgrad og færre med erfaring som klinisk farmasøyt enn i gruppen som hadde fullført. Ni av ti farmasøyter som hadde gjennomført hele videreutdanningen, har hatt klinisk arbeidsoppgaver etterpå, mens seks av ti hadde slike oppgaver før utdanningen. Nesten halvparten hadde vært involvert i kliniske forskningsprosjekter.
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Nilsson, Per Rasmus; Næss-Andresen, Thomas Fredrik; Myklebust, Tor Åge; Bernklev, Tomm; Kersten, Hege & Haug, Erik Skaaheim
(2024).
The association between pre-diagnostic levels of psychological distress and adverse effects after radical prostatectomy.
BJUI Compass.
ISSN 2688-4526.
p. 1–10.
doi:
10.1002/bco2.334.
Show summary
Objectives: To prospectively analyse the associations between pre-diagnostic levels of anxiety and depression and patient-reported urinary and sexual adverse effects after radical prostatectomy in a population-based setting.
Patients and Methods: In three Norwegian county hospitals, men referred with a suspicion of prostate cancer were asked to fill out a patient-reported outcome measurement (PROM) questionnaire prior to prostate biopsy. Those who later underwent radical prostatectomy were stratified into three distress groups according to their Hopkins Symptom Checklist 5-score. Additional PROM questionnaires, including the EPIC-26 to measure adverse effects, were collected at 6 and 12 months postoperatively. Multivariable mixed models were estimated and post hoc pairwise comparisons performed to explore differences in adverse effects between distress groups.
Results: A total of 416 men were included at baseline and of those, 365 (88%)returned questionnaires at 6 months and 360 (87%) at 12 months. After adjusting for confounders, men with high distress at baseline had worse urinary incontinence
domain score (58.9 vs. 66.8, p = 0.028), more urinary bother (64.7 vs. 73.6, p = 0.04) and a higher risk of using incontinence pads (70.6% vs. 54.2%, p = 0.034) at 6 months
than those with low distress. There was no difference in the sexual domain scores between distress groups postoperatively, but the high-distress group expressed more sexual bother (24.9 vs. 37.5, p = 0.015) and the intermediate-distress group had a greater probability of using sexual medications or devices (63.8% vs. 50.0%, p = 0.015) than the low-distress group at 6 months. At 12 months scores generally improved slightly and differences between distress groups were less evident.
Conclusion: Men with higher levels of anxiety and depression before prostate biopsy report more urinary and sexual adverse effects after radical prostatectomy. This should be considered both in treatment decision-making and during follow-up after radical prostatectomy.
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Sarjomaa, Marjut Anneli; Zhang, Chi; Tveten, Yngvar; Kersten, Hege; Reiso, Harald & Eikeland, Randi
[Show all 14 contributors for this article]
(2024).
Risk factors for SARS-CoV-2 infection: A test-negative case-control study with additional population controls in Norway.
BMJ Open.
ISSN 2044-6055.
14(1),
p. 1–11.
doi:
10.1136/bmjopen-2023-073766.
Full text in Research Archive
Show summary
Objectives This study aims to assess risk factors for
SARS-CoV-2 infection by combined design; first comparing
positive cases to negative controls as determined by PCR testing and then comparing these two groups to an additional prepandemic population control group.
Design and setting
Test-negative design (TND), multicentre case–control study with additional population controls in South-Eastern Norway.
Participants
Adults who underwent SARS-CoV-2 PCR testing between February and December 2020. PCR-positive cases, PCR-negative controls and additional age-matched population controls.
Primary outcome measures
The associations between various risk factors based on self- reported questionnaire and SARS-CoV-2 infection comparing PCR-positive cases and PCR-negative controls. Using subgroup analysis, the risk factors for both PCR-positive and PCR-negative participants were compared with a population control
group.
Results
In total, 400 PCR-positive cases, 719 PCR-negative controls and 14 509 population controls were included. Male sex was associated with the risk of SARS-CoV-2 infection only in the TND study (OR 1.9, 95% CI 1.4 to 2.6), but not when PCR-positive cases were compared with population controls (OR 1.2, 95% CI 0.9. to 1.5). Some factors were positively (asthma, wood heating) or negatively (hypertension) associated with SARS-CoV-2 infection when PCR-positive cases were compared with population controls, but lacked convincing association in the TND study. Smoking was negatively associated with the risk of SARS-CoV-2 infection in both analyses (OR 0.5, 95% CI 0.3 to 0.8 and OR 0.6, 95% CI 0.4 to 0.8).
