Forskningsartikler

Key Features

HUNT4 70+ is a sub-cohort of persons aged ≥70 years in the fourth survey of the Trøndelag Health Study (HUNT), established to provide data for aging research.

This population-based sample consists of 9956 individuals from the original HUNT catchment area, included between August 2017 and February 2019. In addition, an urban sample of 1743 persons was included in Trondheim city during October 2018–June 2019.

HUNT4 70+ covers comprehensive aspects of aging health, including clinical examinations, performance-based tests of physical and cognitive function, questionnaires, and biological samples.

High participation rates among the old and frail were obtained by examination in private homes and nursing homes when needed (15% of the participants).

The data can be linked to all national registers in Norway, such as cause of death, prescription, health-care utilization, and diagnosis registries.

Data access requires approval from a Norwegian Research Ethics Committee before application to the HUNT Research Centre. Contact HUNT Research Centre for collaboration and more info (ntnu.edu/hunt).

Håvard K Skjellegrind, Pernille Thingstad, Linda Gjøra, Marit Kolberg, Grete Kjelvik, Linda Ernstsen, Tone N Fagerhaug, Arnulf Langhammer, Steinar Krokstad, Bjørn Olav Åsvold, Marit Næss & Geir Selbæk

Abstract

Background
Older adults receiving psychiatric care are at greater risk of adverse events (AEs) than younger patients. This reflects broader vulnerabilities, including marginalization, complex health needs, and frequent transitions between care settings. It is therefore necessary to investigate AE risk in this population and to validate a previous version of the Global Trigger Tool – Psychiatry (GTT-P), originally developed for the general psychiatric population, for use with older psychiatric patients.ObjectiveTo apply the Norwegian version of GTT-P in psychiatric care for older adults, to identify the prevalence of AEs in this subpopulation.

Methods
A retrospective cohort study was conducted by reviewing medical records of 184 patients aged 65+ admitted to a psychiatric hospital between 2022 and 2023. All patients who did not opt out were included.

Results
AEs were identified in 10.9% of patients. Triggers related to compulsory treatment and medication significantly increased AE risk. No AEs occurred without associated triggers. Of the AEs identified, 63% were considered avoidable.

Conclusions
This study demonstrates the utility of GTT-P in detecting AEs in older psychiatric patients. Specific clinical triggers were significantly associated with AEs. Preventive strategies and improved care coordination are essential to reduce avoidable harm and enhance patient safety in psychiatric care.

Arne Okkenhaug, Eivind Aakhus, Guro F Giskeødegård, Bodil J Landstad, Ellen T Deilkås

Abstract

Post-diagnostic support is a critical yet underdeveloped aspect of dementia care, especially for autistic adults who present with distinct cognitive, sensory, and communication needs. Although interventions such as medication management, psychosocial support, environmental modifications, and carer training are known to improve outcomes, their relevance and accessibility for autistic individuals remain poorly understood. As part of the Second International Summit on Intellectual Disability and Dementia, an international working group examined the intersection of autism and dementia with a focus on post-diagnostic care. Drawing on interdisciplinary expertise, the group identified key barriers and opportunities in clinical practice, caregiving, and service delivery. Recommendations are organized across seven areas, including models of post-diagnostic support, caregiving contexts, pharmacological and non-pharmacological interventions, environmental adaptations, and care planning. The discussion emphasizes the complex needs of autistic adults-many of whom have co-occurring intellectual disabilities, psychiatric conditions, or chronic health issues-and the need for individualized approaches that account for sensory sensitivities and communication differences. Existing dementia care frameworks often fail to address these complexities, resulting in significant service gaps. The report calls for urgent investment in research, workforce training, and policy reform to promote equitable, autism-informed post-diagnostic support and improve quality of life for this underserved population.Lay AbstractAutistic adults who develop dementia often experience challenges that are not well addressed by current dementia care systems. After a dementia diagnosis, people may need help with memory, communication, behavior changes, and daily living. For autistic adults, these supports must be adapted to their individual sensory sensitivities, communication styles, and social differences. This article reports on the work of an international group of researchers, clinicians, and advocates who met during the Second International Summit on Intellectual Disability and Dementia. The group examined how post-diagnostic support for autistic adults with dementia could be improved. They reviewed existing evidence, identified key barriers to care, and proposed strategies to strengthen services in areas such as medication use, environmental design, caregiver training, and personalized care planning. The report emphasizes that many autistic adults also have intellectual disabilities, mental health conditions, or long-term physical health issues, which can make care more complex. Current dementia care frameworks often overlook these overlapping needs, resulting in limited or unsuitable supports. The authors call for more research, workforce training, and autism-informed policy changes to ensure that post-diagnostic care is equitable, individualized, and responsive. Enhancing understanding and adapting support can help autistic adults with dementia maintain dignity, comfort, and quality of life.

