Geir Selbæk

• Lerfald, Maren; Allore, Heather; Nilsen, Tom Ivar Lund; Eldholm, Rannveig Sakshaug; Marinez-Velilla, Nicolas & Selbæk, Geir [Vis alle 7 forfattere av denne artikkelen] (2024). Longitudinal patterns of systolic blood pressure, diastolic blood pressure, cardiorespiratory fitness, and their association with dementia risk: The HUNT study. The journals of gerontology. Series A, Biological sciences and medical sciences. ISSN 1079-5006. doi: 10.1093/gerona/glae161.
• Tevik, Kjerstin Elisabeth; Skråstad, Ragnhild Bergene; Saltyte Benth, Jurate; Selbæk, Geir; Bergh, Sverre & Eldholm, Rannveig Sakshaug [Vis alle 8 forfattere av denne artikkelen] (2024). Prevalence and change in alcohol consumption in older adults over time, assessed with self-report and Phosphatidylethanol 16:0/18:1 —The HUNT Study. PLOS ONE. ISSN 1932-6203. 19(5). doi: 10.1371/journal.pone.0304714.
• Antonsdottir, Inga Margaret; Creese, Byron; Klei, Lambertus; DeMichele-Sweet, Mary Ann A.; Weamer, Elise A. & Garcia-Gonzalez, Pablo [Vis alle 32 forfattere av denne artikkelen] (2024). Genetic associations with psychosis and affective disturbance in Alzheimer's disease. Alzheimer's & Dementia. ISSN 1552-5260. 10(2). doi: 10.1002/trc2.12472.
• Leonardsen, Esten Høyland; Persson, Karin Ester Torun; Grødem, Edvard Olaf Sætersdal; Dinsdale, Nicola; SCHELLHORN, TILL & Roe, James Michael [Vis alle 16 forfattere av denne artikkelen] (2024). Constructing personalized characterizations of structural brain aberrations in patients with dementia using explainable artificial intelligence. npj Digital Medicine. 7(1). doi: 10.1038/s41746-024-01123-7.
• Gjøra, Linda; Strand, Bjørn Heine; Bergh, Sverre; Bosnes, Ingunn; Johannessen, Aud & Livingston, Gill [Vis alle 8 forfattere av denne artikkelen] (2024). Prevalence and Determinants of Diagnosed Dementia: A Registry Linkage Study Linking Diagnosis of Dementia in the Population-Based HUNT Study to Registry Diagnosis of Dementia in Primary Care and Hospitals in Norway. Journal of Alzheimer's Disease. ISSN 1387-2877. 99(1), s. 363–375. doi: 10.3233/JAD-240037.
• Edwin, Trine Holt; Håberg, Asta; Zotcheva, Ekaterina; Bratsberg, Bernt Magne; Jugessur, Astanand & Engdahl, Bo Lars [Vis alle 16 forfattere av denne artikkelen] (2024). Trajectories of Occupational Cognitive Demands and Risk of Mild Cognitive Impairment and Dementia in Later Life: The HUNT4 70+ Study. Neurology. ISSN 0028-3878. doi: 10.1212/WNL.0000000000209353.
• Wang, He-Ling; Siow, Richard; Schmauck-Medina, Tomas; Zhang, Jianying; Sandset, Per Morten & Filshie, Clare [Vis alle 38 forfattere av denne artikkelen] (2024). Meeting Summary of The NYO3 5th NO-Age/AD Meeting and the 1st Norway-UK Joint Meeting on Aging and Dementia: Recent Progress on the Mechanisms and Interventional Strategies. The journals of gerontology. Series A, Biological sciences and medical sciences. ISSN 1079-5006. 79(4). doi: 10.1093/gerona/glae029.
• Ibsen, Tanja Louise; Strand, Bjørn Heine; Bergh, Sverre; Livingston, Gill; Lurås, Hilde & Mamelund, Svenn-Erik [Vis alle 11 forfattere av denne artikkelen] (2024). A longitudinal cohort study on the use of health and care services by older adults living at home with/without dementia before and during the COVID-19 pandemic: the HUNT study. BMC Health Services Research. ISSN 1472-6963. 24. doi: 10.1186/s12913-024-10846-y. Fulltekst i vitenarkiv
• Wedatilake, Yehani; Myrstad, C.; Tom, S. E.; Strand, B. H.; Bergh, S. & Selbæk, G. (2024). Female Reproductive Factors and Risk of Mild Cognitive Impairment and Dementia: The HUNT Study. Journal of Prevention of Alzheimer's Disease (JPAD). ISSN 2274-5807. 2024, s. 1–10. doi: 10.14283/jpad.2024.46. Fulltekst i vitenarkiv
• Persson, Karin Ester Torun; Barca, Maria Lage; Edwin, Trine Holt; Cavallin-Eklund, Lena; Tangen, Gro Gujord & Rhodius-Meester, Hanneke Frederica Maria [Vis alle 9 forfattere av denne artikkelen] (2024). Regional MRI volumetry using NeuroQuant versus visual rating scales in patients with cognitive impairment and dementia. Brain and Behavior. ISSN 2162-3279. 14(2). doi: 10.1002/brb3.3397.
• Molvik, Inger; Kjelvik, Grete; Selbæk, Geir & Rokstad, Anne Marie Mork (2024). Exploring the lived experience : impact of dementia diagnosis on individuals with cognitive impairment - a qualitative study. BMC Geriatrics. ISSN 1471-2318. 24(1). doi: 10.1186/s12877-024-04665-3. Vis sammendrag

  Objective: Although knowledge about the experience of being diagnosed with dementia is limited, with the expected rise in dementia’s prevalence in the coming decades, such knowledge is pivotal for the people diagnosed, their families, and healthcare planners. Thus, the aim of our study was to explore the experience of living with cognitive impairment and dementia and the impact of being diagnosed with dementia. Method: A qualitative design was applied. Participants were recruited based on age-adjusted values below ​​threshold values on the Montreal Cognitive Assessment Scale (i.e. 70–79 years, < 22; 80–89 years, < 21; 90 + years, < 20), and the sample ultimately included 15 participants: six with and nine without a documented dementia diagnosis. Qualitative content analysis was performed on the transcribed interviews in four steps to identify codes, categories, and the overall theme. Results: Three major categories emerged from the interviews: (1) experiences with changes, (2) experiences with being diagnosed with dementia, and (3) existential experience. All participants with and most participants without a dementia diagnosis experienced changes in cognition. Conclusion: Our findings imply that being diagnosed with dementia is a relief because it explains observed cognitive and functional decreases and reduces confusion, shame and stigma. However, it also raises concerns about an unknown future. Most participants not diagnosed with dementia reported having little or no difficulty with everyday living and leading a fulfilling life. Those findings emphasise the significance of timely versus early diagnosis.

• Sandvik, Reidun Karin Norheim Myhre; Husebø, Bettina Elisabeth Franziska; Selbæk, Geir; Strand, Gunhild Vesterhus; Patrascu, Monica & Mustafa, Manal [Vis alle 7 forfattere av denne artikkelen] (2024). Oral symptoms in dying nursing home patients. Results from the prospective REDIC study. BMC Oral Health. ISSN 1472-6831. 24(1). doi: 10.1186/s12903-024-03901-x. Fulltekst i vitenarkiv
• Myrenget, Martin Elstad; Rustøen, Tone; Myskja, Audun X.; Småstuen, Milada Cvancarova; Rangul, Vegar & Håpnes, Odd Sigfast [Vis alle 11 forfattere av denne artikkelen] (2024). The effect of a music-based caregiving intervention on pain intensity in nursing home patients with dementia. A cluster-randomized controlled study. Pain. ISSN 0304-3959. doi: 10.1097/j.pain.0000000000003156. Vis sammendrag

  Treatment of chronic pain in patients with dementia is challenging because they have reduced ability to report pain and are particularly vulnerable to side effects of analgesics. Different types of music-based therapy have been recommended and are used as an alternative to analgesics, but the evidence is lacking. Therefore, we performed a cluster-randomized controlled study (RCT) to reduce pain intensity using music-based caregiving (MBC) over 8 weeks in nursing home patients with dementia and chronic pain. We also investigated if the amount of MBC and different chronic pain syndromes would impact on the effect. Of the 645 patients, 498 patients from 36 wards in 12 nursing homes were screened for dementia and pain. Using the Clinical Dementia Rating Scale and the Mobilization-Observation-Behavior-Intensity-Dementia Pain Scale (range 0-10), 279 (71% females, 42% severe dementia) nursing home patients were randomized to intervention group (n = 134, 18 wards) or control group (n = 145, 18 wards). The main outcome was change in pain intensity before and after the intervention. The study did not reveal any effect of MBC on pain intensity when compared with the control group (B = -0.15, 95% CI [-0.72 to 0.43]). No significant difference was found within the intervention group analyzing the impact of intervention time (B = 0.73, 95% CI [-0.55 to 2.02]) or chronic primary vs secondary pain syndromes (B = 0.45, 95% CI [-0.05 to 0.96]). Our data from this first RCT on music and pain intensity in patients with dementia and chronic pain did not find an effect of MBC on pain.

• Rosenau, Colin; Köhler, Sebastian; Soons, Lion M.; Anstey, Kaarin J.; Brayne, Carol & Brodaty, Henry [Vis alle 20 forfattere av denne artikkelen] (2023). Umbrella review and Delphi study on modifiable factors for dementia risk reduction. Alzheimer's & Dementia. ISSN 1552-5260. doi: 10.1002/alz.13577. Fulltekst i vitenarkiv
• Moradi, Shahram; Engdahl, Bo Lars; Johannessen, Aud; Selbæk, Geir; Aarhus, Lisa & Haanes, Gro Gade (2023). Hearing loss, hearing aid use, and performance on the Montreal cognitive assessment (MoCA): findings from the HUNT study in Norway. Frontiers in Neuroscience. ISSN 1662-4548. 17. doi: 10.3389/fnins.2023.1327759. Fulltekst i vitenarkiv Vis sammendrag

  Purpose. To evaluate the associations between hearing status and hearing aid use and performance on the Montreal Cognitive Assessment (MoCA) in older adults in a cross-sectional study in Norway. Methods. This study utilized data from the fourth wave of the Trøndelag Health Study (HUNT4, 2017–2019). Hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz (or PTA4) in the better hearing ear were used to determine participants’ hearing status (normal hearing [PTA4 hearing threshold, ≤ 15 dB], or slight [PTA4, 16–25 dB], mild [PTA4, 26–40 dB], moderate [PTA4, 41–55 dB], or severe [PTA4, ≥ 56 dB] hearing loss). Both standard scoring and alternate MoCA scoring for people with hearing loss (deleting MoCA items that rely on auditory function) were used in data analysis. The analysis was adjusted for the confounders age, sex, education, and health covariates. Results. The pattern of results for the alternate scoring was similar to that for standard scoring. Compared with the normal-hearing group, only individuals with moderate or severe hearing loss performed worse in the MoCA. In addition, people with slight hearing loss performed better in the MoCA than those with moderate or severe hearing loss. Within the hearing loss group, hearing aid use was associated with better performance in the MoCA. No interaction was observed between hearing aid use and participants’ hearing status with performance on the MoCA test. Conclusion. While hearing loss was associated with poorer performance in the MoCA, hearing aid use was found to be associated with better performance in the MoCA. Future randomized control trials are needed to further examine the efficacy of hearing aid use on the MoCA performance. When compared with standard scoring, the alternate MoCA scoring had no effect on the pattern of results.

• Myrstad, Christian; Engdahl, Bo Lars; Costafreda, Sergi Gonzales; Krokstad, Steinar; Lin, Frank & Livingston, Gill [Vis alle 9 forfattere av denne artikkelen] (2023). Hearing impairment and risk of dementia in The HUNT Study (HUNT4 70+): a Norwegian cohort study. EClinicalMedicine. ISSN 2589-5370. 66, s. 1–10. doi: 10.1016/j.eclinm.2023.102319. Fulltekst i vitenarkiv Vis sammendrag

  Background Hearing impairment is strongly associated with future dementia. No studies have reported objectively measured hearing impairment in a cohort with a long period of follow-up (>20 years), and few have reported follow-up over 10 years. Hence, there is a need for high quality studies with sufficient follow-up time and data to account for reverse causality and confounding. We aimed to address this knowledge gap. Methods This cohort study used individual participant data from The Trøndelag Health Study (HUNT) in Norway. All current residents aged at least 20 years in the former Norwegian Nord-Trøndelag County were invited to participate in four decennial surveys: HUNT1 (1984–1986), HUNT2 (1995–1997), HUNT3 (2006–2008), and HUNT4 (2017–2019) with individuals aged at least 70 years included in a substudy, known as HUNT4 70+. Here, we report the findings of this substudy. HUNT4 70+ comprised 7135 participants who were assessed for dementia using the Diagnostic and Statistical Manual of Mental Disorders 5 criteria and who had audiometry between 1996 and 1998. The primary objective was to investigate, with gold standard audiometric testing and dementia diagnostic assessment, whether hearing impairment was an independent risk factor for all-cause dementia. The secondary objective was to investigate if a risk also applied to Alzheimer dementia and non-Alzheimer dementia. We analysed the association using Poisson regression and adjusted for confounders. This study is registered with ClinicalTrials.gov (NCT04284384). Findings At baseline, 1058 (15%) individuals had acquired hearing impairment with a hearing threshold of at least 25 decibel (dB) and, at follow-up, 1089 (15%) had dementia. In the total group, people with hearing impairment had a relative risk (RR) 1.04 (95% confidence interval (CI) 1.00–1.09) per 10 dB increase in hearing thresholds. For individuals younger than 85 years at follow-up the RR was 1.12 (95% CI 1.05–1.21). Associations between hearing impairment and Alzheimer dementia and non-Alzheimer dementia were similar. There was no association for individuals aged at least 85 years. Interpretation We found a moderate association between objectively measured hearing impairment and dementia in the younger age group (

• Bøen, Rune; Kaufmann, Tobias Herbert; van der Meer, Dennis; Frei, Oleksandr; Agartz, Ingrid & Ames, David [Vis alle 53 forfattere av denne artikkelen] (2023). Beyond the Global Brain Differences: Intraindividual Variability Differences in 1q21.1 Distal and 15q11.2 BP1-BP2 Deletion Carriers. Biological Psychiatry. ISSN 0006-3223. 95(2), s. 147–160. doi: 10.1016/j.biopsych.2023.08.018. Fulltekst i vitenarkiv
• Short, Megan I.; Fohner, Alison E.; Skjellegrind, Håvard Kjesbu; Beiser, Alexa; Gonzales, Mitzi M. & Satizabal, Claudia L. [Vis alle 22 forfattere av denne artikkelen] (2023). Proteome Network Analysis Identifies Potential Biomarkers for Brain Aging. Journal of Alzheimer's Disease. ISSN 1387-2877. 96(4), s. 1767–1780. doi: 10.3233/JAD-230145. Vis sammendrag

  Alzheimer’s disease and related dementias (ADRD) involve biological processes that begin years to decades before onset of clinical symptoms. The plasma proteome can offer insight into brain aging and risk of incident dementia among cognitively healthy adults. Objective: To identify biomarkers and biological pathways associated with neuroimaging measures and incident dementia in two large community-based cohorts by applying a correlation-based network analysis to the plasma proteome. Methods: Weighted co-expression network analysis of 1,305 plasma proteins identified four modules of co-expressed proteins, which were related to MRI brain volumes and risk of incident dementia over a median 20-year follow-up in Framingham Heart Study (FHS) Offspring cohort participants (n = 1,861). Analyses were replicated in the Cardiovascular Health Study (CHS) (n = 2,117, mean 6-year follow-up). Results: Two proteomic modules, one related to protein clearance and synaptic maintenance (M2) and a second to inflammation (M4), were associated with total brain volume in FHS (M2: p = 0.014; M4: p = 4.2×10–5). These modules were not significantly associated with hippocampal volume, white matter hyperintensities, or incident all-cause or AD dementia. Associations with TCBV did not replicate in CHS, an older cohort with a greater burden of comorbidities. Conclusions: Proteome networks implicate an early role for biological pathways involving inflammation and synaptic function in preclinical brain atrophy, with implications for clinical dementia.

