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483 Norwegian breast cancer patients were screened for six different ataxia telangiectasia mutated (ATM) mutations previously found to account for 83% of the disease alleles in Norwegian ataxia telangiectasia (AT) patients. Only one carrier was found. These results provide no evidence in favour of an excess risk of breast cancer associated with heterozygosity for classical AT mutations, but remain consistent with a maximum 2.4-fold increased risk. [ABSTRACT FROM AUTHOR]

Background & Aims: Circulating microvesicles (cMV) are both effectors and biomarkers of cardiovascular disease (CVD), and the effects of omega 3 polyunsaturated fatty acids (n3 PUFA) in MV shedding are not yet well known. Therefore, we aimed to investigate the effects of long-term n3 PUFA supplementation on cMV release from cells of the vascular compartment in elderly subjects at very high risk of CVD., Methods: We included 156 elderly patients 2-8 weeks after suffering an acute myocardial infarction from the OMEMI cohort. Subjects were randomly allocated to receive 930 mg EPA + 660 mg DHA (n3 PUFA intervention) or corn oil (56% linoleic acid, 32% oleic acid, 10% palmitic acid) used as placebo daily for two years. At inclusion and after one-year follow-up, prothrombotic [annexin V (AV) + ] cMV derived from blood and vascular cells were phenotyped by flow cytometry., Results: No differences were observed in the levels of cMV between the randomized groups at inclusion in the study. After one-year follow-up, total AV + , platelet-derived CD61 + /AV + , and endothelial-derived CD31 + /AV + and CD31 + /CD42b - /AV + cMV increased significantly in both groups. In the n3 PUFA supplemented group, platelet-derived CD62P + /AV + , CD42b + /AV + and CD31 + /CD42b + /AV + ; leukocyte-derived CD62L + /AV + , CD45 + /AV + , and CD11b + /AV + , as well as endothelial derived CD146 + /AV + , CD62E + /AV + , and CD309 + /AV + cMV also increased significantly. No significant differences were however, observed in the changes of cMV levels between groups., Conclusion: In elderly Norwegians who have suffered a recent acute myocardial infarction and treated as per guidelines, long-term supplementation with 1.8 g/day n3 PUFA does not modulate prothrombotic MV release from blood and vascular cells., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01841944., Competing Interests: Conflict of Interest The authors declare no conflicts of interest., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Circulating microvesicles (cMV) are small phospholipid-rich blebs shed from the membrane of activated vascular cells that contribute to vascular disease progression. We aimed to investigate whether the quality of the Nordic diet is associated with the degree of blood and vascular cell activation measured by MV shedding in elderly patients after an acute myocardial infarction (AMI). One-hundred and seventy-four patients aged 70-82 years were included in this cross-sectional study. Fasting blood samples were taken within 2 to 8 weeks after an AMI. Annexin V (AV) + cMV derived from blood and vascular cells were measured through flow cytometry. A patient's usual diet was recorded with the SmartDiet® questionnaire. Patients with higher adherence to the Nordic diet (highest diet score) had lower levels of total AV + and platelet-derived (CD61 + /AV + and CD31 + /AV + ) cMV. Dietary habits influence cellular activation. A high adherence to the Nordic diet (assessed by the SmartDiet® score) in elderly post-AMI patients was associated with lower levels of platelet activation, which was reflected by a lesser release of MV carrying platelet-derived epitopes, potentially contributing to an explanation of the cardioprotective effects of the Nordic diet., Competing Interests: The authors declare no conflicts of interest.

