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4. Normative Scores on the Clock Drawing Test Among Older Adults from a Large Population Survey in Norway: The HUNT Study.

Author

Engedal, Knut, Benth, Jūratė Šaltytė, Wagle, Jørgen, Gjøra, Linda, Selbæk, Geir, and Persson, Karin

Subjects
*OLDER people, *ALZHEIMER'S disease, *MONTREAL Cognitive Assessment, *DEMOGRAPHIC surveys, *COGNITIVE testing
Abstract

Background: The Clock Drawing Test (CDT) is used to screen for Alzheimer's disease and other dementia disorders. Normative scores on the version from the Montreal Cognitive Assessment (MoCA) do not exist in the Nordic countries. Objective: To examine the normative scores of the CDT among adults aged 70 years and older. Methods: We included 4,023 cognitively healthy persons aged 70–97 years from a population survey in Norway. They were examined with the CDT, which has a total score between zero and three. A multiple multinominal regression model was applied with a CDT score as the dependent categorical variable and estimated the probabilities of scoring a particular score, stratified by age, sex, and education. These probabilities correspond to an expected proportion of the normative population scoring at, or below a given percentile. Results: None scored zero, 2.1% scored one, 14.9% scored two, and 83% scored three. Higher age, female sex and fewer years of schooling were associated with poorer performance. Scores of zero and one deviated from the normative score regardless of age, sex and education. A score of two was within the norm for a female older than 81 and a male older than 85. Conclusions: The majority (83%) of people 70 years and older had a score of three on the CDT. Lower age, male sex, and higher education were associated with a better performance. Scores of zero and one were below the normative score. Except for the very old, a score of two was also well below the normative score. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Clinically feasible automated MRI volumetry of the brain as a prognostic marker in subjective and mild cognitive impairment.

Author

Amland, Rachel, Selbæk, Geir, Brækhus, Anne, Edwin, Trine H., Engedal, Knut, Knapskog, Anne-Brita, Olsrud, Ellen Regine, and Persson, Karin

Abstract

Background/aims: The number of patients suffering from cognitive decline and dementia increases, and new possible treatments are being developed. Thus, the need for time efficient and cost-effective methods to facilitate an early diagnosis and prediction of future cognitive decline in patients with early cognitive symptoms is becoming increasingly important. The aim of this study was to evaluate whether an MRI based software, NeuroQuant® (NQ), producing volumetry of the hippocampus and whole brain volume (WBV) could predict: (1) conversion from subjective cognitive decline (SCD) at baseline to mild cognitive impairment (MCI) or dementia at follow-up, and from MCI at baseline to dementia at follow-up and (2) progression of cognitive and functional decline defined as an annual increase in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score. Methods: MRI was performed in 156 patients with SCD or MCI from the memory clinic at Oslo University Hospital (OUH) that had been assessed with NQ and had a clinical follow-up examination. Logistic and linear regression analyses were performed with hippocampus volume and WBV as independent variables, and conversion or progression as dependent variables, adjusting for demographic and other relevant covariates including Mini-Mental State ExaminationNorwegian Revised Version score (MMSE-NR) and Apolipoprotein E ɛ4 (APOE ɛ4) carrier status. Results: Hippocampus volume, but not WBV, was associated with conversion to MCI or dementia, but neither were associated with conversion when adjusting for MMSE-NR. Both hippocampus volume and WBV were associated with progression as measured by the annual change in CDR-SB score in both unadjusted and adjusted analyses. Conclusion: The results indicate that automated regional MRI volumetry of the hippocampus and WBV can be useful in predicting further cognitive decline in patients with early cognitive symptoms. [ABSTRACT FROM AUTHOR]

Published
2024
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12. A signature pattern of cortical atrophy in dementia with Lewy bodies: A study on 333 patients from the European DLB consortium

Author

Oppedal, Ketil, Ferreira, Daniel, Cavallin, Lena, Lemstra, Afina W., ten Kate, Mara, Padovani, Alessandro, Rektorova, Irena, Bonanni, Laura, Wahlund, Lars-Olof, Engedal, Knut, Nobili, Flavio, Kramberger, Milica, Taylor, John-Paul, Hort, Jakub, Snædal, Jon, Blanc, Frederic, Walker, Zuzana, Antonini, Angelo, Westman, Eric, and Aarsland, Dag

Published
2019
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13. Umbrella review and Delphi study on modifiable factors for dementia risk reduction.

