Forskningsartikler

Abstract:

Purpose:
Suicide rates are high among older adults, yet research on risk factors associated with suicide in this age group remain largely unexplored. This study aims to examine the relationship between suicide and sociodemographic characteristics among individuals aged 60 and older.

Methods:
We utilized data from Norwegian national registries, identifying individuals aged 60 and older who died by suicide between 2005 and 2019 (n = 2060, 70.7% males), and used a case-control design. To examine the relationships between suicide and sociodemographic factors, we used descriptive analyses and conditional multivariate logistic regression analyses, stratified by sex and age categories.

Results:
Among individuals aged 60 to 69, risk factors for suicide included receiving a disability pension (odds ratio (OR) = 2.79 males, OR = 7.71 females), having mixed income sources (OR = 1.79 males, OR = 3.70 females), living alone (OR = 2.49 males, OR = 2.46 females), and living in urban areas, which was associated with an increased risk for females (OR = 1.85). Among males, living alone was also a significant risk factor for suicide in the 70 to 79 age group (OR = 1.85), and those aged 80 and above (OR = 2.16). Living in rural areas reduced risk for females aged 80 and above (OR = 0.05).

Conclusion:
This first register-based study of suicide in older adults in Norway highlights that living arrangements, urbanization level, and income source are significant risk factors for suicide among older adults. Interventions to improve social connectedness, with a focus on the urban-rural divide, could potentially reduce suicide risk. Sex and age categories should be considered in future research and when implementing preventive measures.

Anna Torp Johansen, Sissel Marguerite Bélanger, Anne Reneflot, Erlend Hem, Eivind Aakhus, Carine Øien-Ødegaard, Kim Stene-Larsen & Cecilie Bhandari Hartberg

Abstarct:

Background: As life expectancy increases, the incidence of age-related chronic health conditions and functional decline rises, increasing the need for institutional long-term care such as nursing homes. In Norway, 84% of nursing home residents have mild cognitive impairment or dementia. This population is characterized by a high burden of neuropsychiatric symptoms (NPS), which contribute to limited physical activity (PA) and a largely sedentary lifestyle. Regular PA is essential for maintaining physical function (PF) and independence, yet nursing home residents spend most of their time being sedentary. The present study aims to explore sensor-based measured PA patterns and investigate how PA is associated with NPS and PF in nursing home residents.

Methods: This cross-sectional study used data from the fourth wave of the population-based Trøndelag Health Study 70-years-and-older cohort (HUNT4 70+), including activity data from a total of 163 nursing home residents. PA was measured using two accelerometers placed on the lower back and thigh. PA patterns were described through the activity types walking, standing, sitting, and lying, activity bouts, and transitions. NPS was assessed using the Nursing Home Version of the Neuropsychiatric Inventory (NPI-NH), and PF using the Short Physical Performance Battery (SPPB). All outcome variables were grouped based on cognitive impairment and dementia severity, set by clinical experts using the DSM-5 diagnostic criteria and the Clinical Dementia Rating (CDR) scale.

Results: Participants’ mean age was 87.8 years, and 62% were female. With a daily average of 17.6 min walking, 1.1 h standing, 9.9 h sitting, and 12.7 h lying, our nursing home residents spent approximately 94% of the day being sedentary. Walking and standing appeared predominantly in bouts under 10 min across cognitive impairment and dementia severity. No association was found between time spent walking, standing, sitting, lying and transitions from sedentary behavior to activity with NPS. Time spent walking, standing, lying and transitions from sedentary behavior to activity was significantly associated with PF.

Conclusions: PA mainly occurred in bouts shorter than 10 min and sitting and lying accounted for most of the daily behavior. No association was detected between time spent in different activities and NPS. Although time spent walking and standing was limited in all groups, it showed an association with PF. This may suggest that even small amounts of PA play a significant role in maintaining or improving physical capabilities in nursing home residents.