Matthew P Janicki, Philip McCallion, Nancy Jokinen, Frode Kibsgaard Larsen, Dawna T Mughal, Kathryn P Service, Tiziano Gomiero, Christina N Marsack-Topolewski, Karen Watchman, Flavia H Santos, Seth M Keller, Shahin Shooshtari, Anupam Thakur, Vikram Palanisamy

Abstract:

Background: Depression in older adults is common in general practice, but the optimal approach for identification and treatment is not entirely clear.

Aim: To explore physicians’ experiences with a structured collaborative model involving joint consultations between patients, general practitioners (GPs), and geriatric psychiatrists for managing depression in adults aged 65 years and older.

Methods: Three focus group discussions were conducted with 13 physicians (10 GPs and 3 psychiatrists) who had participated in a structured collaboration model as part of a recent cluster randomized intervention study. Data were analyzed using Systematic Text Condensation.

Results: Five themes emerged: (1) diagnostic challenges; (2) perceived advantages; (3) feasibility; (4) concerns about overdiagnosis and overtreatment; and (5) suggested adjustments to the model. Somatic presentations often overshadowed depressive symptoms, particularly under GPs time constraints. Joint consultations strengthened the GP-patient relationship and enabled mutual learning. The presence of the GP was viewed as essential for patient engagement. The model addressed a treatment gap for GPs and was considered by psychiatrists to be highly cost-effective. All participants supported broader implementation in clinical practice.

Conclusion: The GPs’ enthusiasm for this collaborative approach indicates an unmet need in the treatment of older patients with depression. By strengthening both the doctor-patient relationship and interdisciplinary collaboration between GPs and psychiatrists in a cost-effective manner, the use of such joint consultations should be further investigated.

Lars Christian Kvalbein-Olsen, Eivind Aakhus, Ole Rikard Haavet & Erik L Werner

Abstract

The increasing presence of older immigrants in European societies has led to growing interest in how they and their families experience and manage care in ageing. This study aimed to explore the pattern of reflections and expectations of 2nd generation Turkish immigrants in Norway regarding family care. Qualitative design was employed in this study. The sample consisted of 18 2ndgeneration individuals of Turkish origin living in Norway. All participants lived in and around the same city in the middle part of Norway. Data was collected through individual face-to-face interviews conducted between November 2024 and January 2025. The transcripts were examined using reflexive thematic analysis. Four main themes were identified. 1) Cultural Background and Caregiving: Traditional Turkish Norms, 2) Intergenerational Care Expectations: Shifting Norms and Values, 3) Family Care Under the Same Roof: Wishes and Realities, and 4) Negotiating Family Care Responsibility. These findings demonstrate that cultural norms and caregiving, intergenerational care expectations, and family care practices are dynamically negotiated among 2nd generation Turkish immigrants. The findings indicate that while caregiving responsibilities are primarily framed in terms of love and moral obligation, economic, spatial, and emotional challenges significantly complicate this process.

Büşra Nur Temür, Nilgün Aksoy, Lillian Karlsen & Anne-Sofie Helvik

Article in press, 26. january 2026

Abstract:

Comprehensive mapping of key physical activity (PA) types, postures, and sleep among older adults is important for informing public health policies and interventions. This study aimed to describe the 24-h time distribution of key PA types, postures, and sleep in a population-based sample of community-dwelling older adults and explore whether age, sex, and educational level influenced this distribution. Participants 65 years and older from the fourth survey of the Trøndelag Health Study (HUNT4, 2017-19) with ≥ 1 day of complete accelerometer recording were included (n = 8,114). PA types (walking, running, cycling), postures (standing, sitting, lying (awake)), and sleep were derived from the accelerometer data using validated machine learning models. Survey-weighted regression models were applied to describe the 24-h time distribution of PA types, postures, and sleep by age, sex, and education. Participants spent 4.1 h standing (SD 85.3 min), 82.8 min (SD 40.3 min) walking, 0.2 min (SD 1.7 min) running, 4.6 min (SD 7.2 min) cycling, 9.2 h (SD 115.5 min) sitting, 2.1 h (SD 86.6 min) lying (awake), and 7.1 h (SD 50.4 min) sleeping per day. Time spent standing and walking decreased, while time spent sitting, lying (awake), and sleeping increased with higher age. Women spent more time standing and sleeping, and less time walking, sitting, and lying (awake) than men. Higher education was associated with more time standing and walking and less time sitting. This study provides novel insights into the distribution of 24-h movement behaviors among older adults and can serve as a benchmark for future research on key PA types, postures, sleep, and their interactions.

Karen Sverdrup, Astrid Ustad, Gro Gujord Tangen, Atle Kongsvold, Beatrix Vereijken, Bjørn Heine Strand, Geir Selbæk, Linda Ernstsen & Paul Jarle Mork

Abstract:

Aim: The aim of this study is to explore the lessons that nursing home staff learned from the COVID-19 pandemic related to the management of pandemic infectious diseases.

Methods: Four focus groups were conducted with nursing home staff who had experienced COVID-19 infections at the nursing home where they were employed. The focus groups, conducted during September and October 2023 at the respective nursing homes, were audio recorded and transcribed verbatim. Data were analyzed using reflexive thematic analysis as described by Braun and Clarke (2022).