Background and Aims: Older age, higher morbidity and lower functional capacity are associated with fall injuries. Inability to get up from the floor is associated with older age, higher morbidity and lower functional capacity. The purpose of this study was to assess the concurrent and predictive validity of the ability of elderly women to get up from lying on the floor., Methods: In a random sample of 307 women aged 75 years and over (mean 80.8 years, response rate 74.5%) living in the community, baseline registrations of ability to get up from lying on the floor, health and function were recorded. Serious fall injuries during the subsequent year served as the outcome., Results: 240 (78.2%) managed to get up independently. The highest independent association was with items primarily related to mobility, e.g., ability to climb steps and performance on the Timed Up & Go test (TUG). However, arthrosis of the hip and difficulty with walking indoors were among the variables independently associated with the ability to get up from lying on the floor. During the follow-up year, 50.5% experienced falls, of which one in four resulted in serious injury and one in eight in a fracture. The ability to get up from lying on the floor was a significant predictor of serious fall-related injury (OR 2.1). Among those who experienced a fall, the risk of injury was markedly higher for those unable to rise (OR 3.7). The positive predictive value of being unable to rise for serious injury was 0.30, indicating that nearly one out of three of the elderly women with such problems are predicted to experience a serious fall-related injury during the following 12 months., Conclusions: The test "get up from lying on the floor" is a marker of failing health and function in the elderly and a significant predictor of serious fall injuries.

Dental teams examined 1910 elderly adults living in long-term care settings (1358 institutionalized, 552 homebound) from all 19 counties in Norway to document oral hygiene, oral symptoms and ability to receive dental treatment. The Mucosal-Plaque Score (MPS) was used to assess oral status. The MPS was significantly better in women than in men, in individuals with dentures than in those with any remaining teeth, and in people who were homebound rather than those who lived in institutions. The MPS did not differ between age groups or geographic regions. According to the Treatment Ability Index, nearly a quarter of the sample was able to receive comprehensive dental care. Reports of "any oral symptom" and "eating/chewing problems" decreased with age and were most prevalent for individuals who had dentures. The MPS had only slight impact on oral symptoms, chewing ability and dry mouth (p > 0.05). Dry mouth was found in 16.9% and was most prevalent in individuals with dentures.

Objectives: The purpose of this study was to estimate the prevalence of teeth and dentures in individuals aged 67 years and above., Methods: A representative random sample of 1152 individuals was drawn from 11 of the 19 counties of Norway. In all, 582 subjects were interviewed and examined clinically by the same dentist (BMH) in 1996-99. Fifty-four had died before contact was established, and the response rate was 53%. The mean age of those examined was 76.4 +/- 5.9 years, range 67-99 years., Results: In all, 40.0% had 'own teeth only', 27.9% 'own teeth and dentures' and 31.6% 'dentures only'. Three participants had neither teeth nor dentures. Interviews with 35 nonparticipants disclosed no statistically significant differences regarding dental/denture status compared to participants. By using stepwise polychotomous logistic regression, three regions of Norway could be identified with respect to the occurrence of teeth and dentures; significant differences existed between them and nonsignificant differences were found within them. In region A (South-East counties including the capital Oslo), region B (West-Central counties), and region C (Northern counties) the prevalence of 'own teeth only', 'own teeth and dentures' and 'dentures only' were 62.0, 26.5 and 11.1% in region A, 27.7, 28.9 and 43.1% in region B and 2.9, 28.6 and 65.7% in region C, respectively. Teeth were observed in 394 individuals, the mean number being 19,15 and 11 in regions A, B and C, respectively (over all mean 17 teeth)., Conclusions: There are large geographical disparities with respect to dental/denture status in Norway. The oral health goals for the year 2000 suggested by WHO/FDI were far from met in large areas of the country at the time when the data were collected, (1996-99).

