Forskningsartikler

Abstract

Objective: This study presents updated regression-based norms for verbal fluency tests: «FAS,» «Animals,» and «Supermarket» in older Norwegian adults. By examining the potential modulating effects and putative interaction effects of age, education, and sex, we aim to investigate cognitive aging and the effects of education.

Method: The study includes 449 healthy participants, aged 70-92 years, from the NorFAST (n = 254) and HUNT (n = 195) studies. Regression-based norms for all three verbal fluency tasks were produced. Models were assessed for pertinent linear, curvilinear, or interaction effects of age, education, and sex. We compared our norms to previously published norms.

Results: The task «FAS» was predicted by education (b = 0.773, partial R2 = 0.117, p < .001) and sex (b = 1.110, partial R2 = 0.037, p < .001), and the task «Animals» was predicted by education (b = 0.313, partial R2 = 0.021, p < .01) and age (b = -0.123, partial R2 = 0.045, p < .001). Higher education and being female were associated with better performance, whereas older age was associated with poorer performance. Finally, for the task «Supermarket,» we found an interaction effect between age and education (b = -0.063, partial R2 = 0.034, p < .01), but the major predictor was sex (b = 1.446, partial R2 = 0.068, p < .001).

Conclusions: The norms were adjusted for the demographic variables that predicted the individual tasks. The illustrative norm comparison estimated similar mean performance but larger differences between the «exceptionally low» scores. The results also indicate that only processing speed declines with age, and that higher education has minimal effect on test-performance.

Therese Händel Waggestad, Bjørn-Eivind Kirsebom, Carsten Strobel, Linda Gjøra, Geir Selbæk, Peter Bekkhus-Wetterberg, Jens Egeland

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