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Alcohol consumption and risk of dementia up to 27 years later in a large, population-based sample: the HUNT study, Norway.

https://arctichealth.org/en/permalink/ahliterature269251
Source
Eur J Epidemiol. 2015 Sep;30(9):1049-56
Publication Type
Article
Date
Sep-2015
Author
Ellen Melbye Langballe
Helga Ask
Jostein Holmen
Eystein Stordal
Ingvild Saltvedt
Geir Selbæk
Arvid Fikseaunet
Sverre Bergh
Per Nafstad
Kristian Tambs
Source
Eur J Epidemiol. 2015 Sep;30(9):1049-56
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Alcohol Drinking - epidemiology - physiopathology
Alzheimer Disease - epidemiology - prevention & control
Cohort Studies
Dementia - epidemiology
Dementia, Vascular - epidemiology - prevention & control
Female
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Population Surveillance
Risk factors
Surveys and Questionnaires
Abstract
The relationship between alcohol consumption and dementia risk is unclear. This investigation estimates the association between alcohol consumption reported in a population-based study in the mid-1980s and the risk for dementia up to 27 years later. The entire adult population in one Norwegian county was invited to the Nord-Trøndelag Health Study during 1984-1986 (HUNT1): 88 % participated. The sample used in this study includes HUNT1 participants born between 1905 and 1946 who completed the questionnaire assessing alcohol consumption. A total of 40,435 individuals, of whom 1084 have developed dementia, are included in the analysis adjusted for age, sex, years of education, hypertension, obesity, smoking, and symptoms of depression. When adjusting for age and sex, and compared to reporting consumption of alcohol 1-4 times during the last 14 days (drinking infrequently), both abstaining from alcohol and reporting consumption of alcohol five or more times (drinking frequently) were statistically significantly associated with increased dementia risk with hazard ratios of 1.30 (95 % CI 1.05-1.61) and 1.45 (1.11-1.90), respectively. In the fully adjusted analysis, drinking alcohol frequently was still significantly associated with increased dementia risk with a hazard ratio of 1.40 (1.07-1.84). However, the association between dementia and abstaining from alcohol was no longer significant (1.15, 0.92-1.43). Equivalent results for Alzheimer's disease and vascular dementia indicated the same patterns of associations. When adjusting for other factors associated with dementia, frequent alcohol drinking, but not abstaining from alcohol, is associated with increased dementia risk compared to drinking alcohol infrequently.
Notes
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PubMed ID
25968174 View in PubMed
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Analgesic prescribing patterns in Norwegian nursing homes from 2000 to 2011: trend analyses of four data samples.

https://arctichealth.org/en/permalink/ahliterature276993
Source
Age Ageing. 2016 Jan;45(1):54-60
Publication Type
Article
Date
Jan-2016
Author
Reidun Sandvik
Geir Selbaek
Oyvind Kirkevold
Dag Aarsland
Bettina Sandgathe Husebo
Source
Age Ageing. 2016 Jan;45(1):54-60
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Analgesics - therapeutic use
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - therapeutic use
Chi-Square Distribution
Cognition
Dementia - psychology
Drug Prescriptions
Drug Utilization Review
Female
Homes for the Aged - trends
Humans
Logistic Models
Male
Multivariate Analysis
Norway
Nursing Homes - trends
Observational Studies as Topic
Odds Ratio
Practice Patterns, Physicians' - trends
Randomized Controlled Trials as Topic
Time Factors
Abstract
the analgesic drug use has been reported to increase in general in nursing home patients. However, there is insufficient evidence in terms of what agents are used, variations of use over time and to whom these drugs are prescribed.
we investigated the prescribing patterns of scheduled analgesic drugs in Norwegian nursing home patients from 2000 to 2011, with the association to age, gender, cognitive function and type of nursing home unit.
secondary analyses of four study samples (three observational studies and one randomised controlled trial).
nursing home patients included in study samples from 2000 (n = 1,926), 2004 (n = 1,163), 2009 (n = 850) and 2011 (n = 1,858) located in 14 Norwegian counties.
trend analyses of analgesic drug prescriptions. Percentages were described using t-test, ?(2) and Mann-Whitney U test and multivariate logistic regression.
the odds ratio for receiving any pain medication in 2011 compared with 2000 was 2.6 (95% CI 2.23-2.91), this is corresponding to a 65% increase from 34.9 to 57.6%. The paracetamol prescription increased by 113%, from 22.7% in 2000 to 48.4% in 2011. Strong opioids (fentanyl, buprenorphine, morphine, oxycodone) increased from 1.9% in 2000 to 17.9% in 2011 (P
Notes
Comment In: Age Ageing. 2016 Jan;45(1):7-826764389
Erratum In: Age Ageing. 2016 Mar;45(2):32326941355
PubMed ID
26764395 View in PubMed
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Antipsychotic Drug Use Is Not Associated With Long-Term Mortality Risk in Norwegian Nursing Home Patients.