Conclusions
Male sex was a possible risk factor for SARS-CoV-2 infection only in the TND study, whereas smoking was negatively associated with SARS-CoV-2 infection in both the TND study and when using population controls. Several factors were associated with SARS-CoV-2 infection when PCR-positive cases were compared with population controls, but not in the TND study, highlighting the strength of combining case–control study designs during the pandemic.
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Sarjomaa, Marjut Anneli; Diep, Lien My; Zhang, Chi; Tveten, Yngvar; Reiso, Harald & Thilesen, Carina
[Show all 14 contributors for this article]
(2022).
SARS-CoV-2 antibody persistence after five and twelve months: A cohort study from South-Eastern Norway.
PLOS ONE.
ISSN 1932-6203.
17(8),
p. 1–15.
doi:
10.1371/journal.pone.0264667.
Full text in Research Archive
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Objectives: To assess total antibody levels against Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS CoV-2) spike protein up to 12 months after Coronavirus Disease (COVID-19) infection in non-vaccinated individuals and the possible predictors of antibody persistence.
Methods: This is the first part of a prospective multi-centre cohort study.
Participants: The study included SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) positive and negative participants in South-Eastern Norway from February to December 2020. Possible predictors of SARS-CoV-2 total antibody persistence was assessed. The SARS-CoV-2 total antibody levels against spike protein were measured three to five months after PCR in 391 PCR-positive and 703 PCR-negative participants; 212 PCR-positive participants were included in follow-up measurements at 10 to 12 months. The participants completed a questionnaire including information about symptoms, comorbidities, allergies, body mass index (BMI), and hospitalisation.
Primary outcome: The SARS-CoV-2 total antibody levels against spike protein three to five and 10 to 12 months after PCR positive tests.
Results: SARS-CoV-2 total antibodies against spike protein were present in 366 (94%) non-vaccinated PCR-positive participants after three to five months, compared with nine (1%) PCR-negative participants. After 10 to 12 months, antibodies were present in 204 (96%) non-vaccinated PCR-positive participants. Of the PCR-positive participants, 369 (94%) were not hospitalised. The mean age of the PCR-positive participants was 48 years (SD 15, range 20-85) and 50% of them were male. BMI ≥ 25 kg/m2 was positively associated with decreased antibody levels (OR 2.34, 95% CI 1.06 to 5.42). Participants with higher age and self-reported initial fever with chills or sweating were less likely to have decreased antibody levels (age: OR 0.97, 95% CI 0.94 to 0.99; fever: OR 0.33, 95% CI 0.13 to 0.75).
Conclusion: Our results indicate that the level of SARS-CoV-2 total antibodies against spike protein persists for the vast majority of non-vaccinated PCR-positive persons at least 10 to 12 months after mild COVID-19.
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Flemmen, Heidi Øyen; Simonsen, Cecilia Smith; Broch, Line; Brunborg, Cathrine; Berg-Hansen, Pål & Moen, Stine Marit
[Show all 8 contributors for this article]
(2022).
The influence of socioeconomic factors on access to disease modifying treatment in a Norwegian multiple sclerosis cohort.
Multiple Sclerosis and Related Disorders.
ISSN 2211-0348.
61,
p. 1–10.
doi:
10.1016/j.msard.2022.103759.
Full text in Research Archive
Show summary
Objective: Several studies report an impact of socioeconomic factors on access to disease modifying treatment (DMT) in multiple sclerosis (MS), with a trend of less access to more deprived persons. We investigated the impact of socioeconomic status (SES) on access to treatment in a well-defined Norwegian MS cohort.
Methods: This is a study of a population-based Norwegian MS cohort. We collected detailed information on disease development, progression, and DMT administered. Socioeconomic data was obtained from Statistics Norway and a questionnaire.