• Lerfald, Maren; Lydersen, Stian; Zotcheva, Ekaterina; Nilsen, Tom Ivar Lund; Eldholm, Rannveig Sakshaug & Martinez-Velilla, Nicolás [Vis alle 8 forfattere av denne artikkelen] (2023). Change in physical activity and systolic blood pressure trajectories throughout mid-life and the development of dementia in older age: the HUNT study. European Review of Aging and Physical Activity. ISSN 1813-7253. 20. doi: 10.1186/s11556-023-00328-1. Fulltekst i vitenarkiv
• Persson, Karin Ester Torun; Leonardsen, Esten Høyland; Edwin, Trine Holt; Knapskog, Anne-Brita; Tangen, Gro Gujord & Selbæk, Geir [Vis alle 9 forfattere av denne artikkelen] (2023). Diagnostic accuracy of brain age prediction in a memory clinic population and comparison with clinically available volumetric measures. Scientific Reports. ISSN 2045-2322. 13. doi: 10.1038/s41598-023-42354-0. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to assess the diagnostic validity of a deep learning-based method estimating brain age based on magnetic resonance imaging (MRI) and to compare it with volumetrics obtained using NeuroQuant (NQ) in a clinical cohort. Brain age prediction was performed on minimally processed MRI data using deep convolutional neural networks and an independent training set. The brain age gap (difference between chronological and biological age) was calculated, and volumetrics were performed in 110 patients with dementia (Alzheimer’s disease, frontotemporal dementia (FTD), and dementia with Lewy bodies), and 122 with non-dementia (subjective and mild cognitive impairment). Area-under-the-curve (AUC) based on receiver operating characteristics and logistic regression analyses were performed. The mean age was 67.1 (9.5) years and 48.7% (113) were females. The dementia versus non-dementia sensitivity and specificity of the volumetric measures exceeded 80% and yielded higher AUCs compared to BAG. The explained variance of the prediction of diagnostic stage increased when BAG was added to the volumetrics. Further, BAG separated patients with FTD from other dementia etiologies with > 80% sensitivity and specificity. NQ volumetrics outperformed BAG in terms of diagnostic discriminatory power but the two methods provided complementary information, and BAG discriminated FTD from other dementia etiologies.

• Zotcheva, Ekaterina; Bratsberg, Bernt Magne; Strand, Bjørn Heine; Jugessur, Astanand; Engdahl, Bo Lars & Bowen, Catherine [Vis alle 17 forfattere av denne artikkelen] (2023). Trajectories of occupational physical activity and risk of later-life mild cognitive impairment and dementia: the HUNT4 70+ study. The Lancet Regional Health - Europe. ISSN 2666-7762. 34. doi: 10.1016/j.lanepe.2023.100721. Fulltekst i vitenarkiv Vis sammendrag

  High levels of occupational physical activity (PA) have been linked to an increased risk of dementia. We assessed the association of trajectories of occupational PA at ages 33–65 with risk of dementia and mild cognitive impairment (MCI) at ages 70+. Methods We included 7005 participants (49.8% were women, 3488/7005) from the HUNT4 70+ Study. Group-based trajectory modelling was used to identify four trajectories of occupational PA based on national registry data from 1960 to 2014: stable low (30.9%, 2162/7005), increasing then decreasing (8.9%, 625/7005), stable intermediate (25.1%, 1755/7005), and stable high (35.2%, 2463/7005). Dementia and MCI were clinically assessed in 2017–2019. We performed adjusted multinomial regression to estimate relative risk ratios (RRR) with 95% confidence intervals (CI) for dementia and MCI. Findings 902 participants were diagnosed with dementia and 2407 were diagnosed with MCI. Absolute unadjusted risks for dementia and MCI were 8.8% (95% CI: 7.6–10.0) and 27.4% (25.5–29.3), respectively, for those with a stable low PA trajectory, 8.2% (6.0–10.4) and 33.3% (29.6–37.0) for those with increasing, then decreasing PA; while they were 16.0% (14.3–17.7) and 35% (32.8–37.2) for those with stable intermediate, and 15.4% (14.0–16.8) and 40.2% (38.3–42.1) for those with stable high PA trajectories. In the adjusted model, participants with a stable high trajectory had a higher risk of dementia (RRR 1.34, 1.04–1.73) and MCI (1.80, 1.54–2.11), whereas participants with a stable intermediate trajectory had a higher risk of MCI (1.36, 1.15–1.61) compared to the stable low trajectory. While not statistically significant, participants with increasing then decreasing occupational PA had a 24% lower risk of dementia and 18% higher risk of MCI than the stable low PA group. Interpretation Consistently working in an occupation with intermediate or high occupational PA was linked to an increased risk of cognitive impairment, indicating the importance of developing strategies for individuals in physically demanding occupations to prevent cognitive impairment.

• Kolberg, Marit; Paur, Ingvild; Sun, Yi-Qian; Gjøra, Linda; Skjellegrind, Håvard Kjesbu & Thingstad, Anne Pernille Mæhle [Vis alle 10 forfattere av denne artikkelen] (2023). Prevalence of malnutrition among older adults in a population-based study - The HUNT Study. Clinical Nutrition ESPEN. ISSN 2405-4577. 57, s. 711–717. doi: 10.1016/j.clnesp.2023.08.016. Fulltekst i vitenarkiv Vis sammendrag

  Background Malnutrition is common in older adults and is associated with increased morbidity and mortality rates. Aim The aim of the study is to describe the prevalence of malnutrition based on low BMI, involuntary weight loss, and reduced food intake, in a Norwegian population of community-dwelling older adults and older adults living in nursing homes. Methods This population-based study is part of the fourth wave of the Trøndelag Health Study (HUNT4) and includes participants ≥70 years from the HUNT4 70+ cohort. The HUNT4 70+ cohort consist of 9930 (response rate 51.2%) participants. In the current study 8127 older people had complete dataset for inclusion in the analyses. Participants completed a self-report questionnaire and standardised interviews and clinical assessments at field stations, in participants’ homes or at nursing homes. Malnutrition was defined using the following criteria: low BMI, involuntary weight loss and severely reduced food intake. The standardised prevalence of malnutrition was estimated using inverse probability weighting (IPW) with weights for sex, age and education of the total population in the catchment area of HUNT. Results Of the 8127 included participants, 7671 (94.4%) met at field stations, 356 (4.4%) were examined in their home, and 100 (1.2%) in nursing homes. In total, 14.3% of the population were malnourished based on either low BMI, weight loss, or reduced food intake, of which low BMI was the most frequently fulfilled criterion. The prevalence of malnutrition was less common among men than among women (10.1 vs 18.0%, p < 0.001), also after adjustment for age (OR 0.53, 95% confidence interval (CI) 0.46–0.61). The prevalence increased gradually with increasing age and the regression analysis adjusted for sex showed that for each year increase in age the prevalence of malnutrition increased with 4.0% (OR 1.04, 95% CI 1.03–1.05). The prevalence was higher both among older adults examined in their homes (26.4%) and residents in nursing home (23.6%), as compared to community-dwelling older adults who met at field stations (13.5%). Conclusion The prevalence of malnutrition is high in the older population. Special attention on prevention and treatment of malnutrition should be given to older women, the oldest age groups, and care-dependent community-dwelling older adults and nursing home residents.

• Aunsmo, Ragnhild Holmberg; Langballe, Ellen Melbye; Hansen, Thomas; Selbæk, Geir & Strand, Bjørn Heine (2023). Time trends in loneliness from 1984 to 2019 among 27,032 older adults in Norway: A HUNT study. Preventive Medicine. ISSN 0091-7435. 175. doi: 10.1016/j.ypmed.2023.107659. Fulltekst i vitenarkiv Vis sammendrag

  The aging population and increasing evidence of the detrimental health impacts of loneliness emphasize the importance of studying and predicting changes in loneliness prevalence among older adults. To understand and project changes in loneliness over time, we examined 35-year trends in adults aged 70 and older, considering factors such as sex, age, and living situation. Cross-sectional data from 27,032 home-dwelling adults aged 70 years and older who participated in at least one of the four Norwegian HUNT surveys from 1984 to 2019, and Norwegian population data from Statistics Norway were used for the analyses. Loneliness was self-reported, and the prevalence of loneliness was standardized to the Norwegian population at the survey year by age and sex. The results showed that the prevalence of loneliness significantly decreased between each survey. The higher categories of loneliness (a good amount, very much) decreased, from 11.4% (1995–97), 6.7% (2006–08), and 5.8% (2017–19). Across surveys, loneliness was significantly more common among women, the oldest, and those living alone. The prevalence of loneliness among the oldest adults living alone increased from 2006 to 2019. The gradual decline in loneliness observed from 1995 to 2019 coincided with notable societal changes in Norway. We estimated that the number of older adults experiencing loneliness in Norway could rise from 184,000 in 2020 to 286,000 in 2035, and potentially reach 380,000 in 2050.

• Zotcheva, Ekaterina; Strand, Bjørn Heine; Bowen, Catherine E; Bratsberg, Bernt Magne; Jugessur, Astanand & Engdahl, Bo Lars [Vis alle 16 forfattere av denne artikkelen] (2023). Retirement age and disability status as pathways to later-life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers. International Journal of Geriatric Psychiatry. ISSN 0885-6230. 38(7), s. 1–10. doi: 10.1002/gps.5967. Fulltekst i vitenarkiv Vis sammendrag

  Background Research shows that retirement age is associated with later-life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later-life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior to old-age pension eligibility) and those who retired via the standard pathway. Methods The study sample comprised 7210 participants from the Norwegian Trøndelag Health Study (HUNT4 70+, 2017–2019) who had worked for at least one year in 1967–2019, worked until age 55+, and retired before HUNT4. Dementia and MCI were clinically assessed in HUNT4 70+ when participants were aged 69–85 years. Historical data on participants' retirement age and pathway were retrieved from population registers. We used multinomial regression to assess the dementia/MCI risk for women and men retiring via the disability pathway, or early (<67 years), on-time (age 67, old-age pension eligibility) or late (age 68+) via the standard pathway. Results In our study sample, 9.5% had dementia, 35.3% had MCI, and 28.1% retired via the disability pathway. The disability retirement group had an elevated risk of dementia compared to the on-time standard retirement group (relative risk ratio [RRR]: 1.64, 95% CI 1.14–2.37 for women, 1.70, 95% CI 1.17–2.48 for men). MCI risk was lower among men who retired late versus on-time (RRR, 0.76, 95% CI 0.61–0.95). Conclusion Disability retirees should be monitored more closely, and preventive policies should be considered to minimize the dementia risk observed among this group of retirees.

• Krogseth, Maria; Davis, Daniel; Jackson, Thomas A; Zetterberg, Henrik; Watne, Leiv & Lindberg, Morten [Vis alle 10 forfattere av denne artikkelen] (2023). Delirium, neurofilament light chain, and progressive cognitive impairment: analysis of a prospective Norwegian population-based cohort. The Lancet Healthy Longevity. ISSN 2666-7568. 4(8), s. e399–e408. doi: 10.1016/S2666-7568(23)00098-3. Fulltekst i vitenarkiv Vis sammendrag

  Background: Previous population-based, longitudinal studies have shown that delirium is associated with an increased risk of dementia and cognitive decline. However, the underlying biological mechanisms are largely unknown. We aimed to assess the effects of delirium on both cognitive trajectories and any neuronal injury, measured via neurofilament light chain (NfL). Methods: In this analysis of a prospective, 2-year follow-up, cohort study of participants aged 65 years or older living in Sandefjord municipality, Norway, we included cohort participants who were receiving domiciliary care services at least once per week between May 12, 2015, and July 8, 2016. Individuals with a life expectancy of less than 1 week, with Lewy body dementia, with psychiatric illness (except dementia), or for whom substance misuse was the principal indication for domiciliary services were excluded. Participants had a comprehensive assessment at 6-month intervals for 2 years, which included the Montreal Cognitive Assessment (MoCA) and a blood sample for NfL to measure neuronal injury. All information on clinical diagnoses and medications were cross-referenced with medical records. During any acute change in mental status or hospitalisation (ie, admission to hospital), participants were assessed once per day for delirium with Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. We also measured NfL from blood samples taken from participants who were acutely hospitalised. Findings: Between May 12, 2015, and July 8, 2016, 210 participants were eligible for inclusion and assessed at baseline (138 [66%] of whom were female and 72 [34%] of whom were male), 203 completed cognitive assessment, and 141 were followed up for 2 years. 160 (76%) of 210 had moderate or severe frailty and 112 (53%) were living with dementia. During the 2-year follow-up, 89 (42%) of 210 participants were diagnosed with one or more episodes of delirium. Incident delirium was independently associated with a decrease in MoCA score at the next 6-month follow-up, even after adjustment for age, sex, education, previous MoCA score, and frailty (adjusted mean difference –1·5, 95% CI –2·9 to –0·1). We found an interaction between previous MoCA score and delirium (β –0·254, 95% CI –0·441 to –0·066, p=0·010), with the largest decline being observed in people with better baseline cognition. Participants with delirium and good previous cognitive function and participants with a high peak concentration of NfL during any hospitalisation had increased NfL at the next 6-month follow-up. Mediation analyses showed independent pathways from previous MoCA score to follow-up MoCA score with contributions from incident delirium (–1·7, 95% CI –2·8 to –0·6) and from previous NfL to follow-up MoCA score with contributions from acute NfL concentrations (–1·8, –2·5 to –1·1). Delirium was directly linked with a predicted value of 1·2 pg/mL (95% CI 1·02 to 1·40, p=0·029) increase in NfL. Interpretation: In people aged 65 years or older, an episode of delirium was associated with a decline in MoCA score. Greater neuronal injury during acute illness and delirium, measured by NfL, was associated with greater cognitive decline. For clinicians, our finding of delirium associated with both signs of acute neuronal injury, measured via NfL, and cognitive decline is important regarding the risk of long-term cognitive deterioration and to acknowledge that delirium is harmful for the brain.