https://arctichealth.org/en/permalink/ahliterature287422
Source
J Am Med Dir Assoc. 2016 May 01;17(5):464.e1-7
Publication Type
Article
Date
May-01-2016
Author
Geir Selbæk
Dag Aarsland
Clive Ballard
Knut Engedal
Ellen Melbye Langballe
Jurate Šaltyte Benth
Sverre Bergh
Source
J Am Med Dir Assoc. 2016 May 01;17(5):464.e1-7
Date
May-01-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Antipsychotic Agents - therapeutic use
Female
Humans
Longitudinal Studies
Male
Mortality - trends
Norway
Nursing Homes
Proportional Hazards Models
Abstract
To assess the long-term mortality risk associated with antipsychotic drug (AP) use in nursing homes.
A longitudinal study with 5 assessments over a 75-month follow-up period.
A representative sample of nursing home patients in 4 Norwegian counties.
At baseline, 1163 patients were included. At the last follow-up, 98 patients were still alive.
Prevalent drug use at each assessment was registered. Level of dementia, neuropsychiatric symptoms, level of functioning, medical health, and use of restraints were recorded at each assessment. A Cox regression model with time-dependent psychotropic drug use as the main predictor was estimated and adjusted for confounders.
In unadjusted Cox regression, a lower mortality risk was associated with the use of other psychotropic drugs, but not APs, compared with nonusers. In the adjusted analysis, neither use of APs nor other psychiatric drugs was associated with increased mortality risk. Higher age, male gender, not being married, medical disease burden, lower level of functioning, more severe degree of dementia, and a higher number of drugs were all associated with increased mortality risk.
In this long-term study of nursing home patients, AP drug use was not associated with increased risk of mortality. This is in line with results from earlier studies of clinical samples, but contrasts with results from randomized controlled trials and registry-based studies. The findings should be interpreted with caution. Taking into account the modest benefit and high risk of adverse effects of AP drug use, nonpharmacological treatment remains the first-line treatment approach.
PubMed ID
26935533 View in PubMed
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Are coping strategies and locus of control orientation associated with health-related quality of life in older adults with and without depression?

https://arctichealth.org/en/permalink/ahliterature276290
Source
Arch Gerontol Geriatr. 2016 May-Jun;64:130-7
Publication Type
Article
Author
Anne-Sofie Helvik
Guro Hanevold Bjørkløf
Kirsten Corazzini
Geir Selbæk
Jerson Laks
Truls Østbye
Knut Engedal
Source
Arch Gerontol Geriatr. 2016 May-Jun;64:130-7
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Aged
Aged, 80 and over
Case-Control Studies
Cognition
Cross-Sectional Studies
Depression - complications - psychology
Depressive Disorder
Female
Health status
Humans
Internal-External Control
Logistic Models
Male
Middle Aged
Norway
Pain Measurement
Quality of Life - psychology
Residence Characteristics
Surveys and Questionnaires
Abstract
The aim of this study was to investigate relationships between coping and health related quality of life (HRQoL) in older adults (aged =60?years) with and without depression. This cross-sectional study included 144 depressed inpatients from seven psychogeriatric hospital units in Norway and 106 community-living older adults without depression. HRQoL was measured using Euro Qol Group's EQ-5D Index and visual analog scale (EQ-VAS). Two aspects of coping were of primary interest for HRQoL: locus of control (LOC) and ways of coping (WOC). Measures of depressive symptoms, cognitive functioning, instrumental activities of daily living, and general physical health were included as covariates. In linear regression analyses adjusted for age, stronger external LOC was associated with poorer HRQoL in both depressed and non-depressed older adults. In the fully-specified regression models for both groups, the association between stronger external LOC and poorer HRQoL remained significant for the EQ-VAS score but not the EQ-5D Index. WOC was not associated with HRQoL in either group. Total amount of explained variance in fully-specified models was considerably lower in the sample of depressed, hospitalized older adults (17.1% and 15.5% for EQ-5D index and EQ-VAS, respectively), than in the sample of non-depressed, community-based older adults (45.8% and 48.9% for EQ-5D Index and EQ-VAS, respectively). One aspect of coping (LOC orientation) was associated with HRQoL in both depressed and non-depressed older adult samples, and therefore may be an important target for intervention for both groups. Differences in the amount of variance explained in models for the two groups warrant further research.
PubMed ID
26874239 View in PubMed
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Association between vascular comorbidity and progression of Alzheimer's disease: a two-year observational study in Norwegian memory clinics.

