Forskningsartikler

Background: As in other countries, the COVID-19 pandemic has affected Norway’s immigrant population disproportionately, with significantly higher infection rates and hospitalisations. The reasons for this are uncertain.
Methods: Through the national emergency preparedness register, BeredtC19, we have studied laboratory-confirmed infections with SARS-CoV-2 and related hospitalisations in the entire Norwegian population, by birth-country background for the period 15 June 2020 to 31 March 2021, excluding the first wave due to limited test capacity and restrictive test criteria. Straightforward linkage of individual-level data allowed adjustment for demographics, socioeconomic factors (occupation, household crowding, education and household income), and underlying medical risk for severe COVID-19 in regression models.
Results: The sample comprised 5.49 million persons, of which 0.91 million were born outside of Norway, there were 82,532 confirmed cases and 3088 hospitalisations. Confirmed infections in this period (per 100,000): foreign-born 3140, Norwegian-born with foreign-born parents 4799 and Norwegian-born with Norwegian-born parent(s) 1011. Hospitalisations (per 100,000): foreign-born 147, Norwegian-born with foreign-born parents 47 and Norwegian-born with Norwegian-born parent(s) 37. The addition of socioeconomic and medical factors to the base model (age, sex, municipality of residence) attenuated excess infection rates by 12.0% and hospitalisations by 3.8% among foreign-born, and 10.9% and 46.2%, respectively, among Norwegian-born with foreign parents, compared to Norwegian-born with Norwegian-born parent(s).

Conclusions: There were large differences in infection rates and hospitalisations by country background, and these do not appear to be fully explained by socioeconomic and medical factors. Our results may have implications for health policy, including the targeting of mitigation strategies.

Angela S Labberton, Anna Godøy, Ingeborg Hess Elgersma, Bjørn Heine Strand, Kjetil Telle, Trude Arnesen, Karin Maria Nygård, Thor Indseth

Background: The effect of the Norwegian General Practice–Nursing Home (NorGeP–NH) criteria has never been tested on clinical outcomes in nursing home (NH) residents. We performed a cluster-randomized trial in Norwegian NHs and tested the effect of NorGeP–NH on QoL (primary outcome), medication prescriptions, and physical and mental health (secondary outcomes) for the enrolled residents;
Methods: Fourteen NHs were randomized into intervention NHs (iNHs) and control NHs (cNHs). After baseline data collection, physicians performed NorGeP–NH on the enrolled residents. We assessed the difference between cNHs and iNHs in the change in primary outcome from baseline to 12 weeks and secondary outcomes from baseline to eight and 12 weeks by linear mixed models; Results: One hundred and eight residents (13 lost to follow-up) and 109 residents (nine lost to follow-up) were randomized to iNHs and cNHs, respectively. Difference in change in QoL at 12 weeks between cNHs and iNHs was not statistically significant (mean (95% CI)): −1.51 (−3.30; 0.28), p = 0.101). We found no significant change in drug prescriptions over time. Difference in depression scores between cNHs and iNHs was statistically significant after 12 weeks.
Conclusions:
Our intervention did not affect QoL or drug prescriptions, but reduced depression scores in the iNHs. NorGeP–NH may be a useful tool, but its effect on clinical outcomes may be scarce in NH residents. Further studies about the effectiveness of NorGeP–NH in other healthcare contexts and settings are recommended.

Enrico Callegari, Jurate Šaltytė Benth, Geir Selbæk, Cato Grønnerød and Sverre Bergh

Introduction: The time from symptom debut to assessment of cognitive impairment (TSA) is usually substantial, and many factors can influence the length of this interval. Our objective was to discern whether elevated alcohol consumption is associated with TSA.
Methods: Alcohol consumption was measured among 3,236 older Norwegians assessed for cognitive impairment. Elevated consumption was defined as drinking 4–7 times a week. TSA was defined as the number of months between symptom debut and assessment. The association between alcohol consumption and TSA was examined with a multiple regression analysis controlled for sociodemographic and clinical covariates.
Results: Mean (SD) and median TSA were 34.8 (35.8) and 24.0 months, respectively. Elevated alcohol consumption was not associated with TSA. Longer TSA was associated with being male, having a high education level, being retired or unemployed, being single, having low scores on the Mini-Mental State Examination (MMSE) or Personal Activities of Daily Living (PADL), having high subsyndrome scores of depression or agitation on The Neuropsychiatric Inventory – Questionnaire (NPI-Q), or having a spouse/cohabitant as the designated next of kin.
Conclusion: This study indicates that elevated alcohol consumption does not influence TSA. Possible explanations are discussed, but further research is needed to determine the effect of alcohol definitively. We did identify other novel characteristics associated with TSA which may be important in minimizing the risk of delayed cognitive assessments and should be kept in mind when considering assessment.