• Kjelvik, Grete; Selbæk, Geir & Rokstad, Anne Marie Mork (2023). Knowledge and motivation to adopt recommended health behaviours to reduce dementia risk among the elderly in Norway: a qualitative study. Public Health. ISSN 0033-3506. 221(August), s. 60–65. doi: 10.1016/j.puhe.2023.06.002. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Dementia is a major healthcare challenge; however, there is evidence that modifiable risk factors may contribute to reduce dementia risk. The aim of the study was to explore the knowledge and motivation for adopting recommended health behaviours among older adults in Norway. Study design: The study has a qualitative, descriptive design. Methods: Individual interviews were used for data collection. The study population comprised 15 participants, five men and 10 women, aged ≥73 years, recruited from a region in the centre of Norway. Interviews were analysed according to qualitative content analysis. Results: Three categories were identified and presented as the main findings, as follows: (1) sufficient knowledge about risk reduction for dementia, including the media as the main source of information; (2) current prevention activities and motivation for risk reduction, including physical, social and cognitive activities and a healthy diet; and (3) motivation for prevention of dementia from a life-course perspective, including experience of health problems, desire to live independently and limited awareness of dementia risk factors in midlife. Conclusions: To tailor information about the modifiable risk factors of dementia and develop preventive interventions, knowledge about motivating factors is essential. Promotion of healthy ageing is required in addition to addressing the fear of future illness and dependency.

• Gjøra, Linda; Strand, Bjørn Heine; Engedal, Knut; Ernstsen, Linda; Myrstad, Christian & Skjellegrind, Håvard Kjesbu [Vis alle 8 forfattere av denne artikkelen] (2023). Demens og mild kognitiv svikt hos eldre personer i Trøndelag. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 143(10), s. 856–861. doi: 10.4045/tidsskr.22.0815. Fulltekst i vitenarkiv Vis sammendrag

  BAKGRUNN Antallet personer med demens forventes tredoblet innen 2050. Vi presenterer forekomsttall for demens og mild kognitiv svikt i Trondheim og viser hvordan vekting for frafall og bostatus påvirker forekomsttallene når vi sammenligner Trondheim med Nord-Trøndelag. MATERIALE OG METODE Personer i alderen 70 år og eldre i Trondheim ble invitert til å delta i helseundersøkelsen HUNT4 (den fjerde Helseundersøkelsen i Trøndelag) Trondheim 70+. Deltakerne ble intervjuet og gjennomgikk kognitiv testing. Et diagnoseteam satte diagnosene demens og mild kognitiv svikt. Frafallsvekter som justerte for utvalgsskjevheter, ble benyttet i sammenligningen av Trondheim og Nord-Trøndelag. RESULTATER Demensforekomsten i Trondheim ble estimert til 16,2 % for aldersgruppen 70 år og eldre etter vekting for skjevt frafall med henblikk på alder, kjønn, utdanning og andel sykehjemsbeboere. Ujustert demensforekomst var 21,0 % i Trondheim og 15,7 % i Nord-Trøndelag. Etter vekting ble forekomsten tilnærmet identisk i de to utvalgene. FORTOLKNING Å vekte for skjevt frafall har stor betydning for å få representative tall i forekomstundersøkelser av demens. HOVEDFUNN Forekomsten av demens og mild kognitiv svikt hos personer i alderen 70 år og eldre i Trondheim ble estimert til henholdsvis 16,2 % og 35,6 %. Ujustert demensforekomst var 21,0 % for Trondheim og 15,7 % for Nord-Trøndelag, men etter vekting for skjevt frafall med hensyn til alder, kjønn, utdanning og sykehjem ble forekomsten tilnærmet identisk i de to utvalgene.

• Reas, Emilie T.; Shadrin, Alexey; Frei, Oleksandr; Motazedi, Ehsan; McEvoy, Linda & Bahrami, Shahram [Vis alle 22 forfattere av denne artikkelen] (2023). Improved multimodal prediction of progression from MCI to Alzheimer's disease combining genetics with quantitative brain MRI and cognitive measures. Alzheimer's & Dementia. ISSN 1552-5260. 19(11), s. 5151–5158. doi: 10.1002/alz.13112. Fulltekst i vitenarkiv
• Oddsson, Asmundur; Sulem, Patrick; Sveinbjornsson, Gardar; Arnadottir, Gudny A.; Steinthorsdottir, Valgerdur & Halldorsson, Gisli H. [Vis alle 54 forfattere av denne artikkelen] (2023). Deficit of homozygosity among 1.52 million individuals and genetic causes of recessive lethality. Nature Communications. ISSN 2041-1723. 14. doi: 10.1038/s41467-023-38951-2. Fulltekst i vitenarkiv
• Fominykh, Vera; Shadrin, Alexey; Jaholkowski, Piotr Pawel; Bahrami, Shahram; Athanasiu, Lavinia & Wightman, Douglas P. [Vis alle 13 forfattere av denne artikkelen] (2023). Shared genetic loci between Alzheimer's disease and multiple sclerosis: Crossroads between neurodegeneration and immune system. Neurobiology of Disease. ISSN 0969-9961. 183. doi: 10.1016/j.nbd.2023.106174. Fulltekst i vitenarkiv Vis sammendrag

  Background Neuroinflammation is involved in the pathophysiology of Alzheimer's disease (AD), including immune-linked genetic variants and molecular pathways, microglia and astrocytes. Multiple Sclerosis (MS) is a chronic, immune-mediated disease with genetic and environmental risk factors and neuropathological features. There are clinical and pathobiological similarities between AD and MS. Here, we investigated shared genetic susceptibility between AD and MS to identify putative pathological mechanisms shared between neurodegeneration and the immune system. Methods We analysed GWAS data for late-onset AD (N cases = 64,549, N controls = 634,442) and MS (N cases = 14,802, N controls = 26,703). Gaussian causal mixture modelling (MiXeR) was applied to characterise the genetic architecture and overlap between AD and MS. Local genetic correlation was investigated with Local Analysis of [co]Variant Association (LAVA). The conjunctional false discovery rate (conjFDR) framework was used to identify the specific shared genetic loci, for which functional annotation was conducted with FUMA and Open Targets. Results MiXeR analysis showed comparable polygenicities for AD and MS (approximately 1800 trait-influencing variants) and genetic overlap with 20% of shared trait-influencing variants despite negligible genetic correlation (rg = 0.03), suggesting mixed directions of genetic effects across shared variants. conjFDR analysis identified 16 shared genetic loci, with 8 having concordant direction of effects in AD and MS. Annotated genes in shared loci were enriched in molecular signalling pathways involved in inflammation and the structural organisation of neurons. Conclusions Despite low global genetic correlation, the current results provide evidence for polygenic overlap between AD and MS. The shared loci between AD and MS were enriched in pathways involved in inflammation and neurodegeneration, highlighting new opportunities for future investigation.

• Abbel, Denise; Åsvold, Bjørn Olav; Kolberg, Marit; Selbæk, Geir; Noordam, Raymond & Skjellegrind, Håvard Kjesbu (2023). The Association between Coffee and Tea Consumption at Midlife and Risk of Dementia Later in Life: The HUNT Study. Nutrients. ISSN 2072-6643. 15(11). doi: 10.3390/nu15112469. Fulltekst i vitenarkiv Vis sammendrag

  Background: Studies exploring the possible protective effect of coffee and tea consumption on dementia have shown inconsistent results so far. We aimed to investigate whether consumption of tea and different types of coffee at midlife are associated with dementia later in life and whether sex or ApoE4 influence such association. Methods: We included 7381 participants from the Norwegian HUNT Study. Self-reported questionnaires assessed daily consumption of coffee and tea at baseline. After 22 years, individuals 70 years or older were screened for cognitive impairment. Results: General coffee consumption and tea consumption was not associated with dementia risk. Compared to daily consumption of 0–1 cups of coffee, daily consumption of ≥8 cups of boiled coffee was associated with increased dementia risk in women (OR: 1.83, 95% CI: 1.10–3.04, p-value for trend = 0.03) and daily consumption of 4–5 cups of other types of coffee was associated with a decrease in dementia risk in men (OR: 0.48, 95% CI: 0.32–0.72, p-value for trend = 0.05). Furthermore, the association between boiled coffee and increased dementia risk was only found in ApoE4 non-carriers. Differences by sex or ApoE4 carrier status were not supported by strong statistical evidence for interaction. Tea consumption was not associated with dementia risk. Conclusion: type of coffee may play a role in the direction of the association between coffee-drinking habits and dementia later in life.

• Avan, Abolfazl; Aamodt, Anne Hege ; Selbæk, Geir; Bovim, Gunnar; Bassetti, Claudio L. A. & Boon, Paul [Vis alle 8 forfattere av denne artikkelen] (2023). Decreasing incidence of stroke, ischaemic heart disease and dementia in Norway, 1990–2019, a Global Burden of Disease study: an opportunity. European Journal of Neurology. ISSN 1351-5101. 30(8), s. 2267–2277. doi: 10.1111/ene.15836. Vis sammendrag

  Background and purpose The declining incidence of stroke, ischaemic heart disease (IHD) and dementia (the ‘triple threat’) in Norway encourages further investigation. The risks and trends of the three conditions were analysed using data from the Global Burden of Disease study. Methods Global Burden of Disease 2019 estimations were used for age-, sex- and risk-factor-specific incidence and prevalence of the ‘triple threat’, their risk-factor-attributed deaths and disability combined, their age-standardized rates per 100,000 population in 2019 and their changes during 1990–2019. Data are presented as means and 95% uncertainty intervals. Results In 2019, 71.1 thousand Norwegians were living with dementia, 157.2 thousand with IHD and 95.2 thousand with stroke. In 2019, there were 9.9 thousand (8.5 to 11.3) new cases of dementia (35.0% increase since 1990), 17.0 thousand (14.6 to 19.6) with IHD (3.6% decrease) and 8.0 thousand (7.0 to 9.1) with stroke (12.9% decrease) in Norway. During 1990–2019, their age-standardized incidence rates decreased significantly—dementia by −5.4% (−8.4% to −3.2%), IHD by −30.0% (−31.4% to −28.6%) and stroke by −35.3% (−38.3% to −32.2%). There were significant declines in the attributable risks to both environmental and behavioural factors in Norway, but contradictory trends for metabolic risk factors during 1990–2019. Conclusions The risk of the ‘triple threat’ conditions is declining in Norway, despite the increased prevalence. This offers the opportunity to find out why and how and to accelerate their joint prevention through new approaches and the promotion of the National Brain Health Strategy.

• Engedal, Knut; Saltyte Benth, Jurate; Gjøra, Linda; Skjellegrind, Håvard Kjesbu; Nåvik, Marit & Selbæk, Geir (2023). Normative Scores on the Norwegian Version of the Mini-Mental State Examination. Journal of Alzheimer's Disease. ISSN 1387-2877. 92(3), s. 831–842. doi: 10.3233/JAD-221068. Vis sammendrag

  Background: The Mini-Mental State Examination (MMSE), a simple test for measuring global cognitive function, is frequently used to evaluate cognition in older adults. To decide whether a score on the test indicates a significant deviation from the mean score, normative scores should be defined. Moreover, because the test may vary depending on its translation and cultural differences, normative scores should be established for national versions of the MMSE. Objective: We aimed to examine normative scores for the third Norwegian version of the MMSE. Methods: We used data from two sources: the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) and the Trøndelag Health Study (HUNT). After persons with dementia, mild cognitive impairment, and disorders that may cause cognitive impairment were excluded, the sample contained 1,050 cognitively healthy persons, 860 from NorCog, and 190 from HUNT, whose data we subjected to regression analyses. Results: The normative MMSE score varied from 25 to 29, depending on years of education and age. More years of education and younger age were associated with higher MMSE scores, and years of education was the strongest predictor. Conclusion: Mean normative MMSE scores depend on test takers' years of education and age, with level of education being the strongest predictor.