Results: We included 1314 persons with relapsing remitting MS at the prevalence date 01/01/2018. The population ever treated with DMTs is younger at onset, has shorter time from onset to diagnosis and lower expanded disability status score (EDSS) at diagnosis. The persons with MS (pwMS) with the highest levels of education, and those who are married are more likely to be ever treated with DMT. In the subgroup treated with a high efficacy DMT as a first drug, the pwMS are younger at prevalence date (39.9 years (SD 12.1)) compared with those who are not treated with a high efficacy DMT as first drug (43.8 years (SD 10.3)). The subgroup treated with a high efficacy DMT as a first drug has a 0.5 point higher EDSS at diagnosis compared to those not treated with a high efficacy DMT as a first drug. The level of education, household income and marital status are inversely related to access to high efficacy DMT as a first drug. None of the above differences persist when analyzing the subgroup diagnosed within the last six years (2012-2017).
Conclusions: Since 2012, the pwMS in this Norwegian cohort are treated equally with DMT in terms of different measures of socioeconomic position.
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Wang-Hansen, Marte Sofie; Kersten, Hege; Saltyte Benth, Jurate & Wyller, Torgeir Bruun
(2022).
The association between geriatric treatment and 30-day readmission risk among medical inpatients aged ≥75 years with multimorbidity
.
PLOS ONE.
ISSN 1932-6203.
17(1).
doi:
10.1371/journal.pone.0262340.
Full text in Research Archive
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Background: Readmission to hospital is frequent among older patients and reported as a post-discharge adverse outcome. The effect of treatment in a geriatric ward for acutely admitted older patients on mortality and function is well established, but less is known about the possible influence of such treatment on the risk of readmission, particularly in the oldest and most vulnerable patients. Our aim was to assess the risk for early readmission for multimorbid patients > 75 years treated in a geriatric ward compared to medical wards and to identify risk factors for 30-day readmissions.
Methods: Prospective cohort study of patients acutely admitted to a medical department at a Norwegian regional hospital. Eligible patients were community-dwelling, multimorbid, receiving home care services, and aged 75+. Patients were consecutively included in the period from 1 April to 31 October 2012. Clinical data were retrieved from the referral letter and medical records.
Results: We included 227 patients with a mean (SD) age of 86.0 (5.7) years, 134 (59%) were female and 59 (26%) were readmitted within 30 days after discharge. We found no statistically significant difference in readmission rate between patients treated in a geriatric ward versus other medical wards. In adjusted Cox proportional hazards regression analyses, lower age (hazard ratio (95% confidence interval) 0.95 (0.91-0.99) per year), female gender (2.17 (1.15-4.00)) and higher MMSE score (1.03 (1.00-1.06) per point) were significant risk factors for readmission.
Conclusions: Lower age, female gender and higher cognitive function were the main risk factors for 30-day readmission to hospital among old patients with multimorbidity. We found no impact of geriatric care on the readmission rate.
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Flemmen, Heidi Øyen; Simonsen, Cecilia Smith; Broch, Line; Brunborg, Cathrine; Berg-Hansen, Pål & Moen, Stine Marit
[Show all 8 contributors for this article]
(2021).
Maternal education has significant influence on progression in multiple sclerosis.
Multiple Sclerosis and Related Disorders.
ISSN 2211-0348.
53,
p. 1–10.
doi:
10.1016/j.msard.2021.103052.
Full text in Research Archive
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Objective: The identification of potential risk factors for disease severity is of great importance in the treatment of multiple sclerosis. The influence of socioeconomic status on progression in multiple sclerosis (MS) is sparsely investigated. Our aim was to investigate how socioeconomic status in adolescence influences disease progression in later life.
Methods: A total of 1598 patients with multiple sclerosis from a well-defined population in Norway were included. Detailed information on disease progression, measured by expanded disability status scale (EDSS) and multiple sclerosis severity score (MSSS), were combined with data on socioeconomic factors. We used residency and parental level of education at patients' age 16 and exposure to second-hand smoking as a measure of socioeconomic status in adolescence, adjusting for the same variables as well as use of disease modifying treatments at prevalence date 01.01.18.
Results: High maternal level of education at patients' age 16 was significantly associated with less pronounced disease progression measured by MSSS (β-coefficient -0.58, p = 0.015), younger age and lower EDSS at disease onset, and shorter time from onset to diagnosis. No significant associations were found for paternal education level and MSSS. The use of any disease modifying treatment before prevalence date was significantly associated with disease progression (β-coefficient -0.49, p=0.004), while residence, current and second-hand smoking were not.
