Forskningsartikler

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.

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

ABSTRACT
Background Subjective memory impairment (SMI) is used as a proxy for objective memory, although their relationship remains unclear. Moreover, SMI is suggested to be a risk factor for dementia. This study investigated associations between SMI and (1) concurrent objective memory performance, (2) early‐life general cognitive abilities (GCA), and (3) if SMI and objective memory scores were associated with distinct or overlapping sociodemographic, health, and lifestyle risk factors for dementia. Material and Methods 2690 participants between 30 and 90 years from the general, geographical population study HUNT4 were included. SMI scores were from the Meta‐Memory‐Questionnaire. Verbal, spatial, and ability to differentiate between similar representations (pattern separation) were tested concurrently. GCA was from conscription at age 18. We implemented multiple imputation and inverse probability weighting from the entire population to account for selection bias. Results Higher SMI scores were associated with verbal memory and GCA, but not spatial or pattern separation memory. There was an interaction between sex and verbal memory on SMI, with men reporting higher SMI than women at similar lower verbal memory performance. Higher SMI scores were associated with higher age, blood pressure, depression, sleep, fatigue, and chronic pain, but not APOE4 or lifestyle variables. All memory tests were positively associated with each other and negatively with age. Diabetes was associated with verbal memory. Conclusion In the general population, SMI was weakly linked to concurrent verbal memory and GCA in adolescence. Health, in particular mental health, was highly associated with SMI but not objective memory performance. Thus, SMI is a complement to memory testing, not a proxy.

Simon Holmvik, Daniel Radosław Sokołowski, Ragnhild Bergene Skråstad, Olav Spigset, Bjørn Heine Strand, Asta Kristine Håberg