• Selbæk-Tungevåg, Selma; Selbæk, Geir; Strand, Bjørn Heine; Myrstad, Christian; Livingston, Gill & Lydersen, Stian [Vis alle 8 forfattere av denne artikkelen] (2023). Insomnia and risk of dementia in a large population-based study with 11-year follow-up: The HUNT study. Journal of Sleep Research. ISSN 0962-1105. 32(4). doi: 10.1111/jsr.13820. Fulltekst i vitenarkiv Vis sammendrag

  Despite evidence suggesting that insomnia is associated with the risk of dementia and cognitive dysfunction, studies have shown mixed results. Dementia has a long prodromal phase, and studies with long follow-up are required to avoid reverse causality. In our 11-year follow-up study, we assessed whether probable insomnia disorder (PID) based on diagnostic criteria, and insomnia symptoms were associated with risk of all-cause dementia, Alzheimer's disease (AD) and cognition, measured with the Montreal Cognitive Assessment scale. We also examined if Apolipoprotein E genotype modified any associations with dementia through interaction. We analysed data from 7492 participants in the Norwegian Trøndelag Health Study. PID was not associated with all-cause dementia (odds ratio = 1.03, 95% confidence interval = 0.74-1.43), AD (odds ratio = 1.07, 95% confidence interval = 0.71-1.60) or Montreal Cognitive Assessment score (regression coefficient = 0.37, 95% confidence interval = -0.06 to 0.80). The insomnia symptom "difficulties maintaining sleep" was associated with a lower risk of all-cause dementia (odds ratio = 0.81, 95% confidence interval = 0.67-0.98), AD (odds ratio = 0.73, 95% confidence interval = 0.57-0.93), and better Montreal Cognitive Assessment score, mean 0.40 units (95% confidence interval = 0.15-0.64). No interaction with Apolipoprotein E genotype was found. PID and insomnia symptoms did not increase the risk of dementia in our study. More research with longer follow-up is needed, and future studies should explore if the associations to dementia risk vary across insomnia subtypes. Keywords: DSM-5; HUNT study; cohort studies; disturbed sleep; epidemiology; major neurocognitive disorder. © 2023 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

• Moradi, Shahram; Engdahl, Bo Lars; Johannessen, Aud; Selbæk, Geir; Aarhus, Lisa & Haanes, Gro Gade (2023). Hearing loss, hearing aid use, and subjective memory complaints: Results of the HUNT study in Norway. Frontiers in Neurology. ISSN 1664-2295. 13. doi: 10.3389/fneur.2022.1094270. Fulltekst i vitenarkiv Vis sammendrag

  Objective. To study the association between hearing loss severity, hearing aid use, and subjective memory complaints in a large cross-sectional study in Norway. Methods. Data were drawn from the fourth wave of the Trøndelag Health Study (HUNT4 Hearing, 2017–2019). Hearing threshold was defined as the pure tone average of 0.5, 1, 2 and 4 kHz in the better ear. The participants were divided into five groups: normal hearing or slight/mild/moderate/severe hearing loss. Subjective self-reported short-term and long-term memory complaints was measured by the nine-item Meta-Memory Questionnaire (MMQ). The sample included 20,092 individuals (11,675 women, mean age 58,3 years) who completed both hearing and MMQ tasks. Multivariate analysis of variance (adjusted for covariates of age, sex, education, and health cofounders) was used to evaluate the association between hearing status and hearing aid use (in the hearing-impaired groups) and long-term and short-term subjective memory complaints. Results. Multivariate analysis of variance, followed by univariate ANOVA and pairwise comparisons showed that hearing loss was associated only with more long-term subjective memory complaints and not with short-term subjective memory complaints. In the hearing-impaired groups, the univariate main effect of hearing aid use was only observed for subjective long-term memory complaints and not for subjective short-term memory complaints. Similarly, the univariate interaction of hearing aid use and hearing status was significant for subjective long-term memory complaints and not for subjective short-term memory complaints. Pairwise comparisons, however, revealed no significant differences between hearing loss groups with respect to subjective long-term complaints. Conclusion. This cross-sectional study indicates an association between hearing loss and subjective long-term memory complaints, but not with subjective short-term memory complaints. In addition, an interaction between hearing status and hearing aid use for subjective long-term memory complaints was observed in hearing-impaired groups, which calls for future research to examine the effects of hearing aid use on different memory systems.

• Watne, Leiv Otto; Pollmann, Christian Thomas; Neerland, Bjørn Erik; Paulsen, Else Quist; Halaas, Nathalie Bodd & Idland, Ane-Victoria [Vis alle 19 forfattere av denne artikkelen] (2022). Cerebrospinal fluid quinolinic acid is strongly associated with delirium and mortality in hip-fracture patients. Journal of Clinical Investigation. ISSN 0021-9738. 133(2). doi: 10.1172/JCI163472. Fulltekst i vitenarkiv Vis sammendrag

  Background: The kynurenine pathway (KP) has been identified as a potential mediator linking acute illness to cognitive dysfunction by generating neuroactive metabolites in response to inflammation. Delirium (acute confusion) is a common complication of acute illness and is associated with increased risk of dementia and mortality. However, the molecular mechanism underlying delirium, particularly in relation to the KP, remain elusive. Methods: We undertook a multi-center observational study with 586 hospitalized patients (248 with delirium) and investigated associations between delirium and KP metabolites measured in cerebrospinal fluid (CSF) and serum by targeted metabolomics. We also explored associations between KP metabolites and markers of neuronal damage and one-year mortality. Results: In delirium, we found concentrations of the neurotoxic metabolite quinolinic acid in CSF (CSF-QA, OR 2.26 [1.78, 2.87], p

• Asante, Ernest Obeng; Mai, Xiao-Mei; Eldholm, Rannveig Sakshaug; Skjellegrind, Håvard; Kolberg, Marit & Brumpton, Ben Michael [Vis alle 9 forfattere av denne artikkelen] (2022). Vitamin D Status Over Time and Cognitive Function in Norwegian Older Adults: A Prospective Cohort of the HUNT Study. The Journal of Nutrition, Health & Aging. ISSN 1279-7707. 27, s. 30–37. doi: 10.1007/s12603-022-1867-8. Fulltekst i vitenarkiv
• Vossius, Corinna Elisabeth; Bergh, Sverre; Selbæk, Geir; Lichtwarck, Bjørn & Myhre, Janne (2022). Cause and place of death in Norwegian nursing home residents. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948221140195. Vis sammendrag

  Nursing home (NH) residents are in their last phase of life, and two aims of the NH’s medical care in Norway is to prevent unnecessary hospital admissions that would not benefit the resident and to facilitate a peaceful death in familiar surroundings when the time comes. However, little is known about the share of residents dying in NHs and the causes of death. We therefore evaluated the cause and place of death in a cohort of NH residents followed from the time of NH admission until death. Methods: NH residents were followed from admission to the NH and over the entire course of their NH stay. Demographic and clinical data were collected. Cause and place of death were retrieved from the Norwegian Cause of Death Registry. Results: Of 1283 residents, 6.2% died in hospital and 91.2% in a NH. Those who died in hospitals were more often male, died sooner after NH admission, had a less severe degree of dementia and had poorer general health. Dementia was the most common underlying cause of death, followed by cardiovascular disease. Conclusions: Dementia is one of the main causes of death in NH residents. In addition, our findings indicate a low number of inappropriate referrals to hospital during the last stage of life. However, further research should explore whether the terminal phase of NH residents is formed in accordance with their preferences and whether appropriate palliative care is offered.

• Nygård, Arnhild Jenssen; Taraldsen, Kristin; Granbo, Randi; Selbæk, Geir & Helbostad, Jorunn L. (2022). Impacts of COVID-19 restrictions on level of physical activity and health in home-dwelling older adults in Norway. European Review of Aging and Physical Activity. ISSN 1813-7253. 19(1). doi: 10.1186/s11556-022-00309-w. Fulltekst i vitenarkiv Vis sammendrag

  The spread of the coronavirus in spring 2020 led to a lockdown of physical activity (PA) offers. The aim of this study was to investigate how PA, as well as general and mental health, in community-dwelling older adults were affected by the COVID-19 restrictions in Norway. Methods Invitation to participate in the study was sent via Facebook and the Norwegian Pensioners’ Association. Inclusion criteria were being ≥ 65 years old and living at home. Participants completed a questionnaire either digitally or on paper in June–August 2020. The questionnaire included questions on PA, general health, and mental health both before (13th of March) and during lockdown. Results We included 565 participants (mean age 74 ± 5.3 years, 60.4% female); almost 60% had a university degree, 84% reported performing PA more than once per week, and 20% reported a fall in the previous 12 months. The Wilcoxon signed-rank test indicated that the corona lockdown significantly reduced activity level (Z = -4.918, p < 0.001), general health (Z = -6,910, p < 0.001) and mental health (Z = -12.114, p < 0.001). Those who were less active during lockdown had higher odds of experiencing worse health than those who maintained their activity level, odds ratio: 9.36 (95% CI = 4.71–18.58, p < 0.001) for general health and 2.41 (95% CI = 1.52–3.83, p < 0.001) for mental health. Those who attended organized exercise offers before lockdown had higher odds of being less active during lockdown compared to those who did not exercise in an organized setting, odds ratio: 3.21 (95% CI = 2.17–5.76, p < 0.001). Conclusions In a relatively highly educated and active group of older participants, COVID-19 restrictions still negatively affected level of activity as well as general and mental health. These short-term decreases in activity level and health suggest that preventive actions and increased focus on measures to support older adults in maintaining an active lifestyle are needed.

• Wagle, Jørgen Olav; Selbæk, Geir; Saltyte Benth, Jurate; Gjøra, Linda; Rønqvist, Thale Kinne & Wetterberg, Peter [Vis alle 8 forfattere av denne artikkelen] (2022). The CERAD Word List Memory Test: Normative Data Based on a Norwegian Population-Based Sample of Healthy Older Adults 70 Years and Above. The HUNT Study. Journal of Alzheimer's Disease. ISSN 1387-2877. 91(1), s. 321–343. doi: 10.3233/JAD-220672. Vis sammendrag

  Background:The CERAD Word List Memory Test (WLMT) is widely used in the assessment of older adults with suspected dementia. Although normative data of the WLMT exist in many different regions of the world, normative data based on large population-based cohorts from the Scandinavian countries are lacking. Objective:To develop normative data for the WLMT based on a large population-based Norwegian sample of healthy older adults aged 70 years and above, stratified by age, gender, and education. Methods:A total of 6,356 older adults from two population-based studies in Norway, HUNT4 70 + and HUNT4 Trondheim 70+, were administered the WLMT. Only persons with normal cognitive function were included. We excluded persons with a diagnosis of mild cognitive impairment (MCI) and dementia, and persons with a history of stroke and/or depression. This resulted in 3,951 persons aged between 70 and 90 years, of whom 56.2% were females. Regression-based normative data were developed for this sample. Results:Age, gender, and education were significant predictors of performance on the WLMT list-learning subtests and the delayed recall subtest, i.e., participants of younger age, female sex, and higher education level attained higher scores compared to participants of older age, male sex, and lower level of education. Conclusion:Regression-based normative data from the WMLT, stratified by age, gender, and education from a large population-based Norwegian sample of cognitively healthy older adults aged 70 to 90 years are presented. An online norm calculator is available to facilitate scoring of the subtests (in percentiles and z-scores).

• Kjelvik, Grete; Rokstad, Anne Marie Mork; Stuebs, Josephine; Thingstad, Pernille; Deckers, Kay & Köhler, Sebastian [Vis alle 7 forfattere av denne artikkelen] (2022). Public knowledge about dementia risk reduction in Norway. BMC Public Health. ISSN 1471-2458. 22(1), s. 1–9. doi: 10.1186/s12889-022-14433-w. Fulltekst i vitenarkiv Vis sammendrag

  Background: Several modifiable lifestyle risk factors for dementia have been identified, but it is unclear how much the Norwegian public knows about the relationship between lifestyle and brain health. Therefore, this study aimed to investigate knowledge about modifiable dementia risk and protective factors and beliefs and attitudes towards dementia and dementia risk reduction in a randomly selected subsample of the Norwegian population. Methods: The total sample (n = 1435) included individuals aged 40–70 years from four counties (Oslo, Innlandet, Nordland and Trøndelag) in Norway. Two online questionnaires were used to measure (1) awareness about dementia risk reduction and (2) an individual`s motivation to change behaviour for dementia risk reduction (MOCHAD-10). Results: Of the participants, 70% were aware of the potential of dementia risk reduction in general. Physical inactivity (86%), cognitive inactivity (84%) and social isolation (80%) were the most frequently recognised dementia risk factors. On the other hand, diabetes (26%), coronary heart disease (19%), hearing loss (18%) and chronic kidney disease (7%) were less often recognised as dementia risk factors. Comparing men and women, the only significant difference was that women were more likely to report parents with dementia as a risk factor compared to men. Gender, age and educational differences were seen in beliefs and attitudes towards dementia prevention:women reported more negative feelings and attitudes towards dementia than men;those aged 40–49 years – more likely than older age groups – reported that ‘knowing family members with dementia’ or ‘having risk factors’ made them believe they had to change their lifestyle and behaviour. Conclusions: The results indicate that 70% of the Norwegian public are aware of the potential for dementia risk reduction in general. However, there are major gaps in existing knowledge, particularly for cardiovascular risk factors such as hypertension, coronary heart disease, hypercholesterolemia and metabolic factors (diabetes, obesity). These findings underline the importance of further informing the Norwegian public about lifestyle-related risk and protective factors of dementia. Differences in beliefs and attitudes towards dementia risk prevention by age, gender and education require tailored public risk reduction interventions.

• Skirbekk, Vegard Fykse; Bowen, Catherine E; Håberg, Asta; Jugessur, Astanand; Engdahl, Bo Lars & Bratsberg, Bernt Magne [Vis alle 15 forfattere av denne artikkelen] (2022). Marital Histories and Associations With Later-Life Dementia and Mild Cognitive Impairment Risk in the HUNT4 70+ Study in Norway. Journal of Aging and Health. ISSN 0898-2643. 35(7-8), s. 543–555. doi: 10.1177/08982643221131926. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Earlier studies suggest that being married in later life protects against dementia, and that being single in old age increases the risk of dementia. In this study, we examine midlife marital status trajectories and their association with dementia and mild cognitive impairment (MCI) at ages 70 plus using a large population based sample from Norway. Methods: Based on a general population sample linked to population registries (N = 8706), we used multinomial logistic regression to examine the associations between six types of marital trajectories (unmarried, continuously divorced, intermittently divorced, widowed, continuously married, intermittently married) between age 44 and 68 years from national registries and a clinical dementia or a MCI diagnosis after age 70. We estimated relative risk ratios (RRR) and used mediation analyses adjusting for education, number of children, smoking, hypertension, obesity, physical inactivity, diabetes, mental distress, and having no close friends in midlife. Inverse probability weighting and multiple imputations were applied. The population attributable fraction was estimated to assess the potential reduction in dementia cases due to marital histories. Results: Overall, 11.6% of the participants were diagnosed with dementia and 35.3% with MCI. Dementia prevalence was lowest among the continuously married (11.2%). Adjusting for confounders, the risk of dementia was higher for the unmarried (RRR = 1.73; 95% CI: 1.24, 2.40), continuously divorced (RRR = 1.66; 95% CI: 1.14, 2.43), and intermittently divorced (RRR = 1.50; 95% CI: 1.09, 2.06) compared to the continuously married. In general, marital trajectory was less associated with MCI than with dementia. In the counterfactual scenario, where all participants had the same risk of receiving a dementia diagnosis as the continuously married group, there would be 6.0% fewer dementia cases. Discussion: Our data confirm that staying married in midlife is associated with a lower risk of dementia and that divorced people account for a substantial share of dementia cases.

• Jansen, Iris E.; van der Lee, Sven J.; Gomez-Fonseca, Duber; de Rojas, Itziar; Dalmasso, Maria Carolina & Grenier-Boley, Benjamin [Vis alle 50 forfattere av denne artikkelen] (2022). Genome-wide meta-analysis for Alzheimer’s disease cerebrospinal fluid biomarkers. Acta Neuropathologica. ISSN 0001-6322. 144(5), s. 821–842. doi: 10.1007/s00401-022-02454-z. Fulltekst i vitenarkiv Vis sammendrag

  Amyloid-beta 42 (Aβ42) and phosphorylated tau (pTau) levels in cerebrospinal fluid (CSF) reflect core features of the pathogenesis of Alzheimer's disease (AD) more directly than clinical diagnosis. Initiated by the European Alzheimer & Dementia Biobank (EADB), the largest collaborative effort on genetics underlying CSF biomarkers was established, including 31 cohorts with a total of 13,116 individuals (discovery n = 8074; replication n = 5042 individuals). Besides the APOE locus, novel associations with two other well-established AD risk loci were observed; CR1 was shown a locus for Aβ42 and BIN1 for pTau. GMNC and C16orf95 were further identified as loci for pTau, of which the latter is novel. Clustering methods exploring the influence of all known AD risk loci on the CSF protein levels, revealed 4 biological categories suggesting multiple Aβ42 and pTau related biological pathways involved in the etiology of AD. In functional follow-up analyses, GMNC and C16orf95 both associated with lateral ventricular volume, implying an overlap in genetic etiology for tau levels and brain ventricular volume.

