Forskningsartikler - Side 2 av 23 - Nasjonalt senter for aldring og helse

Pain, 2022

Consistent pattern between physical activity measures and chronic pain levels: the Tromsø Study 2015-2016

Abstract

Abstract
Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø Study (2015-2016). All residents in the municipality, aged 40 years and older were invited to participate (n=32,591, 51% women). A total of 21,083 (53% women) reported on questionnaires. Additionally, 6,778 participants (54% women) were invited to wear accelerometers (6,125 with complete measurements). Our exposure measures were self-reported leisure time physical activity, exercise frequency, duration and intensity and two accelerometer-measures (steps per day and minutes of moderate to vigorous physical activity per day). Outcome measurements were chronic pain and moderate-to-severe chronic pain. We used Poisson regression to estimate chronic pain prevalence and prevalence ratios for each physical activity measure, with adjustments for sex, age, education level, smoking history, and occupational physical activity. Our main analyses showed an inverse dose-response relationships between all physical activity measures and both severity measures of chronic pain, except that the dose-response relationship with exercise duration was only found for moderate-to-severe pain. All findings were stronger for the moderate-to-severe pain outcomes than for chronic pain. Robustness analyses gave similar results as the main analyses. We conclude that an inverse dose-response association between physical activity and chronic pain is consistent across measures. To summarize, higher levels of physical activity is associated with less chronic pain and moderate-to-severe chronic pain.

Forfattere

Mats Kirkeby Fjeld, Anders Pedersen Årnes, Bo Engdahl, Bente Morseth, Laila Arnesdatter Hopstock, Alexander Horsch, Audun Stubhaug, Bjørn Heine Strand, Christopher Sivert Nielsen, Ólöf Anna Steingrímsdóttir

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BMC trials, 2022

The Effect of an Integrated Care Intervention of Multidisciplinary Mental Health Treatment and Employment Services for Trauma-affected Refugees; Study Protocol for a Randomised Controlled Trial

Abstract

Background
The complexity of past trauma and ongoing post-migration stressors challenges the existing mental health treatment for trauma-affected refugees. Therefore, interventions are needed to accommodate these complex challenges in mental health treatment. This study examines the effect of an add-on integrated care intervention compared to treatment as usual (TAU) for trauma-affected refugees in a randomised controlled trial (RCT).
Methods
The study is carried out at a Danish outpatient clinic and will include 197 treatment-seeking refugees with post-traumatic stress disorder (PTSD) who are unemployed and affiliated with municipal employment services. Mental health TAU comprises 10 sessions with a medical doctor (pharmacological treatment and psychoeducation) and 16–20 sessions with a psychologist (manual-based cognitive behavioural therapy) for a period of eight to 12 months. The add-on intervention strengthens coordination between mental health treatment and employment interventions with three cross-sectoral collaborative meetings during the mental health treatment. The integrated care intervention draws attention to the bidirectional impact of mental health problems and post-migration stressors and focuses on cross-sectoral shared plans. The primary outcome is functioning, measured by WHODAS 2.0, the interviewer-administered 12-item version, with secondary outcomes measuring quality of life, mental health symptoms, and post-migration stressors.
Discussion
The RCT is novel in intervention design for trauma-affected refugees and will bring forward new perspectives and knowledge of integrated care interventions for trauma-affected refugees. The integrated care intervention is expected to reduce post-migration stressors that negatively affect the treatment of trauma-related mental health problems, thereby improving preconditions for enhanced treatment outcomes. The intervention builds on existing practices in the Danish healthcare and employment sectors, which ensures high scalability and sustainability for future practices.

Forfattere

Maja Bruhn, Henriette Laugesen, Matilde Kromann-Larsen, Cathrine Selnes Trevino, Lene Eplov, Carsten Hjorthøj, Jessica Carlsson

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Journal of the American Medical Directors Association, 2022

The Course of Depressive Symptoms Over 36 Months in 696 Newly Admitted Nursing Home Residents