Stine Øverengen Trollebø, Karen Sverdrup, Atle Skjelbred, Kristin Taraldsen, Ellen Marie Bardal, Nina Skjæret-Maroni

ABSTRACT

Objectives:
The study aims to conduct a systematic review of peer-reviewed articles about psychosocial interventions to reduce the caregiver burden in family caregivers of people with dementia to explore the effectiveness and the type of intervention and methodology used.

Methods:
Five databases were searched (AgeLine, CINAHL, MEDLINE, PsycINFO, PubMed) for studies reporting on experimental research of psychosocial interventions for dementia-related caregiver burden. Data quality checks were completed for included papers.

Results:
Forty-three studies were included in the analysis; about half of them (n = 24) were randomized controlled trials. The types of interventions most often used were psychoeducation (n = 21) and multi-component interventions (n = 12). The caregiver burden was after the intervention successfully reduced in about half of the studies (n = 19). Additionally, 10 studies had success in reducing caregiving burden in one of several assessment measures used. The studies using psychoeducation (57%) and multi-component (58%) intervention approaches had the highest success rates.

Conclusion:
Health professionals should be encouraged to implement psychosocial interventions for caregivers of patients with dementia.

Hande Kirisik Surer, Nilufer Korkmaz Yaylagul & Anne-Sofie Helvik

Introduction: Frontotemporal symptoms are usually associated with frontotemporal dementia (FTD), but people with all forms of dementia may develop these symptoms as the dementia disease progresses. Knowledge about psychosocial interventions that meet the needs of people with FTD symptoms, and literature on the subject, is hard to find. The aim of the study was to describe current practice as it is experienced by healthcare experts in the clinical field in Norway.

Method: Three focus groups were conducted. Healthcare personnel with clinical experience in care and treatment to people with FTD and other dementia diseases with frontotemporal symptoms were eligible for inclusion. Qualitative directed content analysis with open coding focusing on both manifest and latent content was applied.

Results: Four categories were described: (1) Dilemmas of anosognosia, (2) establishment of a diagnosis, (3) establishment of post-diagnostic support at home, and (4) establishment of care in the nursing home.

Conclusion: People with FTD and other dementias with frontotemporal symptoms need rigid, easy-to-understand, predictable surroundings and healthcare personnel that are clear, friendly, and respectful in their communication. Post-diagnostic support provided in flexible systems ensuring smooth transitions between services and levels of care is required. To ensure quality of care, frontline healthcare staff should be able to recognize FTD symptoms. To achieve this, supervision and training are needed. More research about clinical care interventions and how to derive good nursing practice should be prioritized.

Marit Mjørud, Anne-Brita Knapskog, Marit Nåvik & Janne Røsvik

Abstract:

Objectives: The prevalence of clinically significant depressive symptoms (CSDS) in community-living older adults ≥70 years living at home in Norway has not been investigated for years. This study aimed to examine the prevalence and variables related to CSDS in older adults 70+, with a sub-analysis among the oldest (80+).

Methods: In the Trøndelag Health Study (HUNT), Norway, 8911 inhabitants comprising 47.1 % men (mean age in women 77, SD 5.6 and men 76.5, SD 5.3, range 70-102.7) completed the Depression subscale in the Hospital Anxiety and Depression Scale (HADS-D). Chi-square and multivariable logistic regression were used to test variables associated with CSDS.

Results: The prevalence of CSDS (HADS-D ≥ 8) was in the total sample 8.4 % among women and 11.5 % among men, while among the oldest (80+), the prevalence was 14.4 % and 16.6 %, respectively. Feeling lonely or perceiving health as poor was associated with CSDS. Reported impaired functioning was associated with CSDS than in those without such limitations in men, but not in women.

Conclusions: Men had a higher prevalence of CSDS than women in the total sample and among the oldest (80+). Loneliness and poor health are important variables associated with CSDS.

Heidi Emly Sivertsen, Gørill Haugan & Anne-Sofie Helvik