The aim of this study was to estimate the prevalence of teeth and dentures in individuals aged 67 years and over receiving social care in Norway. A representative sample of 2893 individuals was selected from all 19 counties of Norway. In all, 1910 individuals (1358 living in institutions, 552 living at home) could be interviewed and examined by calibrated local dental teams in 1996-97. Overall response rate was 66%. Out of the examined, 1359 (71%) were women and 551 (29%) were men. The mean age was 85.1 years for women and 82.2 years for men. In all, 19.6% had 'own teeth only', 21.0% 'own teeth and dentures', 54.0% 'dentures only', and 5.3% 'neither teeth nor dentures'. Previous findings in a random sample of elderly Norwegians from three regions with markedly different dental health were confirmed by using polychotomous logistic regression. Three regions of Norway could be identified with respect to the occurrence of teeth and dentures: region A (South-East counties of Norway including the capital Oslo), region B (West-Central counties), and region C (Northern counties). Significant differences existed between them and non-significant differences within them. A mean number of 12.3 teeth were observed in 773 (40.5%) dentate individuals, 13.4 in region A, 11.4 in region B, and 9.0 in region C, respectively. In conclusion, there are large geographical disparities with respect to dental/denture status also in individuals receiving social care in Norway. When the data were collected (1996-97), the oral health goal for the year 2000 suggested by WHO/FDI aiming at 50% of people aged 65 years and above having a minimum of 20 remaining functional teeth was not fulfilled for individuals receiving social care in large parts of Norway.

Background: Atrophy of the medial part of the temporal lobe is seen in Alzheimer's disease (AD). We studied the usefulness of CT scan measurements of the medial temporal lobe (MTL) in elderly with suspected dementia., Methods: MTL measurements were done with callipers by three raters, blinded to the diagnosis and to each other, on scans from 110 subjects with suspected dementia from a memory clinic in Oslo, Norway and 36 participants included in the OPTIMA study, Oxford, England., Results: The correlation between the MTL and the Mini-Mental State Examination (MMSE) was very low, and there was a marked overlap between Alzheimer and cognitively unimpaired subjects. The inter-rater reliability was lower on the Norwegian than on the OPTIMA scans (R = 0.48 vs R = 0.68), but this was partly explained by larger MTL readings (4.5 mm after adjustment for age, gender and MMSE sumscore) on the OPTIMA scans as the reliability was confounded by MTL width and was higher at larger MTLs. A wider scan width (3 mm vs 2 mm in the OPTIMA scans) can also contribute to differences in reliability., Conclusions: The published threshold values regarding the CT scan MTL measurements for the diagnosis of AD may be invalid when applied by other radiology departments without a local standardisation and validation., (Copyright 2003 John Wiley & Sons, Ltd.)

Objective: To characterize the psychosocial burden on spouses living with the elderly suffering from mild dementia, stroke and Parkinson's disease, and to identify patient characteristics associated with it. Materials and methods Data on patient-spouse couples came from three studies of patients with stroke (36 couples), mild dementia (92 couples) and Parkinson's disease (58 couples). The psychosocial burden was recorded by the 15-item Relatives' Stress Scale (RSS). A factor analysis of this instrument produced a one-factor solution (CFI = 0.98) consisting of eight items with good face validity and acceptable reliability within each diagnostic group (Cronbach's alpha range 0.66-0.69). Covariates of this factor were identified using structural equation modeling (SEM) by regression on patient's age, gender, cognitive function (MMSE), activities of daily living (ADL) and depressive symptoms (MADRS)., Results: Disorganization of household routines, difficulties with going away for holidays, restrictions on social life, and the disturbances of sleep were the most frequently reported problems in all three groups. According to the mean sumscore on the RSS, the perceived psychosocial burden was similar across the diagnostic groups. In the final SEM model, a lower cognitive function of the patient was associated with a higher psychosocial burden on the spouses of patients with stroke (beta = -1.3, p = 0.01) and Parkinson's disease (beta = -0.89, p < 0.01), while in the dementia group, only an insignificant trend was demonstrated. In the dementia group, a significantly higher burden was identified on female spouses (beta = -0.56, p = 0.04). A heavier burden of care was also associated with depressive symptoms in the patients with Parkinson's disease. In neither group did the final model disclose any effect of ADL function on the spouse's psychosocial burden., Conclusion: Spouses caring for patients with dementia, stroke and Parkinson's disease perceive a similar type and level of psychosocial burden, independent of the disease. The cognitive functioning of the patient is a particularly important factor in this, especially when caring for patients with stroke or Parkinson's disease., (Copyright 2002 John Wiley & Sons, Ltd.)