Findings: The analysis resulted in three themes: 1) organization of infection control measures, 2) framework for training in infection control routines, and 3) clinical assessments and measures when suspecting infection. The participants experienced challenges regarding access to personal protective equipment, a lack of knowledge about infection control routines, and the difficulty of limiting infection given the building layout. Using clinical tools or assessments to detect signs of infection in nursing home residents improved nursing home staff’s ability to detect symptoms of contagious infections.

Conclusion: For nursing homes to be more prepared and resilient in the event of a new pandemic, overall planning of nursing homes’ needs should take place at both the national and municipal levels, as well as at the management level within each nursing home. This planning must ensure sufficient staffing, access to infection control equipment, and the updating of employees’ professional and clinical knowledge.

Anita Nilsen, Bjørn Lichtwarck, Siren Eriksen, Anne Marie Mork Rokstad

Abstract:

Purpose: To document use and impact of potentially inappropriate medications on two-year progression of dementia in individuals with cognitive declines.

Methods: A retrospective study of 397 patients with Mild Cognitive Impairment (MCI) or dementia diagnosed and followed-up in outpatient memory clinics in Norway during 2009 − 18. Beers (2019)- and STOPP-2 criteria were used to identify Potentially Inappropriate Medications (PIMcogs) in individuals with cognitive impairments at baseline and two-year-follow-up. PIMcog use in terms of dementia severity, cognitive function, and neuropsychiatric and depressive symptoms were analyzed in regression models.

Results: The prevalence of PIMcogs increased from 16% at baseline to 23% at follow-up. PIMcog users were more likely to be women (63.5%), and they used more drugs, with a median of 5 drugs at baseline and 4 drugs at follow-up, compared to non-users who had a median of 3 used drugs at both time points. PIMcog users had higher median Neuropsychiatric Inventory severity sum scores (6 [3.0–11.0] versus 4.0 [2.0–7.0]) and median Cornell Scale for Depression in Dementia scores (6.5 [3.0–11.0] versus 4.0 [1.0–7.0]) compared to non-users at follow-up (p ≤ 0.002). PIMcog users exhibited more severe dementia, with a Clinical Dementia Rate-Sum of Boxes (CDR-SB) score of 7.0 (4.0–13.0) compared to 6.0 (3.5–10.0) in non-users. The median annual increase in CDR-SB was one unit, and PIMcog use at follow-up was significantly associated with more rapid progression of dementia severity.

Conclusion: Faster dementia progression was documented among PIMcog users although, the prevalence of PIMcogs was generally low in Norwegian memory clinic patients with cognitive impairments.

Hege Kersten, Maria L. Barca, Rannveig Sakshaug Eldholm, Karin Persson, Lara Thomasgaard, Keson Jaioun, Ingvild Saltvedt, Geir Selbæk & Knut Engedal

Sammendrag

Hensikt: Beboere på langtidsopphold på sykehjem har omfattende helsebehov og krever tverrfaglig oppfølging. Til tross for krav om at fysioterapi-tjenester skal være tilgjengelige, er kunnskap om faktisk bruk begrenset. Hensikten med studien er å kartlegge organisering, tidsbruk og omfang av fysioterapitjenester under langtidsopphold på sykehjem.

Design: Tverrsnittstudie

Metode og materiale: Digital undersøkelse med spørsmål om tidsbruk, omfang og organisering av fysioterapiressurser under langtidsopphold på sykehjem ble sendt til leder for kommunale fysioterapeuter i alle kommuner i Norge.

Resultat: Totalt 262 av 357 kommuner besvarte undersøkelsen. De fleste kommunene (n=214, 82 %) hadde ikke avsatt fysioterapistilling(er) til beboere på langtidsopphold på sykehjem. Median tidsbruk for alle kommunene var 2,9 (0-50) minutter fysioterapi pr. langtidsplass pr. uke og 0,3 (0-2,1) henvisninger pr. langtidsplass pr. år. Kommuner med avsatt stilling til langtidsplasser (n=48) og mindre kommuner leverte mer fysioterapi til langtidsopphold på sykehjem enn kommuner uten avsatt stilling og større befolkning. Den vanligste henvisningsårsaken var brudd og andre skader etter fall, og funksjonsfall etter sykdom eller sykehusinnleggelse.

Konklusjon: Fysioterapi under langtidsopphold organiseres som regel via henvisning til kommunal fysioterapitjeneste. Det er betydelige variasjoner i antall henvisninger og tidsbruk mellom kommunene, men både antall henvisninger og tidsbruk fremstår som lavt, gitt beboernes funksjonsnivå og behov for tiltak som opptrening, mobilisering og veiledning av pleiepersonell.

Elisabeth Wiken Telenius, Kristine Bjorheim Bøe, Nina Skjæret-Maroni, Kristin Taraldsen, Gro Gujord Tangen, Karen Sverdrup