Abstract

Objectives
To investigate the course of depressive symptoms in newly admitted nursing home (NH) residents and how resident characteristics were associated with the symptoms. To identify groups of residents following the same symptom trajectory.
Design
An observational, multicenter, longitudinal study over 36 months with 7 biannual assessments.
Setting and Participants
Representing 47 Norwegian NHs, 696 residents were included at admission to a NH.
Methods
Depressive symptoms were assessed with the Cornell Scale for Depression in Dementia (CSDD). We selected severity of dementia, functional impairment, physical health, pain, use of antidepressants, age, and sex as covariates. Time trend in CSDD score was assessed by a linear mixed model adjusting for covariates. Next, a growth mixture model was estimated to investigate whether there were groups of residents following distinct trajectories in CSDD scores. We estimated a nominal regression model to assess whether the covariates at admission were associated to group membership.
Results
There was a nonlinear trend in CSDD score. More severe dementia, a lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher CSDD scores. Growth mixture model identified 4 groups: (1) persistent mild symptoms (32.6%), (2) persistent moderate symptoms (50.8%), (3) increasing symptoms (5.1%), and (4) severe but decreasing symptoms (11.6%). A lower level of functioning, poorer physical health, more pain, use of antidepressants, and younger age at admission were associated with higher odds for belonging to the severe but decreasing symptoms group compared with the persistent mild symptoms group.
Conclusions and Implications
Most NH residents were in trajectory groups with persistent mild or moderate depressive symptoms. Residents with more severe dementia, lower levels of functioning, poor physical health, severe pain, younger age at admittance, and who are using antidepressants should be monitored closely and systematically with respect to depression. Taking actions toward a more personalized treatment for depression in NHs is a priority and should be investigated in future studies.

Forfattere

Tom Borza, Geir Selbæk, Bjørn Lichtwarck, Jūratė Šaltytė Benth, Sverre Bergh

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Frontiers in Aging Neuroscience, 2022

Blood pressure trajectories over 35 years and dementia risk: A retrospective study: The HUNT study

Abstract

High blood pressure is a well-established risk factor of dementia. However, the timing of the risk remains controversial. The aim of the present study was to compare trajectories of systolic blood pressure (SBP) over a 35-year follow-up period in the Health Survey in Trøndelag (HUNT) from study wave 1 to 4 in people with and without a dementia diagnosis at wave 4 (HUNT4). This is a retrospective cohort study of participants aged ≥ 70 years in HUNT4, where 9,720 participants were assessed for dementia. In the HUNT study all residents aged ≥ 20 years have been invited to four surveys: HUNT1 1984–86, HUNT2 1995–97, HUNT3 2006–08 and HUNT4 2017–19. The study sample was aged 70–102 years (mean 77.6, SD 6.0) at HUNT4, 54% were women and 15.5% had dementia, 8.8% had Alzheimer’s disease (AD), 1.6% had vascular dementia (VaD) and 5.1% had other types of dementia. Compared to those without dementia at HUNT4, those with dementia at HUNT4 had higher SBP at HUNT1 and HUNT2, but lower SBP at HUNT4. These differences at HUNT1 and 2 were especially pronounced among women. Results did not differ across birth cohorts. For dementia subtypes at HUNT4, the VaD group had a higher SBP than the AD group at HUNT2 and 3. Age trajectories in SBP showed that the dementia group experienced a steady increase in SBP until 65 years of age and a decrease from 70 to 90 years. SBP in the no- dementia group increased until 80 years before it leveled off from 80 to 90 years. The present study confirms findings of higher midlife SBP and lower late-life SBP in people with dementia. This pattern may have several explanations and it highlights the need for close monitoring of BP treatment in older adults, with frequent reappraisal of treatment needs.

Forfattere

Geir Selbæk, Josephine Stuebs, Knut Engedal, Vladimir Hachinski, Knut Hestad, Cathrine Selnes Trevino, Håvard Skjellegrind, Yehani Wedatilake and Bjørn Heine Strand

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BMJ Open 2022

Safety and efficacy of plasma transfusion from exercise-trained donors in patients with early Alzheimer’s disease: protocol for the ExPlas study