Objective: To examine the prevalence of anxiety symptoms in hospitalized geriatric patients., Design: Controlled cross-sectional study., Subjects: Ninety-eight geriatric in-patients and 68 healthy home-dwelling controls of similar age recruited from senior citizen centres., Outcome Measure: Anxiety measured as a current emotional state by Spielberger's State-Trait Anxiety Inventory (STAI)., Results: The geriatric patients scored significantly higher than the controls. Applying Spielberger's recommended cut-off of 39/40 on the STAI sumscore, 41% of the female and 47% of the male geriatric patients might be suspected of suffering from significant anxiety symptoms. Patients with chronic obstructive pulmonary disease tended to score higher; otherwise no relationship was found between the STAI sumscore and type of chronic somatic disease, nor between the STAI sumscore and number of drugs in regular use., Conclusions: STAI proved feasible for use in the elderly. The scoring on the STAI is high in geriatric in-patients. Further studies are needed to clarify to what extent this relates to a high prevalence of anxiety disorders., (Copyright 2001 John Wiley & Sons, Ltd.)

The objective was to describe the psychosocial burden experienced by informal carers of elderly stroke victims, and to identify its predictors among baseline characteristics of the patients. From a prospective study of 171 elderly stroke patients admitted to a geriatric ward for rehabilitation in the acute phase, 68 patients living at home with a primary caregiver were identified 6 months after the stroke. At baseline, all the patients were assessed with respect to motor function, cognitive function, global handicap and activities of daily living, and after 6 months the caregivers were assessed, using the Relatives' Stress Scale. According to this, the most frequent impacts were worries that an accident might befall their relatives, that they had to reorganise their household routines and further, that their social life and ability to take holidays had been reduced. Impaired cognitive function was the only baseline patient characteristic that predicted a subsequent psychosocial burden on the carer. Special attention should be paid to elderly stroke patients initially assessed with impaired cognitive function and their caregivers., (Copyright 2001 S. Karger AG, Basel)

Background and Purpose: Falls and their after-effects are important contributors to disability in old age, but may be mitigated. The relationship between self-reported health and functioning and falling is examined in the present study., Method: The study design was cross-sectional. Data were collected from interviews with 431 community-dwelling Norwegian subjects aged 67-97 years. Physical health was assessed through items from the Multidimensional Functional Assessment of Older Adults (MFAQ), supplemented with the Body Mass Index (BMI). General health/psychosocial health was assessed with the General Health Questionnaire (GHQ-20), the Mini-mental State Examination, two general health items and items concerning mental and social health from the MFAQ. Falls during the last six months were registered and scored 0 (no falls), 1 (one fall) or 2 (two or more falls)., Results: During the previous six months 24.1% of subjects reported falling. Four variables: 'Perceived difficulty in keeping balance in walking', 'Troubled by heart pounding/shortness of breath', sum score on the GHQ factor 'Depression/hopelessness', and a higher value on BMI, were independently associated with number of falls reported., Conclusions: Score value on 'Perceived difficulty in keeping balance in walking' was the strongest significant predictor of falls in the present study. In contrast with other studies, no association between anxiety, general health and falling was observed.

Purpose: In Norway, the speech therapist is responsible for the assessment of language impairment after stroke, but many hospitals have no speech therapist. This study therefore developed and evaluated a simple method to be used by nurses to detect aphasia in the acute stage of stroke; the Ullevaal Aphasia Screening (UAS) test., Method: The study was carried out among 37 stroke patients admitted to an acute stroke unit. They were assessed by nurses using the UAS, while the results of a comprehensive assessment by a speech therapist acted as the 'gold standard'., Results: The predictive value of a positive test was 0.67 and that of a negative test 0.93; only two out of 28 who screened negative on the UAS were diagnosed with mild aphasia by the speech therapist. The weighted kappa coefficient of agreement was 0.83, indicating a strong agreement between the nurses' and speech therapists' scoring. The screening took 5-15 minutes to complete., Conclusion: The Ullevaal Aphasia screening test seems to be a short and valid screening instrument for aphasia in the acute stage of stroke, but further studies would be needed to substantiate the efficacy of the UAS test.

