Journal of Psychiatric Research, 2026

Reproductive history and cognitive health among older Norwegian females and males: the population-based HUNT Study

Abstract

Abstract

Objectives: We explored the relationship between the number of children and cognitive outcomes in later life in a large cohort of older females and males from Norway.

Design: Cross-sectional analysis using multinomial logistic regression.

Settings: The Norwegian HUNT4 70+ Study.

Participants: Males and females aged ≥70 years.

Measurments: The exposure was the number of biological children (none, one, two, three, or four or more). The primary outcome was categorized as dementia, mild cognitive impairment (MCI), or no cognitive impairment.

Results: Among 9263 participants (mean age 78 years; 54 % females), those without children had higher risk of dementia (relative risk ratio [RRR] 1.82, 95 % confidence interval [CI] 1.37 to 2.42) and MCI (RRR 1.31, 95 % CI 1.08 to 1.59) compared to those who had two children, adjusting for age and sex. Similar pattern was observed for those with one child, whereas those with three children did not have an increased MCI or dementia risk. Having four or more children was marginally associated with higher dementia risk (RRR 1.22, 95 % CI 1.00–1.49), but not with MCI risk. This association was attenuated after adjusting for education and marital status, whereas those without children and with one child had still higher risk. In sex-stratified analysis, having no children was associated with higher risk of dementia only in males.

Conclusions: The weak association with high parity, along with the increased dementia risk observed in males without children, contrasts with previous findings. Our results highlight the need for further investigation

Forfattere

K Wolfova, B H Strand, J Weiss, P Brennan Kearns, T Mekonnen, Y Stern 6, H-P Kohler, V F Skirbekk, S E Tom

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Frontiers in Aging Neuroscience, 2026

NORRISK 2 score is associated with dementia and MCI—the HUNT study

Abstract

Abstract

Background: Cardiovascular disease (CVD) risk factors are associated with the risk of cognitive decline and dementia. Composite CVD risk scores integrate multiple risk factors and may capture the cumulative burden of CVD risk relevant to cognitive outcomes. However, the long-term association between established CVD risk scores and subsequent dementia and mild cognitive impairment (MCI), and potential differences in these associations between males and females, remains insufficiently studied. This study examined the association between NORRISK 2, a CVD risk model estimating 10-year risk of fatal- and non-fatal CVD, and the presence of dementia and mild cognitive impairment (MCI) in males and females, after 22 years of follow-up.

Methods: Participants from The Trøndelag Health Study (HUNT), a longitudinal, population-based health study, were included. NORRISK 2 scores were based on data from HUNT2 (1995-1997). Cognitive status was assessed in the sub-study HUNT4 70+ (2017–2019) and categorized as cognitively unimpaired (CU), MCI, or dementia. We used multinomial logistic regression with NORRISK 2 as the predictor and cognitive status 22 years later as the main covariate.

Results: The study sample consisted of 6,971 participants (57.6% females, mean age at HUNT2 56.1 years). At HUNT4 70+, 14.0% of the participants had developed dementia, and 34.6% had developed MCI. Per one percent increase in NORRISK 2 score, the relative risk of developing dementia increased by 14% for males (relative risk ratio (RRR) = 1.14; 95% CI 1.12–1.17) and 28% for females (RRR = 1.28; 95% CI 1.25–1.31). The relative risk of developing MCI increased by 4% for men (RRR = 1.04; 95% CI 1.02–1.05) and 10% for women (RRR = 1.10; 95% CI 1.08–1.12).

Conclusion: A higher NORRISK 2 score was associated with an increased risk of dementia and MCI in both males and females, with the strongest associations observed in females.

Forfattere

Silje Kleven, Linda Ernstsen, Marte Kvello-Alme, Stian Lydersen, Geir Selbæk, Rannveig Sakshaug Eldholm

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Geriatric Nursing, 2026

A systematic review of the relation between pain and neuropsychiatric symptoms in nursing home residents with dementia

Abstract

Abstract

Dementia and pain are common in nursing home (NH) residents. Several studies have investigated the relation between pain and neuropsychiatric symptoms (NPS) in NH residents with dementia, but there is a lack of systematic reviews regarding this relation. The aim was to systematically review observational studies studying the relation between pain and NPS in NH residents with dementia. A systematic search was conducted in the PubMed, MEDLINE, CINAHL, APA PsycInfo, AgeLine, Cochrane, and Idunn databases for studies published from January 2013 to June 2025. Studies with a quantitative design where self-report, staff assessment, and/or chart review were used to assess pain and NPS were included.
Of 530 articles considered, 18 studies (15 cross-sectional studies and 3 longitudinal studies), 19 articles, were included (N = 84 to 97,789 participants). Fourteen articles had good or strong quality, while five had fair or poor quality. A variety of assessment tools for assessing pain and NPS were used, both self-reporting and staff-reporting. The presence and the severity of pain were associated with more frequent and more severe NPS, while changes in pain were associated with changes in NPS. An association between the presence of pain and agitation/aggression was frequently reported, as well as between pain and depressive symptoms. The findings in studies reporting the association between other NPS and pain were inconclusive.
In conclusion, strong associations between pain and agitation/aggression and depression were reported in NH residents wtih dementia. Assessing and treating pain is important. There is still a lack of longitudinal studies.

