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Forskningsartikler

Alle Aldring Demens Funksjons­evne Fysisk helse Psykisk helse Utviklings­hemning

Aging & Mental Health, 2026

Comparing health and social care systems for dementia across Europe: an INTERDEM policy paper

Abstract

Abstract

Objectives

People with dementia experience multiple barriers to accessing timely diagnosis and care, primarily due to issues on a care system level. The aim of this Policy Paper was to compare health and social care systems for dementia and unpaid carers across 14 European countries.

Method

Each country was represented by a clinical or non-clinical dementia care researcher who provided country-specific data on its health and social care system, sense-checked by health and social care practitioners. National policies were searched to inform the country overview of its health and social care system.

Results

Except for Norway, health and social care are managed separately. Barring Germany, electronic and paper-based health data are routinely collected. Scotland is the only country that collects social care data that can be linked to healthcare data. Access to health care is free at point of access, whilst social care usage is means tested in Poland, Germany, Ireland and the UK, creating a substantial financial barrier for many people with dementia and carers. Three out of 14 countries do not have a national dementia strategy.

Conclusion

Health and social care systems are oftentimes disjointed across Europe, lacking adequately linked data infrastructure. Research needs to explore the interpersonal connectivity between care systems, patients and professionals.

Forfattere

Clarissa Giebel, Rabih Chattat, Iva Holmerova, Louise Hopper, Jurate
Macijauskiene, Megan Rose Readman, Oscar Ribeiro, Anne Marie Rokstad,
Anthony Scerri, Dorota Szczesniak, Catherine Talbot, Jochen Rene Thyrian,
Lindsay Groenvynck, Marco Brigiano, Gill Windle & on behalf of the
INTERDEM Taskforce on Inequalities in Dementia

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eBioMedicine, 2026

Distinct metabolic signatures of Alzheimer’s and Parkinson’s disease revealed through genetic overlap

Abstract

Background

Metabolic dysfunction is a major risk factor for neurodegeneration, yet the genetic architecture linking systemic metabolism to Alzheimer’s disease (AD) and Parkinson’s disease (PD) remains unclear.

Methods

We integrated genome-wide association data for 249 circulating metabolites and proglucagon with summary statistics for AD, PD, and cardiometabolic traits. Genetic correlations, polygenic overlap, causal relationships, and shared genetic loci were quantified using linkage disequilibrium score regression, high-definition likelihood, bivariate mixture modelling, Mendelian randomisation, and conjunctional false discovery rate analyses, followed by functional and tissue-specific enrichment analyses.

Findings

AD displayed a metabolic-genetic profile aligned with body mass index, type 2 diabetes, coronary artery disease, and stroke, whereas PD exhibited largely opposing patterns (Spearman’s rs = −0.26). Mendelian randomization analyses supported causal effects of lipoprotein subclasses, glutamine, and proglucagon on AD risk, with opposite or null effects in PD. Shared loci between metabolites and AD were enriched for lipid metabolism and cholesterol transport, whereas PD-associated loci were enriched for mitochondrial function, vesicle trafficking, and stress-response signalling.

Interpretation

AD and PD are shaped by fundamentally distinct metabolic-genetic architectures. Metabolically targeted interventions, particularly those modulating lipid, amino acid, and proglucagon pathways, may require disease-specific and genetically informed strategies for prevention and treatment of neurodegenerative diseases.

Forfattere

Sara E. Stinson, Alexey A. Shadrin, Zillur Rahman, Linn Rødevand, Iris J. Broce, Geir Selbæk, Hreinn Stefansson, Jan Haavik, Nadine Parker, Elise Koch, Oleksandr Frei, Kevin S. O’Connell, Olav B. Smeland, Srdjan Djurovic, Anders M. Dale, Dennis van der Meer, Ole A. Andreassen

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Aging & Mental Health, 2026

Case management by Norwegian municipal dementia resource teams – fulfilling the role

Abstract

Abstract

Objectives: This study explores how healthcare professionals in Norwegian municipal memory teams experience working as case managers for people with dementia and their informal caregivers, and the approaches they employ to fulfil this role.

Method: A qualitative descriptive design was employed, using focus groups with 18 case managers from a range of municipalities. Data were analysed using thematic content analysis.

Results: Three overarching themes emerged: (1) tailoring support, (2) being committed and available, and (3) contributing to cooperation and competence development. Participants described how they adapted services to individual needs throughout the dementia trajectory, drawing on both professional expertise and personal resources. While the role was experienced as meaningful, it was also described as demanding, involving high levels of personal involvement and vulnerability due to limited resources. Case managers also played a key role in competence development and multidisciplinary collaboration.

Conclusion: The case manager role facilitates flexible, person-centred support, and continuity of care. However, its effectiveness is highly dependent on individual commitment and is vulnerable to resource constraints. Strengthening structural and professional conditions is essential to ensure the delivery of high-quality dementia care.

Forfattere

Mona Michelet, Siren Eriksen, Kariann Krohne, Thea C Bredholt, Knut Engedal, Hege Askestad, Trude Solberg, Anne Marie Mork Rokstad

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BMC Geriatrics, 2026

The effect of a music-based care intervention on neuropsychiatric symptoms: secondary analysis of a cluster-randomised controlled study in nursing home residents with dementia and pain

Abstract

Abstract:

Background: Neuropsychiatric symptoms (NPS) are highly prevalent in nursing home residents. The main aims of this study were to examine whether music-based care (MBC) had sustained effects on NPS in nursing home residents with dementia and chronic pain and to describe the distribution of NPS.

Methods: A secondary analysis of a cluster-randomised controlled trial with intervention and control groups was performed. The 8-week MBC intervention included daily individualised prerecorded music integration. A large sample of nursing home residents with dementia and chronic pain in 12 nursing homes in Norway were screened for pain and dementia by experts and included in the study. The Neuropsychiatric Inventory Nursing Home Edition (NPI-NH) was completed for the residents at pre-test and after the 8-week MBC intervention. Descriptive statistics were used to characterise the sample, and multilevel mixed model analysis assessed the difference in change in NPI-NH scores before and after the intervention between the groups.

Results: The sample (n = 232) had a mean age of 86 years (SD 8.8), with 71% being female. Overall, 41%, 38% and 21% had severe, moderate or mild dementia, respectively, while 77% had moderate pain and 23% severe pain. Over two-thirds (68%) of the sample had at least one clinically important (≥ 4) NPI-NH symptom at pre-test, with mean NPI-NH total score of 19 (range 0–89). The most commonly identified NPI-NH subcategories were agitation (44%), affective symptoms (34%) and psychosis (25%) at pre-test. There was no significant difference in changes either comparing the NPI-NH total score (p = 0.396) (confidence interval: CI [–2.6 to 6.6]) between the intervention group (n = 108) and the control group (n = 124) or comparing any of the three NPI subcategories: psychosis (p = 0.203) (CI [–0.5 to 2.3]), agitation (p = 0.830) (CI [–2.3 to 1.8]) or affective symptoms (p = 0.447) (CI [–0.9 to 2.1]).

Conclusions: No statistically significant sustained effect of the MBC intervention on NPI symptoms was found among residents with dementia and chronic pain. Future studies should include measurement points closer to the intervention to evaluate short-term effects of MBC.

Forfattere

Martin Elstad Myrenget, Reidun Sandvik, Petter Borchgrevink, Geir Selbæk, Milada Småstuen, Vegar Rangul, Odd Håpnes, Audun Myskja, Bettina Husebø, Tone Rustøen

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