Conclusion: This study on a population-based, real-world cohort shows that the parental level of education has a significant impact on a timely diagnosis of MS. In addition to disease modifying treatment, maternal level of education also had an impact on disease progression in later life.
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Sandvik, Miriam Kristine; Watne, Leiv; Brugård, Anniken; Wang-Hansen, Marte Sofie & Kersten, Hege
(2021).
Association between psychotropic drug use and handgrip strength in older hospitalized patients.
European Geriatric Medicine.
ISSN 1878-7649.
12(6),
p. 1213–1220.
doi:
10.1007/s41999-021-00511-6.
Full text in Research Archive
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Purpose: Handgrip strength is an indicator of frailty and longevity in older adults. The association between psychotropic drug use and handgrip strength in older hospitalized patients was investigated in this study.
Methods: A total of 488 patients were included in this retrospective cross-sectional study, 333 women and 155 men, from two different cohorts of older (mean age 84 years) hospitalized in-patients. We used multiple linear regression models to explore the association between psychotropic drug use and handgrip strength. We adjusted for factors known to affect handgrip strength: Age, gender, body mass index (BMI) and comorbidity (Charlson comorbidity index).
Results: Both unadjusted and adjusted analyses showed that psychotropic drug use was associated with handgrip strength (β = - 0.183, p
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Nilsson, Rasmus; Næss-Andresen, Thomas Fredrik; Myklebust, Tor Åge; Bernklev, Tomm; Kersten, Hege & Haug, Erik Skaaheim
(2021).
Fear of Recurrence in Prostate Cancer Patients: A Cross-sectional Study After Radical Prostatectomy or Active Surveillance.
European Urology Open Science.
ISSN 2666-1691.
25,
p. 44–51.
doi:
10.1016/j.euros.2021.01.002.
Full text in Research Archive
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Background: Fear of recurrence (FoR) is a distressing consequence of cancer. Little
is known about the prevalence of FoR in different treatment groups and factors
associated with FoR among prostate cancer (PCa) survivors.
Objective: To investigate the prevalence of high FoR among PCa survivors after
radical prostatectomy (RP) or under active surveillance (AS) and to explore clinical
and psychological factors potentially associated with FoR.
Design, setting, and participants: This is a retrospective cross-sectional study of
606 patients with PCa, treated with either RP (n = 442) or AS (n = 164) at two
Norwegian regional hospitals. The 440 patients (73%) who gave consent to participate
were invited in 2017 to complete a questionnaire measuring FoR, self-rated
health, adverse effects, and psychological factors at a mean of 4.1 yr (standard
deviation 1.7) after their treatment decision. Clinical data were retrieved from
medical records.
Outcome measurements and statistical analysis: FoR was measured using the
Concerns About Recurrence Questionnaire, with high FoR defined as a sum score
of ≥12 points (range 0–40). Using multivariable logistic regression analyses, factors
associated with high FoR were identified.
Results and limitations: One-third of the participants had high FoR; scores were
higher in the AS group and in the RP group with treatment failure. Younger age was
significantly associated with high FoR in the AS group, while high prostate-specific
antigen at diagnosis, biochemical recurrence, positive surgical margin, higher fatigue, and a type D personality were significantly associated with high FoR in the
RP group.
Conclusions: At 4 yr after a diagnosis of PCa, high FoR was common, especially
among AS patients and among RP patients with treatment failure.
Patient summary: In this study, we examined fear that their disease will return or
progress among prostate cancer survivors. We found that such fear was common,
especially among young patients under active surveillance and among radical
prostatectomy patients with treatment failure or with certain psychological
features.
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Romskaug, Rita; Wyller, Torgeir Bruun; Straand, Jørund; Kersten, Hege & Molden, Espen
(2020).
Prescribed Doses of CYP2D6-Metabolized Drugs and Hemodynamic Responses in Relation to CYP2D6 Genotype Among Older Patients Exposed to Polypharmacy.
Drugs & Aging.
ISSN 1170-229X.
37(6),
p. 425–433.
doi:
10.1007/s40266-020-00763-0.