The ATM gene is responsible for the autosomal recessive disorder Ataxia-Telangiectasia (AT). Many different mutations, located all across the gene, have been reported with a predominance of truncating mutations. By using PTT (protein truncation test) a mutation was found in one Norwegian AT family. Sequencing revealed that the mutation affected nucleotides 3245-3247, codon 1082, and changed the sequence from ATC to TGAT, inducing a stop codon downstream at codon 1095 and leading to early truncation of the ATM protein. Perpendicular DGGE (denaturing gradient gel electrophoresis) was used to screen 10 additional families for this mutation. The 3245 delATC insTGAT mutation was found in 12 of 22 proband alleles: five patients were homozygotes and two heterozygotes. Haplotype analyses were performed using eight microsatellite markers, within and flanking the ATM gene. All carriers of the mutation described were found to have a common haplotype of the five closest CA-repeat microsatellite markers. Genealogical investigations of the families identified a common ancestor for three of the families. The common ancestor was a woman born in 1684 in the area from which these families originate. The prevalence of this mutation in Norwegian patients now allows a major subset of AT heterozygotes to be identified, both in the general population and in breast cancer patients, so that their cancer risk can be evaluated.

Background and Purpose: Data on survival and functioning after stroke needs to be supplemented by measures emphasizing the patients' subjective perception. We studied (1) subjective well-being (SWB) as a latent variable in a common-factor model with four items, (2) the reliability of these four items, and (3) variables related to SWB in stroke patients., Methods: Data on all stroke patients (n=1417) and a random subsample of stroke-free individuals of similar age (n=1439) were collected from the Nord-Trøndelag Health Survey, a cross-sectional study of 74977 persons. Based on a two-sample factor analysis model, scores of SWB were calculated, and variables explaining SWB were studied in a regression model., Results: Four items were a priori believed to measure SWB as a latent variable ("satisfaction," "strength," "calmness," and "cheerfulness"). This was confirmed by factor analysis. The reliability of these items (the proportion of the variance of the items that can be explained by the common factor) was between .42 and .53. Regression analyses showed a significant effect of having had a stroke, gender (lower SWB in men), age (increasing SWB with increasing age), perceived general health, nervousness, loneliness, sleep problems, social support, and use of analgesics. There was no statistical interaction between these variables and having had a stroke., Conclusions: Higher SWB after stroke relates to female gender, older age, good general and mental health, and a firm social network.

Background and Purpose: Norway has the highest reported incidence of hip fractures in western Europe. Little is known about the epidemiology of falls in Norway where the winter season is long and dark. The objective of this work was to study reported falls and their consequences among elderly Norwegians living at home., Methods: A cross-sectional design was used for the study. Interviews were performed in the homes of 431 subjects, aged 67-97 years, living at home. Information on falling was gathered through six questions: whether the subject had fallen during the last six months, and if so, how many falls they had, where the last fall occurred, its perceived reason, the activity the subject had been engaged in when the fall occurred, and the resulting injury., Results: In all, 24.1% of subjects reported falling during the last six months, and 9.5% had suffered more than one fall. Falls were most frequently linked to external events (63.1%). Outdoor falls were more frequent (59.0%; 95% CI = 51.2-82.0) than indoor falls. Older subjects were associated with more frequent indoor falls (p < 0.05), but gender was not significant. Fifty-one per cent of subjects had fallen while walking and 53% had suffered an injury from the last fall. In 13.4% of the women and 16.2% of the men, the last fall had resulted in a fracture., Conclusions: Compared to the results of other studies from industrialized Western countries, a similar crude fall rate, similar frequency and similar type of injury were found. However, in contrast to other studies, no gender difference was observed with regard to falling, place of falling and fracture rate.