• Borza, Tom; Selbæk, Geir; Lichtwarck, Bjørn; Saltyte Benth, Jurate & Bergh, Sverre (2022). The Course of Depressive Symptoms Over 36 Months in 696 Newly Admitted Nursing Home Residents. Journal of the American Medical Directors Association. ISSN 1525-8610. 23(11), s. 1838–1844. doi: 10.1016/j.jamda.2022.08.007. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To investigate the course of depressive symptoms in newly admitted nursing home (NH) residents and how resident characteristics were associated with the symptoms. To identify groups of residents following the same symptom trajectory. Design An observational, multicenter, longitudinal study over 36 months with 7 biannual assessments. Setting and Participants Representing 47 Norwegian NHs, 696 residents were included at admission to a NH. Methods Depressive symptoms were assessed with the Cornell Scale for Depression in Dementia (CSDD). We selected severity of dementia, functional impairment, physical health, pain, use of antidepressants, age, and sex as covariates. Time trend in CSDD score was assessed by a linear mixed model adjusting for covariates. Next, a growth mixture model was estimated to investigate whether there were groups of residents following distinct trajectories in CSDD scores. We estimated a nominal regression model to assess whether the covariates at admission were associated to group membership. Results There was a nonlinear trend in CSDD score. More severe dementia, a lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher CSDD scores. Growth mixture model identified 4 groups: (1) persistent mild symptoms (32.6%), (2) persistent moderate symptoms (50.8%), (3) increasing symptoms (5.1%), and (4) severe but decreasing symptoms (11.6%). A lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher odds for belonging to the severe but decreasing symptoms group compared with the persistent mild symptoms group. Conclusions and Implications Most NH residents were in trajectory groups with persistent mild or moderate depressive symptoms. Residents with more severe dementia, lower levels of functioning, poor physical health, severe pain, younger age at admittance, and who are using antidepressants should be monitored closely and systematically with respect to depression. Taking actions toward a more personalized treatment for depression in NHs is a priority and should be investigated in future studies.

• Selbæk, Geir; Stuebs, Josephine; Engedal, Knut; Hachinski, Vladimir; Hestad, Knut & Treviño, Cathrine Selnes [Vis alle 9 forfattere av denne artikkelen] (2022). Blood pressure trajectories over 35 years and dementia risk: A retrospective study: The HUNT study. Frontiers in Aging Neuroscience. ISSN 1663-4365. 14, s. 1–11. doi: 10.3389/fnagi.2022.931715. Fulltekst i vitenarkiv Vis sammendrag

  High blood pressure is a well-established risk factor of dementia. However, the timing of the risk remains controversial. The aim of the present study was to compare trajectories of systolic blood pressure (SBP) over a 35-year follow-up period in the Health Survey in Trøndelag (HUNT) from study wave 1 to 4 in people with and without a dementia diagnosis at wave 4 (HUNT4). This is a retrospective cohort study of participants aged ≥ 70 years in HUNT4, where 9,720 participants were assessed for dementia. In the HUNT study all residents aged ≥ 20 years have been invited to four surveys: HUNT1 1984–86, HUNT2 1995–97, HUNT3 2006–08 and HUNT4 2017–19. The study sample was aged 70–102 years (mean 77.6, SD 6.0) at HUNT4, 54% were women and 15.5% had dementia, 8.8% had Alzheimer’s disease (AD), 1.6% had vascular dementia (VaD) and 5.1% had other types of dementia. Compared to those without dementia at HUNT4, those with dementia at HUNT4 had higher SBP at HUNT1 and HUNT2, but lower SBP at HUNT4. These differences at HUNT1 and 2 were especially pronounced among women. Results did not differ across birth cohorts. For dementia subtypes at HUNT4, the VaD group had a higher SBP than the AD group at HUNT2 and 3. Age trajectories in SBP showed that the dementia group experienced a steady increase in SBP until 65 years of age and a decrease from 70 to 90 years. SBP in the no- dementia group increased until 80 years before it leveled off from 80 to 90 years. The present study confirms findings of higher midlife SBP and lower late-life SBP in people with dementia. This pattern may have several explanations and it highlights the need for close monitoring of BP treatment in older adults, with frequent reappraisal of treatment needs.

• Medbøen, Ingrid Tøndel; Persson, Karin Ester Torun; Nåvik, Marit; Totland, Torunn Holm; Bergh, Sverre & Treviño, Cathrine Selnes [Vis alle 20 forfattere av denne artikkelen] (2022). Cohort profile: the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) - a national research and quality registry with a biomaterial collection. BMJ Open. ISSN 2044-6055. 12(9). doi: 10.1136/bmjopen-2021-058810. Fulltekst i vitenarkiv Vis sammendrag

  Purpose: The Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) was established to harmonise and improve the quality of diagnostic practice across clinics assessing persons with cognitive symptoms in Norwegian specialist healthcare units and to establish a large research cohort with extensive clinical data. Participants: The registry recruits patients who are referred for assessment of cognitive symptoms and suspected dementia at outpatient clinics in Norwegian specialist healthcare units. In total, 18 120 patients have been included in NorCog during the period of 2009-2021. The average age at inclusion was 73.7 years. About half of the patients (46%) were diagnosed with dementia at the baseline assessment, 35% with mild cognitive impairment and 13% with no or subjective cognitive impairment; 7% received other specified diagnoses such as mood disorders. Findings to date: All patients have a detailed baseline characterisation involving lifestyle and demographic variables; activities of daily living; caregiver situation; medical history; medication; psychiatric, physical and neurological examinations; neurocognitive testing; blood laboratory work-up; and structural or functional brain imaging. Diagnoses are set according to standardised diagnostic criteria. The research biobank stores DNA and blood samples from 4000 patients as well as cerebrospinal fluid from 800 patients. Data from NorCog have been used in a wide range of research projects evaluating and validating dementia-related assessment tools, and identifying patient characteristics, symptoms, functioning and needs, as well as caregiver burden and requirement of available resources. Future plans: The finish date of NorCog was originally in 2029. In 2021, the registry's legal basis was reformalised and NorCog got approval to collect and keep data for as long as is necessary to achieve the purpose of the registry. In 2022, the registry underwent major changes. Paper-based data collection was replaced with digital registration, and the number of variables collected was reduced. Future plans involve expanding the registry to include patients from primary care centres. © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

• Tari, Atefe R; Selbæk, Geir; Franklin, Barry A.; Bergh, Sverre; Skjellegrind, Håvard & Sallis, Robert E. [Vis alle 14 forfattere av denne artikkelen] (2022). Temporal changes in personal activity intelligence and the risk of incident dementia and dementia related mortality: A prospective cohort study (HUNT). EClinicalMedicine. ISSN 2589-5370. 52. doi: 10.1016/j.eclinm.2022.101607. Fulltekst i vitenarkiv Vis sammendrag

  The Personal Activity Intelligence (PAI) translates heart rate during daily activity into a weekly score. Obtaining a weekly PAI score ≥100 is associated with reduced risk of premature morbidity and mortality from cardiovascular diseases. Here, we determined whether changes in PAI score are associated with changes in risk of incident dementia and dementia-related mortality. Methods We conducted a prospective cohort study of 29,826 healthy individuals. Using data from the Trøndelag Health-Study (HUNT), PAI was estimated 10 years apart (HUNT1 1984–86 and HUNT2 1995–97). Adjusted hazard-ratios (aHR) and 95%-confidence intervals (CI) for incidence of and death from dementia were related to changes in PAI using Cox regression analyses. Findings During a median follow-up time of 24.5 years (interquartile range [IQR]: 24.1-25.0) for dementia incidence and 23.6 years (IQR: 20.8–24.2) for dementia-related mortality, there were 1998 incident cases and 1033 dementia-related deaths. Individuals who increased their PAI score over time or maintained a high PAI score at both assessments had reduced risk of dementia incidence and dementia-related mortality. Compared with persistently inactive individuals (0 weekly PAI) at both time points, the aHRs for those with a PAI score ≥100 at both occasions were 0.75 (95% CI: 0.58–0.97) for incident dementia, and 0.62 (95% CI: 0.43–0.91) for dementia-related mortality. Using PAI score <100 at both assessments as the reference cohort, those who increased from <100 at HUNT1 to ≥100 at HUNT2 had aHR of 0.83 (95% CI: 0.72–0.96) for incident dementia, and gained 2.8 (95% CI: 1.3–4.2, P<0.0001) dementia-free years. For dementia-related mortality, the corresponding aHR was 0.74 (95% CI: 0.59–0.92) and years of life gained were 2.4 (95% CI: 1.0–3.8, P=0.001). Interpretation Maintaining a high weekly PAI score and increases in PAI scores over time were associated with a reduced risk of incident dementia and dementia-related mortality. Our findings extend the scientific evidence regarding the protective role of PA for dementia prevention, and suggest that PAI may be a valuable tool in guiding research-based PA recommendations.

• Soares, Jelena Zugic; Valeur, Jørgen; Saltyte Benth, Jurate; Knapskog, Anne Brita; Selbæk, Geir & Bogdanovic, Nenad [Vis alle 7 forfattere av denne artikkelen] (2022). Associations Between Intrathecal Levels of Vitamin D, Cytokines, and Core Biomarkers of Alzheimer's Disease: A Cross-Sectional Study. Journal of Alzheimer's Disease. ISSN 1387-2877. 89(3), s. 825–834. doi: 10.3233/JAD-220407. Vis sammendrag

  Background: Several studies have examined association between vitamin D levels in serum and cognition, but little is known of vitamin D levels in cerebrospinal fluid (CSF) and association with Alzheimer’s disease (AD). Objective: In this cross-sectional, explorative study we investigated possible associations of vitamin D in CSF with biomarkers for AD, amyloid-β, tau protein/phosphorylated tau protein in CSF, and with the cytokines IL-6, IL-8, and TNF-α in CSF in patients with cognitive impairment and cognitively healthy controls. Methods: We included 100 outpatients ≥65 years referred for assessment of cognitive impairment and 76 age- and sex-matched cognitively healthy controls. Levels of 25-hydroxyvitamin D (25(OH)D), amyloid-β, tau protein and phosphorylated tau protein, as well as IL-6, IL-8, and TNF-α, were analyzed in CSF in both groups. Results: Higher levels of 25(OH)D in CSF in all groups together were associated with lower levels of tau protein (p = 0.01) and phosphorylated tau protein (p = 0.005). We found no association between 25(OH)D levels in CSF and pathological levels of amyloid-β in CSF nor levels of IL-6 or TNF-α in CSF. Higher levels of 25(OH)D in CSF were associated with higher levels of IL-8 in CSF (p = 0.002). However, vitamin D explained only 6% of variance in IL-8. There was no significant difference between the patient groups and the control group regarding the association between 25(OH)D in CSF and any of the three cytokines in CSF. Conclusion: Participants with higher CSF levels of 25(OH)D exhibited reduced CSF levels of tau protein and phosphorylated tau protein.

• Motazedi, Ehsan; Cheng, Weiqiu; Thomassen, Jesper Qvist; Frei, Oleksandr; Rongve, Arvid & Athanasiu, Lavinia [Vis alle 30 forfattere av denne artikkelen] (2022). Using Polygenic Hazard Scores to Predict Age at Onset of Alzheimer's Disease in Nordic Populations. Journal of Alzheimer's Disease. ISSN 1387-2877. 88(4), s. 1533–1544. doi: 10.3233/JAD-220174. Vis sammendrag

  Background: Polygenic hazard scores (PHS) estimate age-dependent genetic risk of late-onset Alzheimer’s disease (AD), but there is limited information about the performance of PHS on real-world data where the population of interest differs from the model development population and part of the model genotypes are missing or need to be imputed. Objective: The aim of this study was to estimate age-dependent risk of late-onset AD using polygenic predictors in Nordic populations. Methods: We used Desikan PHS model, based on Cox proportional hazards assumption, to obtain age-dependent hazard scores for AD from individual genotypes in the Norwegian DemGene cohort (n = 2,772). We assessed the risk discrimination and calibration of Desikan model and extended it by adding new genotype markers (the Desikan Nordic model). Finally, we evaluated both Desikan and Desikan Nordic models in two independent Danish cohorts: The Copenhagen City Heart Study (CCHS) cohort (n = 7,643) and The Copenhagen General Population Study (CGPS) cohort (n = 10,886). Results: We showed a robust prediction efficiency of Desikan model in stratifying AD risk groups in Nordic populations, even when some of the model SNPs were missing or imputed. We attempted to improve Desikan PHS model by adding new SNPs to it, but we still achieved similar risk discrimination and calibration with the extended model. Conclusion: PHS modeling has the potential to guide the timing of treatment initiation based on individual risk profiles and can help enrich clinical trials with people at high risk to AD in Nordic populations.

• Åsvold, Bjørn Olav; Langhammer, Arnulf; Rehn, Tommy Aune; Kjelvik, Grete; Grøntvedt, Trond Viggo & Sørgjerd, Elin Pettersen [Vis alle 21 forfattere av denne artikkelen] (2022). Cohort Profile Update: The HUNT Study, Norway. International Journal of Epidemiology. ISSN 0300-5771. 52(1). doi: 10.1093/ije/dyac095. Fulltekst i vitenarkiv
• Barca, Maria Lage; Alnæs, Dag; Engedal, Knut; Persson, Karin Ester Torun; Eldholm, Rannveig Sakshaug & Siafarikas, Nikias Ioannis [Vis alle 11 forfattere av denne artikkelen] (2022). Brain Morphometric Correlates of Depressive Symptoms among Patients with and without Dementia. Dementia and Geriatric Cognitive Disorders Extra. ISSN 1664-5464. 12(2), s. 107–114. doi: 10.1159/000521114. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Findings regarding brain morphometry among patients with dementia and concomitant depressive symptoms have been inconsistent. Thus, the aim of the present study was to test the hypothesis that dementia and concomitant depressive symptoms are associated with structural brain changes in the temporal lobe measured with structural magnetic resonance imaging (MRI). Methods: A sample of 492 patients from Norwegian memory clinics (n = 363) and Old Age Psychiatry services (n = 129) was studied. The assessment included the Cornell Scale for Depression in Dementia (CSDD), Instrumental Activities of Daily Living Scale, Mini Mental State Examination, and MRI of the brain, processed with FreeSurfer to derive ROI measures of cortical thickness, volume, and area using the Desikan-Killiany parcellation, as well as subcortical volumes. Dementia was diagnosed according to ICD-10 research criteria. Correlates of brain morphometry using multiple linear regression were examined. Results: Higher scores on the CSDD were associated with larger cortical volume (β = 0.125; p value = 0.003) and area of the left isthmus of the cingulate gyrus (β = 0.151; p value = <0.001) across all patients. Inclusion of an interaction term (dementia × CSDD) revealed a smaller area in the left temporal pole (β = −0.345; p value = 0.001) and right-transverse temporal cortex (β = −0.321; p value = 0.001) in patients with dementia and depressive symptoms. Discussion/Conclusion: We confirm the previous findings of structural brain changes in temporal regions among patients with dementia and concomitant depressive symptoms. This may contribute to a better understanding of the mechanisms underlying depression in dementia. To the best of our knowledge, this is the largest study conducted on this topic to date.