Full text in Research Archive
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Background: Many drugs with dose-dependent effects on hemodynamic variables are metabolized by cytochrome P450 2D6 (CYP2D6). The aim of this study was to compare prescribed dosages and hemodynamic responses of such drugs in relation to pharmacogenetic variability in CYP2D6 metabolism among patients aged ≥ 70 years exposed to polypharmacy.
Materials and methods: We included 173 patients with detailed information about drug use. The patients were retrospectively subjected to CYP2D6 genotyping, which comprised the most common variant alleles encoding reduced, absent, or increased CYP2D6 metabolism. In order to compare dosages across different CYP2D6-metabolized drugs, all prescribed daily doses were harmonized to the 'percent of a daily defined dose' (DDD). The mean harmonized DDD was compared between genotype-predicted normal metabolizers (NMs) and patients with reduced or absent CYP2D6 enzyme activity, defined as intermediate or poor metabolizers (IMs/PMs). Blood pressure, pulse, and patient proportions with orthostatism and bradycardia were also compared between genotype subgroups.
Results: The genotype-predicted phenotype subgroups comprised 79 NMs (45.7%), 75 IMs (43.4%), and 16 PMs (9.2%). There were no differences in dosing of CYP2D6 substrates between NMs and IMs/PMs (p = 0.76). A higher proportion of CYP2D6 IMs/PMs experienced orthostatism (p = 0.03), while there were no significant subgroup differences for the other hemodynamic variables.
Conclusion: In this real-life clinical setting of patients aged ≥ 70 years, dosing of CYP2D6 substrates were not adjusted according to genotype-predicted CYP2D6 metabolism. The increased occurrence of orthostatism in patients with reduced/absent CYP2D6 metabolism may indicate that individualized dosing based on genotype has the potential to prevent adverse effects in these vulnerable patients.
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Flemmen, Heidi Øyen; Simonsen, Cecilia Smith; Berg-Hansen, Pål; Moen, Stine Marit; Kersten, Hege & Heldal, Kristian
[Show all 7 contributors for this article]
(2020).
Prevalence of multiple sclerosis in rural and urban districts in Telemark county, Norway.
Multiple Sclerosis and Related Disorders.
ISSN 2211-0348.
45.
doi:
10.1016/j.msard.2020.102352.
Full text in Research Archive
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Objective: To explore the trends in prevalence and incidence of multiple sclerosis (MS) in Telemark, Norway (latitude 58.7-60.3˚N), over the past two decades, with focus on differences between rural and urban areas.
Methods: Data from all patients with a confirmed diagnosis of MS in Telemark since 1993 were prospectively recorded and collected in a retrospective chart review. Prevalence estimates on January 1st 1999, 2009 and 2019, and incidence rates at five-year intervals between 1999 and 2018 were calculated and all results were adjusted to the European Standard Population. The study population was divided into urban and rural residency using a Norwegian governmental index.
Results: We registered 579 patients with MS in Telemark between 1999 and 2019. The adjusted prevalence estimates for January 1st 1999, 2009 and 2019 were 105.8/105, 177.1/105 and 260.6/105, respectively. In 2019, the prevalence estimates were 250.4/105 in urban and 316.2 /105 in rural areas. Between 1999 and 2018, the yearly incidence increased from 8.4/105 to 14.4/105.
Conclusions: The prevalence of MS in Telemark is among the highest ever reported in Norway, consistent with an increasing incidence in the county over the past twenty years. The even higher prevalence in the rural areas is unlikely to be explained by possible risk factors like latitude, exposure to sunlight and diet. Further studies on differences between urban and rural areas are required to reveal possible new risk factors.
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Hvidsten, Lara H. Thomasgaard; Engedal, Knut; Selbæk, Geir; Wyller, Torgeir Bruun; Saltyte Benth, Jurate & Kersten, Hege
(2019).
Quality of Life of Family Carers of Persons with Young-Onset Dementia: A Nordic Two-Year Observational Multicenter.
PLOS ONE.
ISSN 1932-6203.
14(7).
doi:
10.1371/journal.pone.0219859.
Full text in Research Archive
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Objectives
To identify factors associated with QOL in carers of persons with young-onset Alzheimer’s (AD) and frontotemporal dementia (FTD) and explore development in QOL over a two-year period.
