Forskningsartikler

Abstract

BackgroundStudies have shown that the performance on the Clock Drawing Test (CDT) is influenced by age and education. Thus, normative scores are needed.ObjectiveTo develop normative Norwegian scores for Shulman’s version of CDT.MethodsPerformance on CDT of 2572 cognitively healthy people between age 25 and 95 years were included. Ordinal regression analysis was used to derive regression-based norms with sex, age and education as covariates.ResultsOf all, 76.4% scored five, 12.9% scored four, 8.1% scored three and 2.5% scored zero to two. Men scored higher than women. An interaction between age and education was found. The probability of higher CDT score is highest at younger ages and among those with highest education. It progressively declines with increasing age, while higher education delays, but does not prevent this decline. Participants scoring zero to two fell below the 5th percentile, except among women above 93 years and men above 85 years. By age 95, the probability of different scores converged. In the age range of 60 to 90 years a score of three corresponded to percentiles of 3.7-26.9 in men and 5.2-34.1 in women, while a score of four corresponded to percentiles of 9.7-50.4 in men and 13.2-59.0 in women.ConclusionsScores four and five are considered normal for any person aged 60-90 years. Whether a score of three is normal depends on the person’s sex, age and educational level, whereas score zero to two should not be regarded as normal.

Knut Engedal, Jūratė Šaltytė Benth, Anne-Brita Knapskog, Jørgen Wagle, Karin Persson

Abstract

Aims and objectives: To explore the experiences of receiving and living with a diagnosis of prodromal Alzheimer’s disease.

Background: Alzheimer’s disease is a progressive dementia disorder, with pathology potentially developing years before clinical symptoms. Evidence concerning patients’ perspectives on living with a prodromal Alzheimer’s disease diagnosis remains scarce.

Design and methods: A qualitative, descriptive design was employed. Semi-structured interviews were conducted with 16 participants diagnosed with prodromal Alzheimer’s disease in memory clinics in Denmark, Norway and Iceland. The data were analysed using thematic analysis.

Findings: Four main themes emerged: 1) what led to the assessment, 2) receiving the diagnosis of prodromal Alzheimer’s disease, 3) everyday life after the diagnosis and 4) planning for the future. The participants experienced diverse trajectories to diagnosis, with some being alerted by others to symptoms and some recognising the symptoms themselves. The diagnostic process was often perceived as intimidating, and person-centred care was valued. After the diagnosis, the participants focused on managing daily life, experienced changes in relationships and harboured mixed emotions about the future.

Conclusion: Receiving a prodromal Alzheimer’s disease diagnosis impacts patients’ perceptions of their abilities, relationships and future. There is a need for interventions targeting both patients and their families to maintain a close bond between them and support hope. Clear communication about the distinction between prodromal Alzheimer’s disease and Alzheimer’s dementia is crucial.

Susanne Kristiansen, Siren Eriksen, Cathrine Selnes Treviño, Tarja Välimäki, Helga Atladóttir, Gudlaug Gudmundsdottir, Knut Engedal, Jón Snædal, Anne Marie Mork Rokstad, Hanne Konradsen

Abstract

High blood pressure (BP) is linked to an increased dementia risk. The role of sex and the impact of cardiorespiratory fitness (CRF) on the potential association between genetic predisposition to high blood pressure and dementia are less understood. Our aim was to investigate if there is an association between genetic predisposition to high systolic blood pressure (SBP) and occurrence of dementia in males and females and whether CRF modifies this association. This prospective cohort study utilised data from the population-based Trøndelag Health Study in Norway. We included 9145 participants ≥70 years in the HUNT4 70+ sub-study. The sex-specific association between the BP polygenic score (PGS) and dementia was estimated by logistic regression. Analyses were stratified by CRF to investigate potential effect modification by CRF. Among 5011 females (mean age 78.5 years) and 4134 males (mean age 77.4 years), 812 (16.2%) and 570 (13.8%) dementia cases were identified, respectively. Females in the highest fifth of the PGS had an increased odds of dementia [odds ratio (OR) = 1.45; 95% confidence interval (CI) 1.10 to 1.90]. This was not observed in males (OR = 1.03; 95% CI 0.77 to 1.37). The association was somewhat stronger in females with low fitness (OR = 1.53; 95% CI 1.08 to 2.17) than in females with high fitness (OR = 1.12; 95% CI 0.78 to 1.63). Genetic predisposition to high SBP was associated with higher odds of dementia in females, particularly if they had low CRF. Future studies should further examine sex-specific effects of genetic and modifiable factors on dementia risk.

Maren Lerfald, Karsten Øvretveit, Tom Ivar Lund Nilsen, Rannveig Sakshaug Eldholm, Nora Grøtting, Brooke N Wolford, Geir Selbaek, Linda Ernstsen