Forskningsartikler

Abstract

Background: Late-life depression (LLD) is frequently accompanied by cognitive impairment, but short-term treatment-related cognitive change and its predictors remain uncertain. We investigated whether age at first depressive episode, neuropsychiatric symptom phenotype, and baseline peripheral neuroinflammatory biomarkers are associated with cognitive improvement during inpatient treatment for LLD.

Methods: We analysed older inpatients with DSM-IV major depressive disorder from the multi-centre PRODE cohort (n = 136; age ≥ 60). Clinical care was standard, multidisciplinary, and individualised for about eight weeks. Cognition was assessed at admission and discharge using a comprehensive battery. Baseline neuropsychiatric symptoms were measured using the Neuropsychiatric Inventory (NPI), and 12 serum inflammatory markers were collected at admission.

Results: Mixed-effects models did not detect overall cognitive improvement across cognitive measures. Late-onset depression (LOD, age 50 years or older) predicted greater improvements in immediate (β = 0.48 95 % CI [0.03, 0.92]) and delayed (β = 0.48 95 % CI [0.01, 0.94]) recall, which were not significant after correcting for multiple comparisons (ps > 0.08). Latent class analysis (LCA) supported three neuropsychiatric classes. Compared with the Reference class, the Mild class showed larger gains in verbal fluency and delayed recall and greater reduction in Montgomery Aasberg Depression Rating Scale (MADRS) scores, whereas the Severe class did not differ. Lower baseline interleukin-6 (IL-6) and tumour necrosis factor (TNF) − α predicted better recognition memory (β = −0.15, 95 % CI [−0.25, − 0.05]).

Conclusions: In real-world inpatient care, cognitive improvement in LLD was limited after adjustment. A mild neuropsychiatric profile, and pro-inflammatory biomarkers might be linked to cognitive benefits.

Lingfeng Xue, Dag Aarsland, Mariia Bocharova, Tom Borza, Geir Selbæk, Allan H. Young

Abstract

Older people are increasingly using personal and environmental resources to have a good life in older age. The concept of aging well has gained importance for Turkish circular migrants, who typically split their time between two distinctly different locations. The aim of the present study was to explore older circular migrants’ thoughts and practices to facilitate aging well.

The research draws on qualitative data collected through 20 interviews with 10 transnational and 10 internal older circular migrants in rural areas of Türkiye.

As a result of the thematic analysis, three main themes emerged: (i) Places of belonging: Sense of trust and connection (ii) Home place: Satisfying and different from the host place and (iii) Permanent homecoming is not an option.

The findings showed that both internal and transnational older migrants strategically prefer circular movement with circular migration emerging as an aging well strategy. It is recommended that future studies focus on a life course perspective that intersects with place and belonging, when examining the facilitators or barriers that older circular migrants face in promoting narratives of aging well.

Jülide Yılmaz,  Nilüfer Korkmaz Yaylagül & Anne-S Helvik

Abstract

Background: This longitudinal study explored the one-year change in device-measured daily physical activity in patients attending a memory clinic.

Methods: Physical activity was recorded in 27 memory clinic patients over four days using accelerometers (activPAL3 micro) at baseline and one-year follow-up. Daily physical activity outcomes included upright time, standing time, walking time, number of steps, number of transitions, mean upright event length, and maximum upright event length. Changes between baseline and follow-up were analysed using paired sample t-tests.

Results: Patients’ mean (SD) age was 69.4 (8.1) years, and 14 (51.9%) were women. The only significant change was a decrease in maximum upright event length from a mean (SD) of 84.3 (31.6) minutes at baseline to 59.2 (22.5) minutes at one-year follow-up (p < 0.001).

Conclusion: Daily physical activity volume remained stable over one year, but the reduction in maximum upright event length indicates a shift in activity distribution.

Kim Frederik Gundrosen, Kristin Taraldsen, Karen Sverdrup, Anne-Brita Knapskog, Geir Selbæk & Gro Gujord Tangen

Abstract

Background: Life expectancy for individuals with Down syndrome (DS) has significantly increased, primarily due to medical advances. While DS is considered a genetically determined form of Alzheimer’s disease (DS-AD), with neuropathological markers evident by age 40, the onset of clinical dementia varies. Modifiable risk factors are thought to contribute meaningfully to dementia risk in the general population. Advances in intervention studies in the general population suggest cognitive decline can be reduced through multimodal lifestyle interventions, however no large-scale multimodal studies have been conducted in the DS population.