Ben Kamsvaag, Kjerstin Tevik, Jūratė Šaltytė Benth, Bei Wu, Sverre Bergh, Geir Selbæk, Anne-Sofie Helvik

Background: Several studies have found that normative scores on the Montreal Cognitive Assessment Scale (MoCA) vary depending on the person’s education and age. The evidence for different normative scores between sexes is poor.

Objective: The main aim of the study was to determine normative scores on the MoCA for Norwegian older adults stratified by educational level, age, and sex. In addition, we aimed to explore sex differences in greater detail.

Methods: From two population-based studies in Norway, we included 4,780 people age 70 years and older. People with a diagnosis of dementia or mild cognitive impairment, a history of stroke, and depression were excluded. Trained health personnel tested the participants with the MoCA.

Results: The mean MoCA score varied between 22 and 27 and was highest among women 70-74 years with education >13 years and lowest among men age 85 and older with education ≤10 years. Education, age, and sex were significant predictors of MoCA scores.

Conclusion: In the present study of cognitively healthy Norwegian adults 70 years and older, we found that the normative score on the MoCA varied between 22 and 27 depending on a person’s education, age, and sex. We suggest that normative scores should be determined taking these three variables into consideration.

Knut Engedal, Linda Gjøra, Jūratė Šaltytė Benth, Jørgen Wagle, Thale Kinne Rønqvist, Geir Selbæk

Bakgrunn: Eldre er spesielt sårbare for alvorlig sykdom og død ved covid-19 og
har blitt oppfordret til selvisolering under koronapandemien. Skjermbaserte
medier og telefon har blitt fremhevet som viktige hjelpemidler for å unngå
ensomhet, opprettholde kontakten med venner og familie samt sikre oppfølging av nødvendig helsehjelp. Det har imidlertid manglet kunnskap om hvordan eldre har brukt skjermbaserte medier under pandemien.

Hensikt: Formålet med studien var å undersøke hvordan eldre over 70 år har
benyttet skjermbaserte medier til underholdning, informasjon og kontakt med
venner, sosialt nettverk og helsepersonell. Videre ønsket vi å se på hvordan kjønn og alder påvirket bruken.

Metode: I januar 2021 sendte vi et spørreskjema i posten til 12 772 personer som var 70 år  eller eldre da de deltok i den fjerde runden av Helseundersøkelsen i Nord-Trøndelag (HUNT 4) i perioden 2017–19. Deltakerne ble bedt om å angi hvor mye tid per dag de hadde brukt på henholdsvis underholdning, kontakt med venner eller nettverk og innhenting av kunnskap eller informasjon på skjermbaserte medier.

Resultat: Totalt 9391 personer (73,5 prosent) (72–106 år) svarte på
spørreundersøkelsen. Av disse brukte 83,9 prosent skjermbaserte medier til å
holde kontakten med venner og sosialt nettverk. Åtte prosent svarte at de hadde hatt kontakt med helsepersonell på skjermbaserte medier. Flere kvinner enn menn og flere under 80 år enn over holdt kontakten med andre via skjerm.

Konklusjon: En stor andel eldre har brukt skjermbaserte medier under
pandemien. Studien avdekket at det har vært lite kontakt mellom eldre og
helsepersonell via telefon eller skjerm. Slik kontakt bør styrkes, samtidig som
det må settes søkelys på de i den eldste delen av befolkningen som ikke benytter seg av kommunikasjonsteknologi.

Siren Eriksen, Anne Marie Mork Rokstad, Geir Selbæk, Guro Hanevold Bjørkløf, Marit Tveito, Sverre Bergh, Arnulf Langhammer, Marit Næss, Tanja Louise Ibsen