https://arctichealth.org/en/permalink/ahliterature298599
Source
BMC Geriatr. 2018 05 22; 18(1):120
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
05-22-2018
Author
Rannveig Sakshaug Eldholm
Karin Persson
Maria Lage Barca
Anne-Brita Knapskog
Lena Cavallin
Knut Engedal
Geir Selbaek
Eva Skovlund
Ingvild Saltvedt
Author Affiliation
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. rannveig.s.eldholm@ntnu.no.
Source
BMC Geriatr. 2018 05 22; 18(1):120
Date
05-22-2018
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis - epidemiology
Brain Infarction - diagnostic imaging - etiology
Comorbidity
Disease Progression
Female
Heart Diseases - epidemiology
Humans
Longitudinal Studies
Magnetic Resonance Imaging - methods - statistics & numerical data
Male
Norway - epidemiology
Risk Assessment - methods
Risk factors
Vascular Diseases - complications - epidemiology
Abstract
Vascular risk factors increase the risk of Alzheimer's disease (AD), but there is limited evidence on whether comorbid vascular conditions and risk factors have an impact on disease progression. The aim of this study was to examine the association between vascular disease and vascular risk factors and progression of AD.
In a longitudinal observational study in three Norwegian memory clinics, 282 AD patients (mean age 73.3 years, 54% female) were followed for mean 24 (16-37) months. Vascular risk factors and vascular diseases were registered at baseline, and the vascular burden was estimated by the Framingham Stroke Risk Profile (FSRP). Cerebral medical resonance images (MRIs) were assessed for white matter hyperintensities (WMH), lacunar and cortical infarcts. The associations between vascular comorbidity and progression of dementia as measured by annual change in Clinical Dementia Rating Sum of Boxes (CDR-SB) scores were analysed by multiple regression analyses, adjusted for age and sex.
Hypertension occurred in 83%, hypercholesterolemia in 53%, diabetes in 9%, 41% were overweight, and 10% were smokers. One third had a history of vascular disease; 16% had heart disease and 15% had experienced a cerebrovascular event. MRI showed lacunar infarcts in 16%, WMH with Fazekas score 2 in 26%, and Fazekas score 3 in 33%. Neither the vascular risk factors and diseases, the FSRP score, nor cerebrovascular disease was associated with disease progression in AD.
Although vascular risk factors and vascular diseases were prevalent, no impact on the progression of AD after 2 years was shown.
PubMed ID
29788900 View in PubMed
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Being stuck in a vice: The process of coping with severe depression in late life.