Methods
Eighty-eight family carers of community-dwelling people with young-onset AD (n = 50) and FTD (n = 38) recruited from Nordic memory clinics. Carer QOL was assessed using the Quality of Life–Alzheimer’s Disease questionnaire. Carer burden was assessed by the Relatives’ Stress scale and depressive symptoms by the Montgomery-Åsberg Depression Rating Scale. Factors associated with QOL in YOD and development in QOL over time were explored with growth mixture model trajectories and mixed model analyses.
Results
We identified two carer groups of persons with YOD following trajectories with better (n = 53) versus poorer (n = 30) QOL. Carers who reported more burden at baseline had greater odds of belonging to the poorer QOL group (OR 1.1 (1.0–1.2), p = 0.004). Analyses of the development in QOL showed a significant decline in QOL–AD scores among the AD-carers from baseline to two-year follow-up (p = 0.044), while the score remained stable among the FTD-carers. The FTD-carer group had significantly higher mean QOL–AD scores at one- and two-year follow-up (p = 0.022 and 0.045, respectively). However, the difference between the two groups regarding time trend was non-significant. Poorer QOL was associated with increased carer burden (p = 0.01), more depressive symptoms (p = 0.024), and being male carer (p = 0.038).
Conclusion
Higher care burden, more depressive symptoms, and being a male carer was associated with poorer QOL in family carers for persons with YOD. Carers of persons with AD may experience greater challenges in preserving QOL compared to carers of persons with FTD.
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Hvidsten, Lara H. Thomasgaard; Engedal, Knut; Selbæk, Geir; Wyller, Torgeir Bruun; Bruvik, Frøydis Kristine & Kersten, Hege
(2018).
Quality of Life in People with Young-Onset Alzheimer’s Dementia and Frontotemporal Dementia.
Dementia and Geriatric Cognitive Disorders.
ISSN 1420-8008.
45(1-2),
p. 91–104.
doi:
10.1159/000487263.
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Barca, Maria Lage; Persson, Karin; Eldholm, Rannveig Sakshaug; Saltyte Benth, Jurate; Kersten, Hege & Knapskog, Anne Brita
[Show all 9 contributors for this article]
(2017).
Trajectories of depressive symptoms and their relationship to the progression of dementia.
Journal of Affective Disorders.
ISSN 0165-0327.
222,
p. 146–152.
doi:
10.1016/j.jad.2017.07.008.
Full text in Research Archive
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Background
The relationship between progression of Alzheimer's disease and depression and its underlying mechanisms has scarcely been studied.
Methods
A sample of 282 outpatients with Alzheimer's disease (AD; 105 with amnestic AD and 177 with Alzheimer's dementia) from Norway were followed up for an average of two years. Assessment included Cornell Scale for Depression in Dementia and Clinical Dementia Rating Scale (CDR) at baseline and follow-up to examine the relationship between AD and depression. Additionally, MRI of the brain, CSF dementia biomarkers and APOE status were assessed at baseline. Progression of dementia was defined as the difference between CDR sum of boxes at follow-up and baseline (CDR-SB change). Trajectories of depressive symptoms on the Cornell Scale were identified using growth mixture modeling. Differences between the trajectories in regard to patients’ characteristics were investigated.
Results
Three distinct trajectories of depressive symptoms were identified: 231 (82.8%) of the patients had stable low-average scores on the Cornell Scale (Class 1); 11 (3.9%) had high and decreasing scores (Class 2); and 37 (13.3%) had moderate and increasing scores (Class 3). All classes had average probabilities over 80%, and confidence intervals were non-overlapping. The only significant characteristic associated with membership in class 3 was CDR-SB change.
Limitations
Not all patients screened for participation were included in the study, but the included and non-included patients did not differ significantly. Some patients with amnestic MCI might have been misdiagnosed.
Conclusion
A more rapid progression of dementia was found in a group of patients with increasing depressive symptoms.
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Kersten, Hege; Hvidsten, Lara H. Thomasgaard; Gløersen, Gløer; Wyller, Torgeir Bruun & Wang-Hansen, Marte Sofie
(2015).
Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity.
Scandinavian Journal of Primary Health Care.