Forfattere

Anne-S. Helvik, Büşra Nur Temür, Sverre Bergh, Kjerstin Tevik

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Brain communications, 2026

Increased cerebrospinal fluid YKL-40 concentration in hip fracture patients with delirium

Abstract

Abstract

The underlying mechanisms of the neuropsychiatric syndrome delirium are still unknown, but neuroinflammation is a central hypothesis. Chitinase-3-like-protein-1 (YKL-40/CHI3L1) is considered a marker of neuroinflammation when measured in cerebrospinal fluid (CSF). The aim of this study was to examine concentrations of CSF YKL-40 in patients with and without delirium, to enhance the understanding of delirium pathophysiology. A total of 545 hip fracture patients were included from two similar cohorts. CSF samples were collected in conjunction with spinal anaesthesia for hip fracture surgery. The patients were screened for delirium both pre- and postoperatively. Those with delirium were further divided into subgroups based on whether they developed it before surgery (prevalent delirium) or after surgery (incident delirium). Among patients without delirium, those who met some, but not all diagnostic criteria, were classified as having subsyndromal delirium. Prefracture cognitive function was assessed, and American Society of Anaesthesiologists physical status score was included as a marker of comorbidity. In total, 257 (47%) of the patients developed delirium. These patients were older and had a higher prevalence of dementia and severe systemic diseases. Among the patients without dementia, those with delirium had higher median concentration of CSF YKL-40 compared with those without delirium (first cohort: 175 versus 132 ng/mL, P = 0.01, second cohort: 243 versus 174 ng/mL, P < 0.001). No association was found among the patients with dementia. The results remained consistent when adjusting for age and comorbidity. No difference in median CSF YKL-40 concentration was found between patients who had delirium at the time of surgery (prevalent delirium) and those who developed it afterwards (incident delirium). Our findings support the hypothesis of neuroinflammation as a mechanism for delirium in patients without dementia.

Forfattere

Thea Berntsen, Kaj Blennow, Henrik Zetterberg, Ingrid Fæhn Brekke, Mathias Nikolai Petersen Hella, Tom Tarjei Lian, Lene B Solberg, Christian Thomas Pollmann, Adi Karabeg, Olav Tobias Ødegaard, Marius Myrstad, Kristian Sydnes, Roy Bjørkholt Olsen, Torgeir Bruun Wyller, Leiv Otto Watne, Bjørn Erik Neerland

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International Journal of Epidemiology, 2026

Cohort Profile Update: HUNT4 70+

Abstract

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).

Forfattere

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

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Rhinology, 2026

Olfactory bulb volume changes following olfactory training in normosmic individuals

Abstract

Abstract

Background: Olfactory training (OT) has been linked to changes in olfactory function and structural modifications in the olfactory bulb (OB); however, the neuroplastic potential in the OB remains unclear. In this pilot study, we investigate how OT with different exposure lengths influences olfactory bulb volume (OBV) and olfactory function in individuals with normosmia.

Methodology: Seventy-seven normosmic individuals were assigned to either standard OT, extended OT, or a control group. The intervention groups performed OT for three months, sniffing four odours – eucalyptus, lavender, mint and lemon ※ for 10 seconds per bottle, twice daily, totalling either 40 seconds (standard OT) or 4 minutes (extended OT), while the control group did not perform any OT. OBV (manual segmentation of 3-Tesla magnetic resonance images) and olfactory function (Sniffin’ Sticks test) were assessed at baseline, post-intervention and at one-year follow-up.

Results: OBV increased significantly in both the standard and extended OT groups after the intervention and at follow-up, compared to controls. There were no differences between the training methods and no significant changes in olfactory function.

Conclusions: In normosmic individuals, OBV increased after both standard and extended OT, with no differences between training methods. The volume increase was evident at three-month assessment and persisted at one-year follow-up, indicating that neuroplastic changes induced by OT occur rapidly and may extend beyond the duration of the training itself, an effect not previously reported. However, the OBV changes were not accompanied by improve-ments in olfactory function.

Forfattere

I Torvik Heian, A-S Helvik, T A Myklebust, E M Berntsen, T Hummel, S Nordgard, M Bratt, W Moe Thorstensen

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International Journal of Risk & Safety in Medicine, 2026

Mitigating risk in psychiatric hospital care for older adults by identifying adverse events with Global Trigger Tool for psychiatric patients

Abstract

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.

Forfattere

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

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Autism, 2026

Autism, dementia, and post-diagnostic support: A consensus report from the Second International Summit on Intellectual Disabilities and Dementia

Abstract

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.

Forfattere

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

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BMC Primary Care, 2026

Joint consultations with general practitioners and geriatric psychiatrists for older adults with depression: a focus group study

Abstract

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.

Forfattere

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

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