https://arctichealth.org/en/permalink/ahliterature271514
Source
Int J Qual Stud Health Well-being. 2015;10:27187
Publication Type
Article
Date
2015
Author
Guro Hanevold Bjørkløf
Marit Kirkevold
Knut Engedal
Geir Selbæk
Anne-Sofie Helvik
Source
Int J Qual Stud Health Well-being. 2015;10:27187
Date
2015
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Aged, 80 and over
Aging - psychology
Depressive Disorder, Major - psychology
Female
Humans
Male
Middle Aged
Norway
Qualitative Research
Quality of Life - psychology
Abstract
Articles describing older persons' experiences of coping with severe depression are, to our knowledge, lacking. This article is methodologically grounded in phenomenological hermeneutics, inspired by Paul Ricoeur, and applies a descriptive design with in-depth interviews for producing the data. We included 18 older persons, 13 women and 5 men, with a mean age of 77.9 years, depressed to a severe or moderate degree, 1-2 weeks after admission to a hospital for treatment of depression. We found the metaphor "being in a vice" to capture the essence of meaning from the participants' stories, and can be understood as being stuck in an immensely painful existence entirely dominated by depression in late life. This is the first article where coping in older men and women experiencing the most severe phase of depression is explored.
Notes
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PubMed ID
26119368 View in PubMed
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Characteristics of patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare.

https://arctichealth.org/en/permalink/ahliterature312064
Source
Scand J Prim Health Care. 2020 Jun; 38(2):107-116
Publication Type
Comparative Study
Journal Article
Observational Study
Date
Jun-2020
Author
Mona Michelet
Anne Lund
Bjørn Heine Strand
Knut Engedal
Geir Selbaek
Sverre Bergh
Author Affiliation
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
Source
Scand J Prim Health Care. 2020 Jun; 38(2):107-116
Date
Jun-2020
Language
English
Publication Type
Comparative Study
Journal Article
Observational Study
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Ambulatory Care Facilities
Cognition
Cognitive Dysfunction - complications - diagnosis - psychology
Dementia - complications - diagnosis - psychology
Depression - complications - diagnosis
Diagnostic Services
Female
General practice
General practitioners
Geriatric Assessment
Humans
Male
Mass Screening
Middle Aged
Norway
Primary Health Care
Psychiatric Status Rating Scales
Referral and Consultation
Severity of Illness Index
Specialization
Surveys and Questionnaires
Abstract
Objective: The aim of this study was to describe patients assessed for cognitive decline in primary healthcare, compared to patients assessed in specialist healthcare and to examine factors associated with depression.Design: This was an observational study.Setting: Fourteen outpatient clinics and 33 general practitioners and municipality memory teams across Norway.Subjects: A total of 226 patients assessed in primary healthcare and 1595 patients assessed in specialist healthcare outpatient clinics.Main outcome measures: Cornell scale for depression in dementia (CSDD), Mini-Mental Status Examination (MMSE), Clock drawing test, Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Instrumental Activities of Daily Living, Personal Self-Maintenance Scale, Relatives' stress scale (RSS), and Neuropsychiatric Inventory Questionnaire (NPI-Q)Results: Patients assessed in primary healthcare were older (mean age 81.3 vs 73.0?years), less educated, had poorer cognition (MMSE median 22 vs 25), more limitations in activities of daily living (ADL), more behavioural and psychological symptoms of dementia (BPSD), more depressive symptoms (CSDD median 7 vs 5), more often lived alone (60% vs 41%) and were more often diagnosed with dementia (86% vs 47%) compared to patients diagnosed in specialist healthcare. Depression was associated with female gender, older age, more severe decline in cognitive functioning (IQCODE, OR 1.65), higher caregiver burden (RSS, OR 1.10) and with being assessed in primary healthcare (OR 1.53).Conclusion: Post-diagnostic support tailored to patients diagnosed with dementia in primary healthcare should consider their poor cognitive function and limitations in ADL and that these people often live alone, have BPSD and depression.Key pointsPeople diagnosed in Norwegian primary healthcare had more needs than people diagnosed in specialist healthcare. • They were older, less educated, had poorer cognitive functioning and activity limitations, more often lived alone, and had more BPSD and depression. • Depression was associated with being female, older, having cognitive decline, being assessed in primary care and the caregiver experiencing burden • Post diagnostic support for people with dementia should be tailored to the individual's symptoms and needs.
PubMed ID
32362213 View in PubMed
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Cohort profile: the Health and Memory Study (HMS): a dementia cohort linked to the HUNT study in Norway.