ISSN 0281-3432.
33(4),
p. 243–251.
doi:
10.3109/02813432.2015.1084766.
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Kersten, Hege
(2015).
Legemiddelbruk relatert til demensutvikling.
Norsk Farmaceutisk Tidsskrift.
ISSN 0029-1935.
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Nesset, Magnar; Kersten, Hege & Ulstein, Ingun
(2014).
Brief Tests such as the Clock Drawing Test or Cognistat Can Be Useful Predictors of Conversion from MCI to Dementia in the Clinical Assessment of Outpatients.
Dementia and Geriatric Cognitive Disorders Extra.
ISSN 1664-5464.
4(2),
p. 263–270.
doi:
10.1159/000363734.
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Kersten, Hege; Molden, Espen; Willumsen, Tiril; Engedal, Knut Arne & Wyller, Torgeir Bruun
(2013).
Higher anticholinergic drug scale (ADS) scores are associated with peripheral but not cognitive markers of cholinergic blockade. Cross sectional data from 21 Norwegian nursing homes.
British Journal of Clinical Pharmacology.
ISSN 0306-5251.
75(3),
p. 842–849.
doi:
10.1111/j.1365-2125.2012.04411.x.
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Kersten, Hege; Ruths, Sabine & Wyller, Torgeir Bruun
(2009).
Farmakoterapi i sykehjem.
Tidsskrift for Den norske legeforening.
ISSN 0029-2001.
129(17),
p. 1732–1735.
View all works in Cristin
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Tveito, Marit; Engedal, Knut & Kersten, Hege
(2021).
Legemidler.
In Krohne, Kariann (Eds.),
ABC Aldring og omsorg.
Aldring og helse.
ISSN 9788280616500.
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Eldholm, Rannveig Sakshaug; Barca, Maria Lage; Persson, Karin Ester Torun; Knapskog, Anne Brita; Kersten, Hege & Skovlund, Eva
[Show all 9 contributors for this article]
(2018).
Do vascular risk factors and vascular diseases influence disease progression in Alzheimer's disease?
Foredrag som ledd i felles symposium med tittelen "Biomarkers and clinical factors in mild cognitive impairment and dementia - a multicenter study" holdt av forskningsgruppen bak studien Progression of Alzheimer's Disease and Resource use (PADR).
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Eldholm, Rannveig Sakshaug; Persson, Karin; Barca, Maria Lage; Brækhus, Anne; Knapskog, Anne Brita & Selbæk, Geir
[Show all 9 contributors for this article]
(2016).
Progression of Alzheimer's disease: the influence of vascular risk factors and diseases. A longitudinal study in Norwegian memory clinics.
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Eldholm, Rannveig Sakshaug; Persson, Karin; Barca, Maria Lage; Brækhus, Anne; Knapskog, Anne Brita & Selbæk, Geir
[Show all 9 contributors for this article]
(2016).
Prognostic factors for Progression of Alzheimer's disease and use of Resources (PADR) study.
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Barca, Maria Lage; Persson, Karin; Eldholm, Rannveig Sakshaug; Knapskog, Anne Brita; Kersten, Hege & Saltvedt, Ingvild
[Show all 9 contributors for this article]
(2016).
Prognostic factors in mild cognitive impairment and Alzheimer's disease (symposium).
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Kersten, Hege
(2016).
The prevalence and cognitive correlates of drugs with potential risk of dementia.
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Kersten, Hege
(2016).
The incidence and prognosis of dementia related to drug use, the IPOD-D study.
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Hvidsten, Lara H. Thomasgaard; Millenaar, Joany; Kersten, Hege; Engedal, Knut; Selbæk, Geir & Bruun Wyller, Torgeir
[Show all 14 contributors for this article]
(2016).
Consequences of Young Onset Dementia on daily living and important predictors of quality of life- results from a European multicenter assesment.
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Hvidsten, Lara H. Thomasgaard; Engedal, Knut; Selbæk, Geir; Wyller, Torgeir Bruun & Kersten, Hege
(2016).
Cognitive characteristics in persons with young onset Alzheimer’s Disease and Frontotemporal Dementia in Nordic Memory Clinics.