Abstract

ABSTRACT
Introduction Given that exercise training reduces the risk of developing Alzheimer’s disease (AD), induces changes in the blood composition and has widespread systemic benefits, it is reasonable to hypothesise that exercised plasma (ExPlas) may have rejuvenative properties. The main objective is to test safety and tolerability of transfusing ExPlas from young, healthy, fit adults to patients with mild cognitive impairment (MCI) or early AD. The study is a pilot for a future efficacy study. The key secondary objectives are examining the effect of plasma transfusions on cognitive function, fitness level, vascular risk profile, assessment of cerebral blood flow and hippocampal volume, quality of life, functional connectivity assessed by resting state functional MRI and biomarkers in blood and cerebrospinal fluid.
Methods and analysis ExPlas is a double-blinded, randomised controlled clinical single-centre trial. Patients up to 75 years of age with diagnosis early symptomatic phase AD will be recruited from two Norwegian hospitals. ExPlas is plasma drawn by plasmapheresis once a month for 4 months, from a total of 30 fit male donors (aged 18–40, BMI≤27 kg/m2 and maximal oxygen uptake>55 mL/kg/min). All units will be virus inactivated by the Intercept method in accordance with procedures at St. Olavs University Hospital. Comparison with isotonic saline allows differentiation from a non-blood product. The main study consists of 6 rounds of examinations in addition to 12 plasma transfusions divided over three 4-week periods during study year-1. It is also planned to conduct follow-up examinations 2 and 5 years after baseline
Ethics and dissemination Written informed consent will be obtained from all participants and participation is voluntary. All participants have a next of kin who will follow them throughout the study to represent the patient’s interest. The study is approved by the Regional Committee for Medical and Health Research Ethics (REK 2018/702) and the Norwegian Medicines Agency (EudraCT No. 2018-000148-24). The study will be published in an open access journal and results will be presented at numerous national and international meetings as well as on social media platforms.

Forfattere

Atefe R Tari , Helene Haugen Berg, Vibeke Videm, Geir Bråthen, Linda R White, Ragnhild Nyhus Røsbjørgen, Katja Scheffler,  Havard Dalen, Espen Holte, Asta K Haberg, Geir Selbæk, Stian Lydersen, Emrah Duezel, Sverre Bergh, Kjell Rune Logan-Halvorsrud, Sigrid Botne Sando, Ulrik Wisløff

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BMJ Open 2022

Cohort profile: the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) – a national research and quality registry with a biomaterial collection

Abstract

ABSTRACT
Purpose The Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) was established to harmonise and improve the quality of diagnostic practice across clinics assessing persons with cognitive symptoms in Norwegian specialist healthcare units and to establish a large research cohort with extensive clinical data.
Participants The registry recruits patients who are referred for assessment of cognitive symptoms and suspected dementia at outpatient clinics in Norwegian specialist healthcare units. In total, 18 120 patients have been included in NorCog during the period of 2009–2021. The average age at inclusion was 73.7 years. About half of the patients (46%) were diagnosed with dementia at the baseline assessment, 35% with mild cognitive impairment and 13% with no or subjective cognitive impairment; 7% received other specified diagnoses such as mood disorders.
Findings to date All patients have a detailed baseline characterisation involving lifestyle and demographic variables; activities of daily living; caregiver situation; medical history; medication; psychiatric, physical and neurological examinations; neurocognitive testing; blood laboratory work-up; and structural or functional brain imaging. Diagnoses are set according to standardised diagnostic criteria. The research biobank stores DNA and blood samples from 4000 patients as well as cerebrospinal fluid from 800 patients. Data from NorCog have been used in a wide range of research projects evaluating and validating dementia-related assessment tools, and identifying patient characteristics, symptoms, functioning and needs, as well as caregiver burden and requirement of available resources.
Future plans The finish date of NorCog was originally in 2029. In 2021, the registry’s legal basis was reformalised and NorCog got approval to collect and keep data for as long as is necessary to achieve the purpose of the registry. In 2022, the registry underwent major changes. Paper-based data collection was replaced with digital registration, and the number of variables collected was reduced. Future plans involve expanding the registry to include patients from primary care centres.

Forfattere

Ingrid Tøndel Medbøen, Karin Persson, Marit Nåvik, Torunn Holm Totland, Sverre Bergh, Cathrine Selnes Treviño, Ingun Ulstein, Knut Engedal, Anne-Brita Knapskog,  Anne Brækhus, Anne Rita Øksengård, Peter Otto Horndalsveen, Ingvild Saltvedt, Anne Liv Lyngroth, Anette Hylen Ranhoff, Dagny Bekkeheien Skrettingland, Mala Naik, Jelena Zugic Soares, Bente Johnsen, Geir Selbæk