Stroke is an age-related disorder where nearly 70% of the patients are over 70 years of age. More knowledge about the outcome and prognosis among the eldest stroke victims is needed. We studied 171 elderly stroke patients admitted to geriatric wards for rehabilitation. The patients were assessed on admittance to and discharge from hospital, and six and 12 months after the stroke. The mean age was 78.4 years. During the first year, 19% died and 25% were admitted to nursing homes. After 12 months six out of ten patients were living at home. Our results indicate that even elderly stroke patients have a potential for functional improvement after a stroke.

Dementia and confusion are frequently overlooked by general practitioners. A memory clinic was established at the Department of Geriatric Medicine, Ullevål Hospital in September 1990 with the intention of creating a standardized programme for diagnosing dementia and cognitive impairment in the elderly in an out-patient setting. The activities and services offered by the clinic are described: diagnoses, information to patients, their family and staff in the primary health care system about the symptoms and treatment of dementia. In addition, advice is given on follow-up care and how to apply for care through the national health service. There has been a great demand for the services of the Memory Clinic, and we believe that the methods used are adequate in an out-patient setting. The concept could easily be transferred to other specialist clinics involved with the elderly, and parts of the programme could also be used by general practitioners.

Data from Statistics Norway is used in this study of demographic development till 2020 in the population of the very old. There is a marked increase in the percentage of elderly women (80 years and over) in the population, from 2% in 1970 to nearly 5% in 1993. This is related to increased life expectancy and occurred parallel to a reduced rate in cardio-vascular mortality, which also occurred in men. However, in men this reduction is counter balanced by a serious increase, nearly 50%, in age-specific cancer mortality. The predictions for the population seem somewhat ambiguous, in particular as regards the percentage of elderly women, which is underestimated. There are significant regional differences with regard to the expected development in the population of people 80 years and older. On the whole, these differences do not seem to be related to mortality.

Seasonal fluctuations in mortality are associated with age, outdoor temperature, and influenza. The relative excess winter mortality is approximately twice as high in the UK compared with the Scandinavian countries. Using data from Norway and England plus Wales, this study compares the effect of age, temperature and influenza on winter excess mortality in the two countries. Bivariate analyses showed that the excess winter mortality (December-March) in England and Wales was nearly twice as high in old as in middle-aged people, and also markedly higher than in Norway, while the association between excess winter deaths and influenza was of a similar magnitude. In the British data only, a marked and statistically significant negative relationship existed between outdoor temperature and excess winter mortality, corresponding to an increase of approximately 3,500 deaths in England and Wales (approximately 2/10,000 in the population aged 45 years and over) per 1 degree C reduction in winter temperature, after adjustment for age and influenza. Using data from 20 Western European countries, a highly significant positive correlation (R = 0.71, p < 0.001) was found between total mortality rates for the elderly (65 years and over) and relative excess winter mortality.

Objectives: To study how well the scoring on each item of the MMSE relates to the sum-score when the purpose is to identify persons with cognitive impairment, and to identify an equally effective subset of MMSE items for predicting cognitive impairment., Design: Retrospective survey of MMSE data for 850 elderly., Setting: A variety of clinical settings., Participants: Mean age 82 years (range 54 to 99), 74% women. The subjects were of three different categories: geriatric in-patients, patients living under supervision, and elderly people living independently at home., Results: Five of the binomial ("State," "Town," "Name a pencil," "Name a watch," "Read and obey") and one of the polychotomous MMSE variables ("Learn three words and repeat immediately") had low sensitivity and gave high percentages of misclassifications versus the sumscore dichotomized at the cut-point 23/24. Univariate logistic regression indicated that the three remaining polychotomous variables ("Spell backwards," "Recall three words," and "Three-stage command") can be scored binomially. Two factors were identified on factor analysis. Logistic regression analysis showed that 12 of the original 20 items predicted the sumscore dichotomized at 23/24 with only 3% misclassifications. Validation against the psychogeriatrician's diagnosis showed that this 12-items MMSE derivative performs as well as the full MMSE., Conclusions: Six of the 20 MMSE variables perform poorly regarding sensitivity and misclassifications versus the sumscore at cut-point 23/24. Two additional items did not contribute to the prediction of a low/high sumscore. The remaining 12 MMSE items can all be scored binomially and produce a sumscore which is equally as effective as the sumscore of the full MMSE when the purpose is to identify elderly patients with cognitive impairment.