Search strategy: A comprehensive search was conducted across five electronic databases—Medline, EMBASE, CINAHL, Web of Science, and ASSIA to identify studies that examined the relationship between lifestyle interventions and cognitive outcomes in adults with DS. The search combined database-specific controlled language with keywords related to exercise, diet, social activities, cardiovascular health, and brain stimulation. Studies included were peer-reviewed original research articles focusing on adults with DS and reported on cognitive outcomes or AD-related biomarkers.

Results: The search yielded 24,774 articles, with 16,868 remaining after duplicates were removed. A total of 44 articles met inclusion criteria across the domains of exercise, diet, cardiovascular health, social connectedness, and cognitive stimulation. Most studies focused on exercise, indicating some cognitive benefits, particularly in executive functions and working memory, though results were inconsistent, and many suggested the necessity of high adherence to intervention protocols. No studies were found that examined the direct impact of diet on cognition in DS. Findings on cognitive stimulation, cardiovascular health and social connectedness suggested potential but inconclusive benefits for cognitive function.

Conclusions: This review underscores the significant gaps in research regarding non-pharmacological interventions for DS-AD. It highlights the need for tailored, well-structured studies to better understand and leverage potential cognitive benefits of lifestyle interventions in the DS population. Implementing such interventions early in life and before significant disease progression may help maintain quality of life and independence among individuals with DS. Future research should focus on comprehensive, multi-domain interventions to ascertain their efficacy and optimal application.

Eimear McGlinchey, Sarah Pape, Shahid H. Zaman, Jessica Eustace-Cook, Anna Stockbauer, Eleni Baldimtsi, Ellen Melbye Langballe, Frode Kibsgaard Larsen, Katja Sandkühler, Phoebe Ivain, Anne-Sophie Rebillat, Pierre Ecrement, Mary McCarron, Bessy Benejam, Wan Ming Khoo, Juan Fortea, Johannes Levin, Fredrik Öhman, Ann-Charlotte Granholm-Bentley, Andre Strydom & Georg Nübling

Sammendrag
Bakgrunn: Nærmere 90 % av norske kommuner har et hukommelsesteam eller en ressursperson for demens, men det er lite kunnskap om innholdet i tjenestene og hvordan teamene ivaretar sine oppgaver.

Metode: Hensikten med studien var å undersøke og beskrive ansatte i hukommelsesteams erfaringer med organisering, rammefaktorer og ivaretagelse av oppgaver. Vi gjennomførte fire fokusgruppeintervjuer med 18 ansatte i hukommelsesteam fra ulike deler av landet. Intervjuene ble analysert i tråd med prinsipper for innholdsanalyse.

Hovedresultater: Deltagerne beskrev ingen sammenheng mellom kommunestørrelse og hukommelsesteametsstørrelse. De opplevde et stort sprik mellom behov og ressurser. Hukommelsesteamene trakk frem at samarbeidetmed fastlegen er svært viktig, men samarbeidet er sårbart, og mange kommuner mangler arenaer og systematikk for samarbeid. Mangel på kommunale planer og prioriteringer gjør at det er opp til teamene selv å prioritere de knappe ressursene de har.

Konklusjon: Resultatene fra studien indikerer et behov for at kommunene gir hukommelsesteamene en tydelig posisjon i organiseringen av tilbudet til personer med demens og deres familier. Det synes å være behov for økte ressurser, tydeligere retning for prioritering og kvalitet, samt tilrettelegging av arenaer for samarbeid internt i kommunene, spesielt med fastleger.

Siren Eriksen, Mona Michelet, Klaus Amundsen, Hege Askestad, Thea Cathrine Bredholt, Torunn Edøy, Knut Engedal, Marianne Lingner, Kjersti Løkken Aakerholm, Trude Irene Solberg & Anne Marie Mork Rokstad