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Acta Neuropathologica, 2022

Genome-wide meta-analysis for Alzheimer’s disease cerebrospinal fluid biomarkers

Abstract

Abstract
Amyloid-beta 42 (Aβ42) and phosphorylated tau (pTau) levels in cerebrospinal fluid (CSF) reflect core features of the pathogenesis of Alzheimer’s disease (AD) more directly than clinical diagnosis. Initiated by the European Alzheimer & Dementia Biobank (EADB), the largest collaborative effort on genetics underlying CSF biomarkers was established, including 31 cohorts with a total of 13,116 individuals (discovery n = 8074; replication n = 5042 individuals). Besides the APOE locus, novel associations with two other well-established AD risk loci were observed; CR1 was shown a locus for Aβ42 and BIN1 for pTau. GMNC and C16orf95 were further identified as loci for pTau, of which the latter is novel. Clustering methods exploring the influence of all known AD risk loci on the CSF protein levels, revealed 4 biological categories suggesting multiple Aβ42 and pTau related biological pathways involved in the etiology of AD. In functional follow-up analyses, GMNC and C16orf95 both associated with lateral ventricular volume, implying an overlap in genetic etiology for tau levels and brain ventricular volume.

Forfattere

Iris E. Jansen, Sven J. van der Lee, Duber Gomez-Fonseca, Itziar de Rojas, Maria Carolina Dalmasso, Benjamin Grenier-Boley, Anna Zettergren, Aniket Mishra, Muhammad Ali, Victor Andrade, Céline Bellenguez, Luca Kleineidam, Fahri Küçükali, Yun Ju Sung, Niccolo Tesí, Ellen M. Vromen, Douglas P. Wightman, Daniel Alcolea, Montserrat Alegret,…Sverre Bergh…Geir Selbæk… Wiesje van der Flier

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Journal of Gerontological Social Work, 2022

Friendship in Befriending? Older Service Users’ Notions of Friendship in a Befriending Scheme

Abstract

ABSTRACT
Social isolation and feelings of loneliness are main reasons that befriending services are approached by older adults. The promise of an individually matched volunteer, a befriender, paying them regular visits, offers hope of increased social interaction, meaningfulness, and connectedness in everyday life. The current consensus in qualitative research literature is that loneliness and isolation may be alleviated by such home visits. Still, the actual mechanisms of successful befriending have not been identified. In this small-scale qualitative study, we highlight older befriendees’ notions of friendship in befriending. Drawing on in-depth interviews with seven Norwegian befriendees over the age of 80 years, we suggest that having a befriender visit regularly spurs a new bond and supports befriendees’ notions of a relationship consistent with a traditional understanding of friendship. Our findings illustrate how the older befriendees identify and portray notions of friendship in terms of bonding, compatibility and meaningful activities, commitment, appreciation, and insecurities. Understanding how a formalized volunteer service is recognized and valued as a friendship may contribute to a better starting point for improving befriending services. Furthermore, it can improve our understanding of the significance of friendship in old age.

Forfattere

Kariann Krohne, Annelise D. Flor & Magnhild Nicolaisen

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International Journal for Quality in Health Care, 2022

Psychometric Properties of the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) in a Norwegian Radiotherapy Setting

Abstract

Background
The number of older adults with cancer is increasing. Radiotherapy is an important treatment modality in cancer, and may cause side effects and distress. Patient-reported experience measures aim to measure patients’ experience with health care. This can help health care services to improve in line with patients’ needs. To assess how Norwegian patients receiving radiotherapy experience their care, a valid and reliable tool is required. We selected the Person-centred coordinated care experience questionnaire as a tool. The aim of the study is to validate the Norwegian version of this questionnaire in a radiotherapy setting.
Methods
A feasibility study of the Person-centred coordinated care experience questionnaire and a cross-sectional study – testing psychometric properties of the questionnaire in a Norwegian radiotherapy setting – were conducted. Participants were recruited from two different hospitals in Norway. Patient characteristics and item scores are described using descriptive statistics. We performed an exploratory factor analysis, and applied principal component analysis with a varimax rotation. Cronbach’s α was used to assess internal consistency.
Results
24 patients participated in the feasibility test, and 176 were included in the cross-sectional study where we explored the psychometric properties of the Person-centred coordinated care experience questionnaire. Three factors were identified. Internal consistency was established for the ten-item scale, with Cronbach’s α = 0.698.
Conclusion
Conclusions must consider the Norwegian setting and health care context. We found that the Norwegian version of the Person-centred coordinated care experience questionnaire is a relevant, valid, and reliable tool to provide insight into different areas of patients’ experiences upon receiving radiotherapy. However, further testing on a larger sample is necessitated.

Forfattere

May Ingvild Volungholen Sollid, Marit Slaaen, Signe Danielsen, Øyvind Kirkevold

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