The programme, which was provided as a supplement to the standard information on the patient's medication upon discharge from hospital, consisted of oral information about which drugs to use and how to take them, a medication card, and one page of general information on how to take drugs. The programme was tested in an open, controlled manner in 24 test and 23 control patients, mean age 80 years. The results revealed that the patients' knowledge about their medication was generally good at follow-up four weeks later. The test group achieved a significantly higher score on questions about the technique for taking oral medication and why this is important. It is concluded that this type of information should be supplied when elderly patients are discharged from hospital.

The mortality of 318 patients residing permanently in a nursing home was analyzed over two years in a retrospective study. Survival analysis showed that age was significantly associated with increased mortality, and dementia with decreased mortality. The results may to some extent explain the large percentage of demented patients in nursing homes, and provide some support for the hypothesis that demented patients accumulate in the nursing homes, partly due to inappropriate community services for these patients, leading to a relatively early institutionalization.

We reviewed the routines for providing information on drugs, and for training in the use of drugs and aids to medication in hospital and nursing homes by interviewing 11 ward supervisors. We found that little attention was given to systematic training in the use of drugs, training and aids to medication as part of the patient rehabilitation. All wards informed the patients about the type and dosage of drugs to be taken after discharge. However, printed information from the Norwegian Medicines Control Authority was not used to any significant extent. Lack of time was stated as the major reason for not providing more systematic information and training on drug usage as part of the rehabilitation programme for elderly inpatients.

The prevalence of dementia in the age group 75 and over was studied in a random sample of elderly living at home. The MMS and the GMS were used as screening instruments, supplemented by medical history and a physical examination. The dementia diagnosis was confirmed by psychogeriatric assessment and a follow-up after 18 months. The prevalence of dementia in this sample was 10.5%; for severe dementia 3.8%, and for mild dementia 6.7%. Its occurrence was found to be unrelated to gender, marital status, domestic status, and duration of schooling.

In the first year after registration, 103 reports on suspected adverse reaction to piroxicam (Feldene) were submitted to the Norwegian Adverse Drug Reaction Committee. Eighty-three reactions were classified as probable side-effects, and 73 of these were related to the upper gastrointestinal tract. Peptic ulcer and upper gastrointestinal haemorrhages predominated. Two deaths were classified as probably due to piroxicam. There were 8 life-threatening reactions, all due to haemorrhages. No severe cutaneous reactions were reported. A significant fraction of the gastrointestinal reactions occurred in patients with a previous history of peptic ulcer disease. Nearly every fourth patient with proven ulcer or haematemesis/melaena had simultaneously been taking other drugs with the propensity of causing gastrointestinal haemorrhage. The gastrointestinal adverse reactions to piroxicam can probably be reduced by a more accurate selection of patients.

The relationship between hospitalization, as a measure of morbidity, and mortality is examined. The difference between age at hospitalization in a general medical department and age at death in Oslo, Norway, is studied. The problem is transferred to the one of examining the difference between two cumulative distribution functions F and G. For this purpose, a quantile distance function based on the inverses of the distribution functions is applied. We give the natural estimate of the quantile distance function, and some asymptotic properties of the corresponding empirical process. For the particular situation where one of the distribution functions is known, a confidence band for the quantile distance function is derived. Applying these results, we show that there are reasons to believe that age at hospitalization and age at death are equally distributed, apart from a constant shift.