• Gedde, Marie H.; Husebø, Bettina Elisabeth Franziska; Mannseth, Janne; Naik, Mala; Selbæk, Geir & Vislapuu, Maarja [Vis alle 7 forfattere av denne artikkelen] (2022). The impact of medication reviews by general practitioners on psychotropic drug use and behavioral and psychological symptoms in home-dwelling people with dementia: results from the multicomponent cluster randomized controlled LIVE@Home.Path trial. BMC Medicine. ISSN 1741-7015. 20(1). doi: 10.1186/s12916-022-02382-5. Fulltekst i vitenarkiv Vis sammendrag

  Background There is limited knowledge regarding the process of deprescribing psychotropic drugs to people with dementia (PwD) conducted by general practitioners (GP). We investigated the impact of a multicomponent intervention, emphasizing medication reviews, on psychotropic drugs and behavioral and psychological symptoms (BPSD) in home-dwelling PwD and quantified change in patient-GP communication evaluated by their informal caregivers. Methods LIVE@Home.Path is a stepped-wedge closed-cohort cluster randomized controlled trial for people with mild to moderate dementia aged ≥65 and their informal caregivers (dyads) in Norway. Complementary to health care as usual (control condition), municipal coordinators implemented the multicomponent LIVE intervention: Learning, Innovation, Volunteer support, and Empowerment (including medication review by the PwD’s regular GPs). Block-randomization was used to allocate dyads in three groups receiving the intervention sequentially in periods of 6 months duration. Prepandemic data from the first period is reported, resulting in a 1:2 intervention-to-control ratio. Primary outcome was change in psychotropic drug use. Secondary outcomes were changes in BPSD by Neuropsychiatric Inventory and Cornell Scale of Depression in Dementia and patient-GP communication by an adaption of the Clinical Global Impression of Change. Results Four hundred thirty-eight dyads were screened, 280 included, and 237 participated at 6 months (intervention group n=67; control condition n=170). At baseline, 63% used psychotropic medication regularly: antidementia drugs (47%), antidepressants (13%), hypnotics/sedatives (13%), antipsychotics (5%), and anxiolytics (2%). At 6 months, medication reviews were more frequently conducted in the intervention group compared to control (66% vs 42%, P=0.001). We found no differences regarding a change in drug use and BPSD. Patient-GP communication enhanced in the intervention group (mean score 0.95 [standard deviation 1.68] vs 0.41 [1.34], P=0.022). In the intervention group, control group, and overall sample, the informal caregivers of those who had their medications reviewed reported improved patient-GP communication compared to those who did not. Conclusions Change in psychotropic drug use and BPSD did not differ, even though patient-GP communication improved with medication reviews. Restricted psychotropic drug use among PwD likely reflects more judicious prescribing practices in recent years. Nevertheless, medication reviews could be cultivated to optimize pharmacologic treatment for this complex population.

• Bellenguez, Céline; Küçükali, Fahri; Jansen, Iris E.; Kleineidam, Luca; Moreno-Grau, Sonia & Amin, Najaf [Vis alle 407 forfattere av denne artikkelen] (2022). New insights into the genetic etiology of Alzheimer's disease and related dementias. Nature Genetics. ISSN 1061-4036. 54(4), s. 412–436. doi: 10.1038/s41588-022-01024-z. Fulltekst i vitenarkiv Vis sammendrag

  Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele.

• Leonardsen, Esten Høyland; Peng, Han; Kaufmann, Tobias; Agartz, Ingrid; Andreassen, Ole & Celius, Elisabeth Gulowsen [Vis alle 19 forfattere av denne artikkelen] (2022). Deep neural networks learn general and clinically relevant representations of the ageing brain. NeuroImage. ISSN 1053-8119. 256. doi: 10.1016/j.neuroimage.2022.119210. Fulltekst i vitenarkiv Vis sammendrag

  The discrepancy between chronological age and the apparent age of the brain based on neuroimaging data — the brain age delta — has emerged as a reliable marker of brain health. With an increasing wealth of data, approaches to tackle heterogeneity in data acquisition are vital. To this end, we compiled raw structural magnetic resonance images into one of the largest and most diverse datasets assembled (n=53542), and trained convolutional neural networks (CNNs) to predict age. We achieved state-of-the-art performance on unseen data from unknown scanners (n=2553), and showed that higher brain age delta is associated with diabetes, alcohol intake and smoking. Using transfer learning, the intermediate representations learned by our model complemented and partly outperformed brain age delta in predicting common brain disorders. Our work shows we can achieve generalizable and biologically plausible brain age predictions using CNNs trained on heterogeneous datasets, and transfer them to clinical use cases.

• Vossius, Corinna Elisabeth; Bergh, Sverre; Selbæk, Geir; Saltyte Benth, Jurate; Myhre, Janne & Aakhus, Eivind [Vis alle 7 forfattere av denne artikkelen] (2022). Mortality in nursing home residents stratified according to subtype of dementia: a longitudinal study over three years. BMC Geriatrics. ISSN 1471-2318. 22(1), s. 1–10. doi: 10.1186/s12877-022-02994-9. Fulltekst i vitenarkiv Vis sammendrag

  Background: There are several subtypes of dementia caused by different pathophysiology and with different clinical characteristics. Irrespective subtype, the disease is progressive, eventually leading to the need for care and supervision on a 24/7 basis, often provided in nursing homes (NH). The progression rate and course of the disease might vary according to subtype. The aim of this study was to explore whether the mortality rate for NH residents varied according to the subtype of dementia. Methods: NH residents were followed from admission to NH over a period of 36 months or until death with annual follow-up examinations. Demographic and clinical data were collected. The diagnosis of dementia and its subtype at baseline (BL) were set according to international accepted criteria. Kaplan-Meier analysis was performed to estimate median survival time. A Cox regression model was estimated to assess the impact of dementia diagnosis and demographic and clinical variables on mortality. Results: A total of 1349 participants were included. When compared to persons with Alzheimer's disease (AD), persons with frontotemporal dementia (FTD) and dementia with Lewy bodies or Parkinson's disease dementia (DLB/PDD) were younger and had more neuropsychiatric symptoms. Median survival for the total sample was 2.3 years (95% confidence interval: 2.2-2.5). When compared to persons with AD, having no dementia or unspecified dementia was associated with higher mortality, while we found similar mortality in other subtypes of dementia. Higher age, male gender, poorer general health, higher dependency in activities of daily living, and more affective symptoms were associated with higher mortality. Conclusion: Mortality did not differ across the subtypes of dementia, except in persons with unspecified dementia or without dementia, where we found a higher mortality. With a median survival of 2.3 years, NH residents are in the last stage of their lives and care and medical follow-up should focus on a palliative approach. However, identifying the subtype of dementia might help carers to better understand and address neuropsychiatric symptoms and to customize medical treatment. Keywords: Dementia; Dementia subtypes; Long term nursing home residents; Mortality; Nursing home; Nursing home mortality. © 2022. The Author(s).

• Persson, Karin Ester Torun; Edwin, Trine Holt; Knapskog, Anne Brita; Tangen, Gro Gujord; Selbæk, Geir & Engedal, Knut (2022). Hippocampal Atrophy Subtypes of Alzheimer's Disease Using Automatic MRI in a Memory Clinic Cohort: Clinical Implications. Dementia and Geriatric Cognitive Disorders. ISSN 1420-8008. 51(1), s. 80–89. doi: 10.1159/000522382. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: One pathological hallmark of Alzheimer’s disease (AD) is atrophy of medial temporal brain regions that can be visualized on magnetic resonance imaging (MRI), but not all patients will have atrophy. The aim was to use MRI to categorize patients according to their hippocampal atrophy status and to present prevalence of the subtypes, difference in clinical symptomatology and progression, and factors associated with hippocampal subtypes. Methods: We included 215 patients with AD who had been assessed with the clinically available MRI software NeuroQuant (NQ; CorTechs labs/University of California, San Diego, CA, USA). NQ measures the hippocampus volume and calculates a normative percentile. Atrophy was regarded to be present if the percentile was ≤5. Demographics, cognitive measurements, AD phenotypes, apolipoprotein E status, and results from cerebrospinal fluid and amyloid positron emission tomography analyses were included as explanatory variables of the hippocampal subtypes. Results: Of all, 60% had no hippocampal atrophy. These patients were younger and less cognitively impaired concerning global measures, memory function, and abstraction but impaired concerning executive, visuospatial, and semantic fluency, and more of them had nonamnestic AD, compared to those with hippocampal atrophy. No difference in progression rate was observed between the two groups. In mild cognitive impairment patients, amyloid pathology was associated with the no hippocampal atrophy group. Conclusion: The results have clinical implications. Clinicians should be aware of the large proportion of AD patients presenting without atrophy of the hippocampus as measured with this clinical MRI method in the diagnostic set up and that nonamnestic phenotypes are more common in this group as compared to those with atrophy. Furthermore, the findings are relevant in clinical trials.

• Hoel, Kari Anne; Lichtwarck, Bjørn; Væringstad, Anette; Feiring, Ingvild Hjorth; Rokstad, Anne Marie Mork & Selbæk, Geir [Vis alle 8 forfattere av denne artikkelen] (2022). Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) in home care services: a cluster randomized feasibility trial. BMC Health Services Research. ISSN 1472-6963. 22(1), s. 1–12. doi: 10.1186/s12913-022-07830-9. Fulltekst i vitenarkiv Vis sammendrag

  Background: Behavioral and psychological symptoms of dementia (BPSD) occur frequently in people with dementia and can contribute to an increased need for help and a reduced quality of life, but also predict early institutionalization. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) might be a useful personalized approach to BPSD in people with dementia. The main objective of this feasibility trial was to explore the trial design and methods along with the patients’ and the home care staff’s acceptance of the TIME intervention before developing a definitive trial. Additionally, we wanted to explore whether TIME could be appropriate for staff in home care services in their approach towards people with dementia with anxiety and depression. Methods: This was a 18-month feasibility trial using a parallel cluster randomized controlled design. Nine municipalities from the eastern part of Norway (clusters) — 40 people with dementia and 37 of their next of kin— were randomized to the TIME intervention or to treatment as usual. In addition, qualitative data as field notes were collected and summarized. Results: The staff in home care services experienced TIME as an appropriate method; in particular, the systematic approach to the patient’s BPSD was experienced as useful. However, the completion of the assessment phase was considered exhaustive and time-consuming, and some of the staff found it challenging to find time for the case conferences. Conclusions: We consider that TIME, with some adjustments, could be useful for staff in home care services in cases where they face challenges in providing care and support to people with dementia. This feasibility trial indicates that we can move forward with a future definitive randomized controlled trial (RCT) to test the effect of TIME in people with dementia receiving home care services.

• Callegari, Enrico; Saltyte Benth, Jurate; Selbæk, Geir; Grønnerød, Cato & Bergh, Sverre (2022). The Effect of the NorGeP–NH on Quality of Life and Drug Prescriptions in Norwegian Nursing Homes: A Randomized Controlled Trial. Pharmacy. ISSN 2226-4787. 10(1). doi: 10.3390/pharmacy10010032. Fulltekst i vitenarkiv Vis sammendrag

  Background: The effect of the Norwegian General Practice–Nursing Home (NorGeP–NH) criteria has never been tested on clinical outcomes in nursing home (NH) residents. We performed a cluster-randomized trial in Norwegian NHs and tested the effect of NorGeP–NH on QoL (primary outcome), medication prescriptions, and physical and mental health (secondary outcomes) for the enrolled residents; Methods: Fourteen NHs were randomized into intervention NHs (iNHs) and control NHs (cNHs). After baseline data collection, physicians performed NorGeP–NH on the enrolled residents. We assessed the difference between cNHs and iNHs in the change in primary outcome from baseline to 12 weeks and secondary outcomes from baseline to eight and 12 weeks by linear mixed models; Results: One hundred and eight residents (13 lost to follow-up) and 109 residents (nine lost to follow-up) were randomized to iNHs and cNHs, respectively. Difference in change in QoL at 12 weeks between cNHs and iNHs was not statistically significant (mean (95% CI)): −1.51 (−3.30; 0.28), p = 0.101). We found no significant change in drug prescriptions over time. Difference in depression scores between cNHs and iNHs was statistically significant after 12 weeks. Conclusions: Our intervention did not affect QoL or drug prescriptions, but reduced depression scores in the iNHs. NorGeP–NH may be a useful tool, but its effect on clinical outcomes may be scarce in NH residents. Further studies about the effectiveness of NorGeP–NH in other healthcare contexts and settings are recommended.

• Soares, Jelena Zugic; Valeur, Jørgen; Saltyte Benth, Jurate; Knapskog, Anne Brita; Selbæk, Geir & Arefi, Golchin [Vis alle 10 forfattere av denne artikkelen] (2022). Vitamin D in Alzheimer's Disease: Low Levels in Cerebrospinal Fluid Despite Normal Amounts in Serum. Journal of Alzheimer's Disease. ISSN 1387-2877. 86(3), s. 1301–1314. doi: 10.3233/JAD-215536. Vis sammendrag

  Background:Vitamin D insufficiency has been suggested as a dementia risk factor. Objective:In this cross-sectional, explorative study we investigated whether levels of vitamin D in cerebrospinal fluid (CSF) are lower in patients with positive biomarkers of Alzheimer’s disease (AD) compared to cognitively healthy controls and whether polymorphisms of the vitamin D receptor (VDR) gene, FokI, BsmI, ApaI, and TaqI, are associated with levels of vitamin D in CSF and cognition. Methods:We included 100 patients≥65 years assessed for cognitive impairment and 76 cognitively healthy controls. Levels of 25-hydroxyvitamin D (25(OH)D) in both serum and CSF, and VDR polymorphisms were analyzed. Results:The mean level of 25(OH)D in serum was 78.6 (SD 28.9) nmol/l. While serum levels of 25(OH)D were not significantly different between the groups, CSF levels of 25(OH)D were significantly lower in patients with positive AD core biomarkers (p = 0.001) compared to patients without such biomarkers. Individuals with the BsmI major homozygote genotype had significantly lower results on a 10-word delayed recall test (p = 0.044) and verbal fluency test (p = 0.013), and individuals with the TaqI major homozygote genotype had significantly lower results on a verbal fluency test (p = 0.030) compared to individuals with the corresponding minor homozygote genotype. Conclusion:Patients with positive AD core biomarkers have low CSF levels of 25(OH)D, despite sufficient serum levels. CSF levels of 25(OH)D do not seem to be affected by any of the four VDR gene polymorphisms. TaqI and BsmI major homozygote genotypes might be at increased risk for development of cognitive decline.