Author

Rosenau, Colin, Köhler, Sebastian, Soons, Lion M., Anstey, Kaarin J., Brayne, Carol, Brodaty, Henry, Engedal, Knut, Farina, Francesca R., Ganguli, Mary, Livingston, Gill, Lyketsos, Constantine G., Mangialasche, Francesca, Middleton, Laura E., Rikkert, Marcel G. M. Olde, Peters, Ruth, Sachdev, Perminder S., Scarmeas, Nikolaos, Salbæk, Geir, van Boxtel, Martin P. J., and Deckers, Kay

Abstract

A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta‐analyses with a two‐round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will validate the updated LIBRA score in different cohorts. Highlights: An umbrella review was combined with opinions of 18 dementia experts.Various candidate targets for dementia risk reduction were identified.Experts prioritized hearing impairment, social contact, and sleep.Re‐assessment of dementia risk scores is encouraged.Future work should evaluate the predictive validity of updated risk scores. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Distinguishing early and late brain aging from the Alzheimer's disease spectrum: consistent morphological patterns across independent samples

Author

Doan, Nhat Trung, Engvig, Andreas, Zaske, Krystal, Persson, Karin, Lund, Martina Jonette, Kaufmann, Tobias, Cordova-Palomera, Aldo, Alnæs, Dag, Moberget, Torgeir, Brækhus, Anne, Barca, Maria Lage, Nordvik, Jan Egil, Engedal, Knut, Agartz, Ingrid, Selbæk, Geir, Andreassen, Ole A., and Westlye, Lars T.

Published
2017
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34. Meta-analysis of Alzheimer’s disease on 9,751 samples from Norway and IGAP study identifies four risk loci

Author

Witoelar, Aree, Rongve, Arvid, Almdahl, Ina S., Ulstein, Ingun D., Engvig, Andreas, White, Linda R., Selbæk, Geir, Stordal, Eystein, Andersen, Fred, Brækhus, Anne, Saltvedt, Ingvild, Engedal, Knut, Hughes, Timothy, Bergh, Sverre, Bråthen, Geir, Bogdanovic, Nenad, Bettella, Francesco, Wang, Yunpeng, Athanasiu, Lavinia, Bahrami, Shahram, Le Hellard, Stephanie, Giddaluru, Sudheer, Dale, Anders M., Sando, Sigrid B., Steinberg, Stacy, Stefansson, Hreinn, Snaedal, Jon, Desikan, Rahul S., Stefansson, Kari, Aarsland, Dag, Djurovic, Srdjan, Fladby, Tormod, and Andreassen, Ole A.

Published
2018
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40. One-Year Change in Locus of Control among People with Dementia

Author

Halse, Ingeborg, Bjørkløf, Guro Hanevold, Engedal, Knut, Selbæk, Geir, and Barca, Maria Lage

Subjects
coping, Psychiatry and Mental health, Geriatrics, Cognitive Neuroscience, RC952-954.6, locus of control, Neurology. Diseases of the nervous system, RC346-429, Research Article, dementia
Abstract

Introduction: Knowledge of how perceptions of personal control change over time may provide valuable insights into how people cope with having dementia. The present study aimed to examine change in locus of control over a 12-month period in persons with dementia. Method: The study included 52 participants with dementia. Locus of control was measured with the Locus of Control of Behavior Scale (LoCB), with higher scores indicating a more external locus of control, interpreted as perceiving less personal control. A ≥5% change on the LoCB was considered clinically meaningful. We recorded sociodemographic characteristics and assessed dementia severity, cognition, ability to function independently in daily activities and physical self-maintenance, depressive symptomatology, and number of prescribed medications. Analyses were performed to examine differences between those with increases (more external) or decreases (less external) in the LoCB score after 12 months and to examine associations between baseline variables and change in the LoCB score. Results: The mean LoCB score for the total sample did not change after 12 months (baseline mean 29.33 vs. follow-up mean 30.33, p = 0.553); however, 2 subgroups emerged. Using the ≥5% cutoff revealed that the LoCB score changed for 92.3% of the sample, becoming less external (lower LoCB) for 21 participants and more external (higher LoCB) for 27 participants. At baseline, the mean LoBC score was higher in the group that became less external (33.81 vs. 24.56), p = 0.006, while this was reverse at follow-up (23.57 vs. 34.41), p = 0.001. Dementia severity and dependence in physical self-maintenance increased during the 12 months in both groups. Among those becoming more external, we also found a decline in cognition (p = 0.002), an increase in dependence in daily activities (p = 0.003), an increase in the use of prescribed medication, and a decrease in depressive symptomatology (p = 0.003). The baseline LoCB score was the only variable associated with 12-month change in LoCB scores (p = 0.001). Conclusion: Most participants showed a clinically meaningful change in locus of control after 12 months. Those with more signs of dementia progression reported a decrease in personal control but also a decrease in depressive symptoms. These findings are interesting for our understanding of coping but must be replicated with a larger sample.

Published
2021

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

Author

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

Subjects
Aging, Cognitive Neuroscience, trajectory, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Geriatri: 778, cohort study, Alzheimer, blood pressure, vascular dementia, dementia
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.

Published
2022

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

Author

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

Published
2022
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