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Hvidsten, Lara H. Thomasgaard; Engedal, Knut; Selbæk, Geir; Wyller, Torgeir Bruun & Kersten, Hege
(2015).
Kognitive karakteristika hos yngre med demens i norske hukommelsesklinikker - Alzheimers demens og frontotemporallappsdemens.
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Hvidsten, Lara H. Thomasgaard; Bruun Wyller, Torgeir; Selbæk, Geir; Engedal, Knut & Kersten, Hege
(2015).
Cognitive Characteristics in Persons with Young Onset Alzheimer’s Disease and Frontotemporal Dementia in Norwegian Memory Clinics Study Population.
European Geriatric Medicine.
ISSN 1878-7649.
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Kersten, Hege; Hvidsten, Lara H. Thomasgaard; Bruun Wyller, Torgeir; Selbæk, Geir & Engedal, Knut
(2015).
Cognitive Characteristics in Persons with Young Onset Alzheimer’s Disease and Frontotemporal Dementia in Norwegian Memory Clinics Study Population.
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Hvidsten, Lara Hisami Thomasgaard; Engedal, Knut; Selbæk, Geir; Wyller, Torgeir Bruun; Høgh, Peter & Snaedal, Jon
[Show all 9 contributors for this article]
(2015).
Young Onset Dementia study - A Prospective Cohort Study of Quality of Life and Specific Needs in Persons with Young Onset Dementia and their Families.
Journal of Clinical Trials.
ISSN 2167-0870.
5(1).
doi:
10.4172/2167-0870.1000204.
Show summary
Background: Young-Onset Dementia (YOD) causes challenges and concerns that are likely to affect quality of life and generate specific needs for health care, which may be different from what is observed in late onset dementia. The knowledge about the impact of YOD, in particular Fronto Temporal Dementia (FTD), on the affected families is scarce, and previous studies have underscored the importance of differentiating between diagnostic subgroups of YOD in future research. Accordingly, the aims of this study are to identify and compare factors influencing quality of life between persons with young onset FTD and Alzheimer’s Dementia (AD) and their families as the condition progresses. An additional aim is to compare the use of health care services among younger and older persons with dementia, and to
investigate the life-stage specific needs for health care services in persons with YOD.
Methods/Design: This is a two-year observational Nordic multicentre cohort study of community-dwelling persons with YOD and their families. Two diagnostic subgroups, each consisting of 75 dyads with AD and 75 dyads with FTD with symptom debut <65 years, will be included, and compared with a control group consisting of 100 older persons with dementia and onset >70 years. Participants are recruited from nine Nordic memory clinics.
Comprehensive assessments are made at baseline, 12 and 24 months, supplemented with telephone follow-ups at 6 and 18 months. Primary outcome measure is Quality of life measured by Quality of Life in Alzheimer’s Disease (QoL-AD) and EuroQol-5D (EQ-5D). Secondary outcome measures are needs for health care services measured by Camberwell Assessment of Needs in the Elderly (CANE) and Resource Utilization in Dementia Lite (RUD Lite). The
inclusion period is from February 2014 to February 2015, with follow-up data collection until February 2017.
Conclusion: The sample size, the outcome measures, and the explanatory factors chosen in this study will provide new knowledge of quality of life in families with young onset FTD and AD, and contribute to tailoring the health care services to the life stage-specific needs of families with YOD.
ClinicalTrials.gov identifier: NCT02055092
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Kersten, Hege; Bruun Wyller, Torgeir & Molden, Espen
(2012).
Elevated serum anticholinergic activity in CYP 2D6 poor metabolizers.
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Kersten, Hege; Wyller, Torgeir Bruun & Ruths, Sabine
(2008).
Medication reviews in Norwegian nursing home residents showed different quality of the drug treatments.
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Kersten, Hege; Ruths, Sabine & Wyller, Torgeir Bruun
(2008).
Medication reviews in Norwegian nursing homes.
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Kersten, Hege & Wyller, Torgeir Bruun
(2013).
Reducing anticholinergic burden in a frail elderly population: Translating the inappropriateness of anticholinergic drugs into patient-related outcomes.
Universitetet i Oslo.
ISSN 978-82-8264-417-4.
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Published
Aug. 17, 2023 3:12 PM
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Aug. 17, 2023 3:12 PM