• Engedal, Knut; Gjøra, Linda; Saltyte Benth, Jurate; Wagle, Jørgen Olav; Rønqvist, Thale Kinne & Selbæk, Geir (2022). The Montreal Cognitive Assessment: Normative Data from a Large, Population-Based Sample of Cognitive Healthy Older Adults in Norway - The HUNT Study. Journal of Alzheimer's Disease. ISSN 1387-2877. 86(2), s. 589–599. doi: 10.3233/JAD-215442. Vis sammendrag

  Background:Several studies have found that normative scores on the Montreal Cognitive Assessment Scale (MoCA) vary depending on the person’s education and age. The evidence for different normative scores between sexes is poor. Objective:The main aim of the study was to determine normative scores on the MoCA for Norwegian older adults stratified by educational level, age, and sex. In addition, we aimed to explore sex differences in greater detail. Methods:From two population-based studies in Norway, we included 4,780 people age 70 years and older. People with a diagnosis of dementia or mild cognitive impairment, a history of stroke, and depression were excluded. Trained health personnel tested the participants with the MoCA. Results:The mean MoCA score varied between 22 and 27 and was highest among women 70–74 years with education >13 years and lowest among men age 85 and older with education ≤10 years. Education, age, and sex were significant predictors of MoCA scores. Conclusion:In the present study of cognitively healthy Norwegian adults 70 years and older, we found that the normative score on the MoCA varied between 22 and 27 depending on a person’s education, age, and sex. We suggest that normative scores should be determined taking these three variables into consideration.

• Kamsvaag, Ben; Tevik, Kjerstin Elisabeth; Saltyte Benth, Jurate; Wu, Bei; Bergh, Sverre & Selbæk, Geir [Vis alle 7 forfattere av denne artikkelen] (2022). Does Elevated Alcohol Consumption Delay the Diagnostic Assessment of Cognitive Impairment among Older Adults? Dementia and Geriatric Cognitive Disorders Extra. ISSN 1664-5464. 12(1), s. 14–23. doi: 10.1159/000521924. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: The time from symptom debut to assessment of cognitive impairment (TSA) is usually substantial, and many factors can influence the length of this interval. Our objective was to discern whether elevated alcohol consumption is associated with TSA. Methods: Alcohol consumption was measured among 3,236 older Norwegians assessed for cognitive impairment. Elevated consumption was defined as drinking 4-7 times a week. TSA was defined as the number of months between symptom debut and assessment. The association between alcohol consumption and TSA was examined with a multiple regression analysis controlled for sociodemographic and clinical covariates. Results: Mean (SD) and median TSA were 34.8 (35.8) and 24.0 months, respectively. Elevated alcohol consumption was not associated with TSA. Longer TSA was associated with being male, having a high education level, being retired or unemployed, being single, having low scores on the Mini-Mental State Examination (MMSE) or Personal Activities of Daily Living (PADL), having high subsyndrome scores of depression or agitation on The Neuropsychiatric Inventory - Questionnaire (NPI-Q), or having a spouse/cohabitant as the designated next of kin. Conclusion: This study indicates that elevated alcohol consumption does not influence TSA. Possible explanations are discussed, but further research is needed to determine the effect of alcohol definitively. We did identify other novel characteristics associated with TSA which may be important in minimizing the risk of delayed cognitive assessments and should be kept in mind when considering assessment.

• Eriksen, Siren ; Rokstad, Anne Marie Mork; Selbæk, Geir; Björklöf, Guro Hanevold; Tveito, Marit & Bergh, Sverre [Vis alle 9 forfattere av denne artikkelen] (2022). Bruk av skjermbaserte medier blant eldre under covid-19-pandemien : en HUNT studie. Sykepleien Forskning. ISSN 1890-2936. 17. doi: 10.4220/Sykepleienf.2022.88131. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn: Eldre er spesielt sårbare for alvorlig sykdom og død ved covid-19 og har blitt oppfordret til selvisolering under koronapandemien. Skjermbaserte medier og telefon har blitt fremhevet som viktige hjelpemidler for å unngå ensomhet, opprettholde kontakten med venner og familie samt sikre oppfølging av nødvendig helsehjelp. Det har imidlertid manglet kunnskap om hvordan eldre har brukt skjermbaserte medier under pandemien. Hensikt: Formålet med studien var å undersøke hvordan eldre over 70 år har benyttet skjermbaserte medier til underholdning, informasjon og kontakt med venner, sosialt nettverk og helsepersonell. Videre ønsket vi å se på hvordan kjønn og alder påvirket bruken. Metode: I januar 2021 sendte vi et spørreskjema i posten til 12 772 personer som var 70 år eller eldre da de deltok i den fjerde runden av Helseundersøkelsen i Nord-Trøndelag (HUNT 4) i perioden 2017–19. Deltakerne ble bedt om å angi hvor mye tid per dag de hadde brukt på henholdsvis underholdning, kontakt med venner eller nettverk og innhenting av kunnskap eller informasjon på skjermbaserte medier. Resultat: Totalt 9391 personer (73,5 prosent) (72–106 år) svarte på spørreundersøkelsen. Av disse brukte 83,9 prosent skjermbaserte medier til å holde kontakten med venner og sosialt nettverk. Åtte prosent svarte at de hadde hatt kontakt med helsepersonell på skjermbaserte medier. Flere kvinner enn menn og 􀃩ere under 80 år enn over holdt kontakten med andre via skjerm. Konklusjon: En stor andel eldre har brukt skjermbaserte medier under pandemien. Studien avdekket at det har vært lite kontakt mellom eldre og helsepersonell via telefon eller skjerm. Slik kontakt bør styrkes, samtidig som det må settes søkelys på de i den eldste delen av befolkningen som ikke benytter seg av kommunikasjonsteknologi.

• Tevik, Kjerstin Elisabeth; Bergh, Sverre; Selbæk, Geir; Johannessen, Aud & Helvik, Anne-Sofie (2021). A systematic review of self-report measures used in epidemiological studies to assess alcohol consumption among older adults. PLOS ONE. ISSN 1932-6203. 16(12), s. 1–38. doi: 10.1371/journal.pone.0261292. Fulltekst i vitenarkiv Vis sammendrag

  Background: There is a lack of standardization regarding how to assess and categorize alcohol intake in older adults. The aim of this study was to systematically review methods used in epidemiological studies to define drinking patterns and measure alcohol consumption among older adults. Methods: A systematic search was conducted in the MEDLINE, PubMed, PsycINFO, EMBASE, and CINAHL databases for studies published from January 2009 to April 2021. Studies were included if they were observational studies with a quantitative design; the mean age of the participants was ≥ 65 years; questionnaires, screening tools, or diagnostic tools were used to define alcohol consumption; and alcohol consumption was self-reported. Results: Of 492 studies considered, 105 were included. Among the 105 studies, we detected 19 different drinking patterns, and each drinking pattern had a wide range of definitions. The drinking patterns abstaining from alcohol, current drinking, and risk drinking had seven, 12 and 21 diverse definitions, respectively. The most used questionnaire and screening tools were the quantity-frequency questionnaire, with a recall period of 12 months, and the full and short versions of the Alcohol Use Disorders Identification Test, respectively. Conclusion: No consensus was found regarding methods used to assess, define, and measure alcohol consumption in older adults. Identical assessments and definitions must be developed to make valid comparisons of alcohol consumption in older adults. We recommend that alcohol surveys for older adults define the following drinking patterns: lifetime abstainers, former drinkers, current drinkers, risk drinking, and heavy episodic drinking. Standardized and valid definitions of risk drinking, and heavy episodic drinking should be developed. The expanded quantity-frequency questionnaire including three questions focused on drinking frequency, drinking volume, and heavy episodic drinking, with a recall period of 12 months, could be used.

• de Rojas, Itziar; Moreno-Grau, Sonia; Tesi, Niccolo; Grenier-Boley, Benjamin; Andrade, Victor & Jansen, Iris E. [Vis alle 51 forfattere av denne artikkelen] (2021). Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores. Nature Communications. ISSN 2041-1723. 12, s. 1–16. doi: 10.1038/s41467-021-22491-8. Fulltekst i vitenarkiv Vis sammendrag

  Genetic discoveries of Alzheimer’s disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer’s disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer’s disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer’s disease.

• Halse, Ingeborg; Bjørkløf, Guro Hanevold; Engedal, Knut; Selbæk, Geir & Barca, Maria Lage (2021). One-Year Change in Locus of Control among People with Dementia. Dementia and Geriatric Cognitive Disorders Extra. ISSN 1664-5464. 11(3), s. 298–305. doi: 10.1159/000520248. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia. Method: The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score. Results: The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001). Conclusion: Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.

• Strand, Bjørn Heine; Skirbekk, Vegard Fykse; Langballe, Ellen Melbye; Bergh, Sverre; Landmark, Brynjar Fowels & Wangensteen, Sigrid [Vis alle 8 forfattere av denne artikkelen] (2021). Cohort profile: Norwegian survey of health and ageing (NORSE). BMC Public Health. ISSN 1471-2458. 21, s. 1–7. doi: 10.1186/s12889-021-12294-3. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The Norwegian Survey of Health and Ageing (NORSE) was set up to provide internationally comparable data on ageing in Norway, which includes measured intrinsic capacity and cognitive function. Participants NORSE is a population-based health examination study of seniors aged 60+ from the 1921–1958 birth cohorts in the former Norwegian county of Oppland, interviewed and examined during 2017–19 (N = 957, 16% response rate). NORSE is to some extent based on the SHARE-questionnaire (share-project.org), which includes work-related information, self-assessed and retrospective health, and expectations on longevity, quality of life, volunteering activities, consumption, and financial arrangements. In addition, several objective measures of intrinsic and cognitive capacity are included in NORSE. Findings to date A shorter preferred life expectancy (PLE) was found to be associated with the prospects of a life with dementia and chronic pain. Motivation for retirement was found to be related to work-life experience and health. Social media was mostly used in the younger age groups and there was a tendency towards more use in the higher educational groups. NORSE incorporates questions on religion, and older women tend to have a higher degree of religiosity (proxied as self-assessed religiosity) than men in their 80s, but more similar (and lower levels) among those in their 60s. Future plans NORSE participants have allowed their data to be linked to National registry data and midlife health examination studies and thereby provide a longitudinal design as well as information on disability status, socioeconomic status, household and marital status, support to/from children and parents, and pension status.

• Zotcheva, Ekaterina; Håberg, Asta; Wisløff, Ulrik; Salvesen, Øyvind; Selbæk, Geir & Stensvold, Dorthe [Vis alle 7 forfattere av denne artikkelen] (2021). Effects of 5 Years Aerobic Exercise on Cognition in Older Adults: The Generation 100 Study: A Randomized Controlled Trial. Sports Medicine. ISSN 0112-1642. 52(7), s. 1689–1699. doi: 10.1007/s40279-021-01608-5. Fulltekst i vitenarkiv Vis sammendrag

  Objective The objective of this study was to investigate whether a 5-year exercise intervention and change in peak oxygen uptake (VO2peak) is associated with cognitive function in older adults. Methods Nine hundred and forty-five participants (48% women, mean age at study end 78.2 ± 2.02 years) from the Generation 100 Study were randomized 2:1:1 to a control group, moderate-intensity continuous training or high-intensity interval training twice weekly for 5 years. Peak oxygen uptake was measured using ergospirometry at baseline and after 5 years. Global cognition and mild cognitive impairment (MCI) were assessed with the Montreal Cognitive Assessment scale (MoCA) after 5 years. Results Compared to the control group, the combined moderate-intensity continuous training plus high-intensity interval training (ExComb) group did not have significantly different cognitive scores (beta value 0.26, 95% confidence interval [CI] − 0.17, 0.69) or odds of MCI (odds ratio 0.86, 95% CI 0.66, 1.13). Men in the ExComb group had 0.80 points higher MoCA (95% CI 0.21, 1.40) and 32% lower odds of MCI compared with male controls (95% CI 0.47, 0.99), with no such findings in women. In the total sample, each 1 metabolic equivalent of task increase in VO2peak corresponded to 0.46 points higher MoCA (95% CI 0.25, 0.67) and 27% lower odds of MCI (95% CI 0.63, 0.85). Compared to VO2peak stable, participants whose VO2peak increased did not have significantly different cognitive scores (beta value 0.24, CI − 0.68, 1.15) or odds of MCI (odds ratio 0.70, 95% CI 0.36, 1.34), whereas participants whose VO2peak decreased had 0.64 points lower MoCA (95% CI − 1.15, − 0.14) and 35% higher odds of MCI (95% CI 0.98, 1.87). Conclusions Overall, exercise was not significantly associated with cognition among older adults. However, maintaining or increasing VO2peak appeared to benefit cognition.

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• Kjelvik, Grete; Selbæk, Geir & Rokstad, Anne Marie Mork (2023). The knowledge and motivation to adopt health behaviour to reduce dementia risk among elderly citizens in Norway- A qualitative study.
• Myrstad, Christian; Larssen, Marie Hjelmseth; Skjervold, Inghild Johanne & Selbæk, Geir (2023). Smoking and Risk of Dementia: The HUNT Study, Norway. European Geriatric Medicine. ISSN 1878-7649. 14(Suppl 1), s. 11–11. doi: 10.1007/s41999-023-00883-x. Vis sammendrag

  Background: Even though smoking is considered a risk factor for dementia, uncertainty remains. The main objective of this study was to investigate smoking as an independent risk factor for all-cause dementia in a large longitudinal population-based cohort study. As a secondary objective we investigated the association between smoking and dementia subtypes. Methods: This study was based on data from the Trøndelag Health Study (HUNT). Participants’ smoking status was collected at baseline (HUNT2, 1995–97), and their cognitive status assessed after two decades of follow-up (HUNT4 70+, 2017–19, N = 8532). Packyears were calculated at HUNT4 (2017–19). Risk ratios (RR) were estimated by applying Poisson regression models after adjustment for covariates, with stratification by age (C / \85 years) and separate analyses for women and men. Results: Current smokers had a 31% higher dementia risk (RR 1.31, 95% confidence interval (CI) 1.12–1.52). Women\85 had a 54% increased risk (RR 1.54, 95% CI 1.20–1.98). Men \85 had a 36% increased risk (RR 1.35, 95% CI 1.01, 1.82). No associations were found for persons C 85. Current smokers had an increased risk for other dementias, but not for Alzheimer dementia in subgroup analyses. Former smoking and pack-years were not associated with dementia risk. Key Conclusions: Current smoking was associated with higher dementia risk. This association was not found for persons C 85, probably due to death as a competing risk. Former smokers did not show increased dementia risk. Our results add to the litterature an optimism about the effect of changing smoking habits and may encourage smoking cessation.

• Tevik, Kjerstin Elisabeth; Skråstad, Ragnhild Bergene; Benth, Jurate Saltyte; Selbæk, Geir; Bergh, Sverre & Eldholm, Rannveig Sakshaug [Vis alle 8 forfattere av denne artikkelen] (2023). Alkoholbruk blant eldre, før og nå – En HUNT Studie.
• Asante, Ernest Obeng; Eldholm, Rannveig Sakshaug; Kolberg, Marit; Skjellegrind, Håvard Kjesbu; Selbæk, Geir & Yue, Chen [Vis alle 8 forfattere av denne artikkelen] (2023). The association between cognitive function and oral health in home dwellers and nursing home residents: The HUNT Study.
• Selbæk, Geir & Strand, Bjørn Heine (2023). Hva har forskning om Covid-pandemien lært oss om bruk av helse og omsorgstjenester til eldre? .
• Selbæk, Geir & Strand, Bjørn Heine (2023). The use of health care services before and during the COVID-19 pandemic for home dwelling older adults with and without dementia in Norway. A HUNT-study .
• Lund, Anne; Engedal, Knut; Kirkevold, Øyvind; Selbæk, Geir; Saltyte Benth, Jurate & Rokstad, Anne Marie Mork (2023). Self-reported quality of life in people with dementia attending a day care program: a 24-month follow-up.
• Lerfald, Maren; Lydersen, Stian; Zotcheva, Ekaterina; Nilsen, Tom Ivar Lund; Eldholm, Rannveig Sakshaug & Martinez-Velilla, Nicolás [Vis alle 8 forfattere av denne artikkelen] (2023). Systolic Blood Pressure Trajectories And Physical Activity Levels Throughout Midlife And The Risk Of Dementia. Medicine & Science in Sports & Exercise. ISSN 0195-9131. doi: 10.1249/01.mss.0000986932.51335.de.
• Kinge, Jonas Minet; Godager, Geir & Selbæk, Geir (2023). En sterk økning i demens vil kreve store ressurser. Dagens medisin. ISSN 1501-4290. Vis sammendrag

  Demens er dyrest av alle sykdommer i Norge og utgjør en presserende helseutfordring. En aldrende befolkning gjør at forekomsten av demens er i ferd med å øke. Dessverre har vi ikke noen effektiv kur mot denne tilstanden. For å opprettholde tjenestetilbudet til personer med demens trengs betydelig økninger i bevilgningene til omsorgstjenesten.

• Lerfald, Maren; Lydersen, Stian; Zotcheva, Ekaterina; Nilsen, Tom Ivar Lund; Eldholm, Rannveig Sakshaug & Martinez-Velilla, Nicolás [Vis alle 8 forfattere av denne artikkelen] (2023). Change in Phyiscal Actitivity and Systolic Blood Pressure Trajectories Throughout Mid-life and the Development of Dementia in Older Age: The HUNT Study.
• Engedal, Knut; Wagle, Jørgen Olav; Saltyte Benth, Jurate; Gjøra, Linda; Skjellegrind, Håvard Kjesbu & Selbæk, Geir (2023). Normverdier for kognitive tester i demensutredningen. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 143(7). doi: 10.4045/tidsskr.23.0180.
• de Rojas, Itziar; Moreno-Grau, Sonia; Tesi, Niccolo; Grenier-Boley, Benjamin; Andrade, Victor & Jansen, Iris E. [Vis alle 293 forfattere av denne artikkelen] (2023). Erratum: Author Correction: Common variants in Alzheimer's disease and risk stratification by polygenic risk scores (Nature communications (2021) 12 1 (3417)). Nature Communications. ISSN 2041-1723. 14(1). doi: 10.1038/s41467-023-36192-x.
• Ibsen, Tanja Louise; Strand, Bjørn Heine; Rokstad, Anne Marie Mork; Bergh, Sverre & Selbæk, Geir (2022). The impact of the COVID 19 pandemic on older adults’ health, including people with cognitive impairment and dementia, A HUNT study.
• Myrstad, Christian; Engdahl, Bo Lars; Livingston, Gill; Costafrede, Sergi; Strand, Bjørn Heine & Selbæk, Geir (2022). Mid-life Hearing Impairment As Risk Factor For Dementia In People Aged ≥ 70 Years. A Population-Based Prospective Cohort Study: The HUNT Study, Norway . European Geriatric Medicine. ISSN 1878-7649. 13, s. 1233–1233. doi: 10.1007/s41999-021-00585-2. Vis sammendrag

  Mid-life Hearing Impairment As Risk Factor For Dementia In People Aged ≥ 70 Years. A Population-Based Prospective Cohort Study: The HUNT Study, Norway

• Tevik, Kjerstin Elisabeth; Helvik, Anne-Sofie; Selbæk, Geir; Engedal, Knut; Seim, Arnfinn & Krokstad, Steinar (2022). Bruk av alkohol og vanedannende legemidler blant eldre.
• Tevik, Kjerstin Elisabeth; Helvik, Anne-Sofie; Bergh, Sverre; Selbæk, Geir & Johannessen, Aud (2022). Hvordan spørre om og undersøke alkoholbruk hos eldre?
• Callegari, Enrico; Saltyte Benth, Jurate; Selbæk, Geir; Grønnerød, Cato & Bergh, Sverre (2022). Correction: Do prescription rates of psychotropic drugs change over three years from nursing home admission? (BMC Geriatrics, (2021), 21, 1, (496), 10.1186/s12877-021-02437-x). BMC Geriatrics. ISSN 1471-2318. 22(1). doi: 10.1186/s12877-022-03486-6.
• Engdahl, Bo Lars; Livingston, Gill; Costafrede, Sergi; Strand, Bjørn Heine & Selbæk, Geir (2022). Mid-life Hearing Impairment As Risk Factor For Dementia In People Aged ≥ 70 Years. A Population-Based Prospective Cohort Study: The HUNT Study, Norway. European Geriatric Medicine. ISSN 1878-7649.
• Zotcheva, Ekaterina; Strand, Bjørn Heine; Håberg, Asta; Selbæk, Geir; Bratsberg, Bernt Magne & Skirbekk, Vegard Fykse (2022). Sex-specific associations of occupational physical demands and dementia risk: the HUNT Study.
• Engdahl, Bo Lars; Livingston, Gill; Costafrede, Sergi; Strand, Bjørn Heine & Selbæk, Geir (2022). Mid-life Hearing Impairment As Risk Factor For Dementia In People Aged ≥ 70 Years. A Population-Based Prospective Cohort Study: The HUNT Study, Norway. European Geriatric Medicine. ISSN 1878-7649. doi: 10.1007/s41999-021-00585-2.
• Tari, Atefe R; Berg, Helene Haugen; Videm, Vibeke; Bråthen, Geir; White, Linda Rosemary & Røsbjørgen, Ragnhild [Vis alle 17 forfattere av denne artikkelen] (2022). Safety and efficacy of plasma transfusion from exercise - trained donors in patients with early Alzheimer’s disease: protocol for the ExPlas study. BMJ Open. ISSN 2044-6055. doi: 10.1136/bmjopen-2021-056964. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Given that exercise training reduces the risk of developing Alzheimer's disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesise that exercised plasma (ExPlas) may have rejuvenative properties. The main objective is to test safety and tolerability of transfusing ExPlas from young, healthy, fit adults to patients with mild cognitive impairment (MCI) or early AD. The study is a pilot for a future efficacy study. The key secondary objectives are examining the effect of plasma transfusions on cognitive function, fitness level, vascular risk profile, assessment of cerebral blood flow and hippocampal volume, quality of life, functional connectivity assessed by resting state functional MRI and biomarkers in blood and cerebrospinal fluid. Methods and analysis: ExPlas is a double-blinded, randomised controlled clinical single-centre trial. Patients up to 75 years of age with diagnosis early symptomatic phase AD will be recruited from two Norwegian hospitals. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 fit male donors (aged 18-40, BMI≤27 kg/m2 and maximal oxygen uptake>55 mL/kg/min). All units will be virus inactivated by the Intercept method in accordance with procedures at St. Olavs University Hospital. Comparison with isotonic saline allows differentiation from a non-blood product. The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions divided over three 4-week periods during study year-1. It is also planned to conduct follow-up examinations 2 and 5 years after baseline ETHICS AND DISSEMINATION: Written informed consent will be obtained from all participants and participation is voluntary. All participants have a next of kin who will follow them throughout the study to represent the patient's interest. The study is approved by the Regional Committee for Medical and Health Research Ethics (REK 2018/702) and the Norwegian Medicines Agency (EudraCT No. 2018-000148-24). The study will be published in an open access journal and results will be presented at numerous national and international meetings as well as on social media platforms.

• Siafarikas, Nikias Ioannis; Kirsebom, Bjørn-Eivind; Srivastava, Deepak P.; Eriksson, Cecilia Magdalena; Auning, Eirik & Hessen, Erik [Vis alle 10 forfattere av denne artikkelen] (2022). Author Correction: Cerebrospinal fluid markers for synaptic function and Alzheimer type changes in late life depression (Scientific Reports, (2021), 11, 1, (20375), 10.1038/s41598-021-99794-9). Scientific Reports. ISSN 2045-2322. 12(1). doi: 10.1038/s41598-022-22274-1.
• Wightman, Douglas P.; Jansen, Iris E.; Savage, Jeanne E.; Shadrin, Alexey; Bahrami, Shahram & Holland, Dominic [Vis alle 114 forfattere av denne artikkelen] (2022). Author Correction: A genome-wide association study with 1,126,563 individuals identifies new risk loci for Alzheimer’s disease (Nature Genetics, (2021), 53, 9, (1276-1282), 10.1038/s41588-021-00921-z). Nature Genetics. ISSN 1061-4036. 54(7). doi: 10.1038/s41588-022-01126-8.
• Hoel, Kari Anne; Lichtwarck, Bjørn; Væringstad, Anette; Feiring, Ingvild Hjorth; Rokstad, Anne Marie Mork & Selbæk, Geir [Vis alle 8 forfattere av denne artikkelen] (2022). Correction: Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) in home care services: a cluster randomized feasibility trial (BMC Health Services Research, (2022), 22, 1, (415), 10.1186/s12913-022-07830-9). BMC Health Services Research. ISSN 1472-6963. 22(1). doi: 10.1186/s12913-022-08308-4.
• Asante, Ernest Obeng; Mai, Xiao-Mei; Eldholm, Rannveig Sakshaug; Skjellegrind, Håvard; Kolberg, Marit & Brumpton, Ben Michael [Vis alle 9 forfattere av denne artikkelen] (2022). Vitamin D Status Over Time and Cognitive Function in Norwegian Older Adults: A Prospective Cohort of the HUNT Study.
• Hoel, Kari Anne; Rokstad, Anne Marie Mork; Feiring, Ingvild Hjorth; Lichtwarck, Bjørn; Selbæk, Geir & Bergh, Sverre (2022). Correction: Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study (BMC Health Services Research, (2021), 21, 1, (723), 10.1186/s12913-021-06722-8). BMC Health Services Research. ISSN 1472-6963. 22(1). doi: 10.1186/s12913-022-08312-8.
• Neerland, Bjørn Erik; Busund, Rolf; Haaverstad, Rune; Helbostad, Jorunn L.; Landsverk, Svein A. & Martinaityte, Ieva [Vis alle 19 forfattere av denne artikkelen] (2022). Alpha-2-adrenergic receptor agonists for the prevention of delirium and cognitive decline after open heart surgery (ALPHA2PREVENT): protocol for a multicentre randomised controlled trial. BMJ Open. ISSN 2044-6055. 12(6). doi: 10.1136/bmjopen-2021-057460.
• Selbæk, Geir & Neerland, Bjørn Erik (2022). Cognitive decline and dementia: does delirium matter? The Lancet Healthy Longevity. ISSN 2666-7568. 3, s. e217–e218. doi: 10.1016/S2666-7568(22)00056-3.
• Engdahl, Bo Lars; Livingston, Gill; Costafrede, Sergi; Strand, Bjørn Heine & Selbæk, Geir (2021). Mid-life Hearing Impairment As Risk Factor For Dementia In People Aged ≥ 70 Years. A Population-Based Prospective Cohort Study: The HUNT Study, Norway. European Geriatric Medicine. ISSN 1878-7649. doi: 10.1007/s41999-022-00671-z.
• Bocharova, Mariia; Aarsland, Dag ; Young, AH; Engedal, Knut; O'Brien, John & Selbæk, Geir [Vis alle 7 forfattere av denne artikkelen] (2021). Plasma inflammatory markers do not predict progression from late-life depression to dementia: findings from a longitudinal cohort study.
• Kjelvik, Grete; Rokstad, Anne Marie Mork & Selbæk, Geir (2023). Dette motiverer oss til en livsstil som gir god helse i eldre år [Kronikk]. Forskning.no. Vis sammendrag

  Gode opplevelser, frykt for ikke å klare seg selv, eller ønske om å kunne bo hjemme, motiverer eldre til å gjøre valg i hverdagen, som kan forebygge demens eller andre helseutfordringer i alderdommen, viser ny studie fra Nasjonalt senter for aldring og helse

• Soares, Jelena Zugic; Bogdanovic, Nenad; Pettersen, Renate Regine; Selbæk, Geir & Valeur, Jørgen (2023). Vitamin D in cognitive impairment and Alzheimer`s disease. Universitetet i Oslo. ISSN 9788234802416.
• Ibsen, Tanja Louise; Rokstad, Anne Marie Mork; Eriksen, Siren ; Björklöf, Guro Hanevold; Tveito, Marit & Bergh, Sverre [Vis alle 7 forfattere av denne artikkelen] (2022). Sosial isolasjon blant eldre under koronapandemien. Rapport helsedirektoratet. Aldring og helse. ISSN 978-82-8061-791-0.

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