https://arctichealth.org/en/permalink/ahliterature266117
Source
Int J Epidemiol. 2014 Dec;43(6):1759-68
Publication Type
Article
Date
Dec-2014
Author
Sverre Bergh
Jostein Holmen
Jessica Gabin
Eystein Stordal
Arvid Fikseaunet
Geir Selbæk
Ingvild Saltvedt
Ellen M Langballe
Kristian Tambs
Source
Int J Epidemiol. 2014 Dec;43(6):1759-68
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - epidemiology - nursing
Caregivers
Cohort Studies
Dementia - epidemiology - nursing
Dementia, Vascular - epidemiology - nursing
Female
Headache - epidemiology
Health Services - utilization
Humans
Male
Memory Disorders - epidemiology
Middle Aged
Norway - epidemiology
Nursing Homes
Risk factors
Abstract
The aim of the Health and Memory Study (HMS) of Nord-Trøndelag, Norway, was primarily to establish a database suitable as basis for a large number of studies on dementia. Data from the HMS study were collected via questionnaires and examinations during the period from 1995 to 2011. The dementia panel consists of 620 participants residing in nursing homes and 920 participants referred to memory clinics of Nord-Trøndelag. Data from this dementia panel may be linked to the Nord-Trøndelag Health Study (the HUNT study), three large population based health surveys that took place in 1984-86 (HUNT1), 1995-97 (HUNT2) and 2006-08 (HUNT3). Data collection is complete and the participation rate in the HUNT1 for patients diagnosed with dementia was 86%. The sub-studies in the HMS are focused on examining risk factors, caregiver burden, healthcare consumption and economic consequences of treating and having dementia. Researchers interested in the HMS study are invited to contact HUNT at hunt@medisin.ntnu.no.
PubMed ID
24526272 View in PubMed
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Comorbid Dementia and Cancer in Residents of Nursing Homes: Secondary Analyses of a Cross-Sectional Study.

https://arctichealth.org/en/permalink/ahliterature299399
Source
Cancer Nurs. 2018 Mar/Apr; 41(2):E13-E20
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Author
Kjersti Marie Blytt
Geir Selbæk
Jorunn Drageset
Gerd Karin Natvig
Bettina S Husebo
Author Affiliation
Author Affiliations: Department of Global Public Health and Primary Care (Ms Blytt and Drs Drageset, Natvig, and Husebo) and Centre for Elderly and Nursing Home Medicine (Ms Blytt and Dr Husebo), University of Bergen; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen (Ms Blytt); Faculty of Medicine, University of Oslo; Ageing and Health, Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tonsberg; and Centre for Old Age Psychiatry Research, Innlandet Hospital Trust, Ottestad (Dr Selbæk); Faculty for Health and Social Sciences, Bergen University College (Dr Drageset); and the Municipality of Bergen (Dr Husebo), Norway.
Source
Cancer Nurs. 2018 Mar/Apr; 41(2):E13-E20
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Analgesics - therapeutic use
Comorbidity
Cross-Sectional Studies
Dementia - complications - drug therapy
Female
Humans
Male
Neoplasms - complications
Norway
Nursing Homes - statistics & numerical data
Oncology Nursing - standards
Practice Guidelines as Topic
Prevalence
Psychomotor Agitation - drug therapy
Sleep Wake Disorders - drug therapy - etiology
Abstract
Life expectancy is increasing continuously, which increases the likelihood of developing dementia or cancer. Both dementia and cancer are serious conditions that give manifold symptoms. The interaction of these conditions is however complex and less explored.
The aim of this study was to identify the prevalence of cancer and differences regarding neuropsychiatric symptoms (NPS) and medication among nursing home (NH) patients with and without dementia and cancer.
This is a cross-sectional study of Norwegian NH patients (N = 1825). Participants were categorized according to degree of dementia (Clinical Dementia Rating > 1) and cancer diagnoses. Differences in NPS and other symptoms, as well as the use of medication, were explored.
Eighty-four percent of NH patients had dementia, and 5.5% had comorbid dementia and cancer. Patients with comorbid dementia and cancer received significantly more analgesics compared with patients without cancer but with dementia (P
PubMed ID
28146014 View in PubMed
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A comparison of depressive symptoms in elderly medical inpatients and the elderly in a population-based health study (the Nord-Trøndelag Health Study 3).

https://arctichealth.org/en/permalink/ahliterature130876
Source
Nord J Psychiatry. 2012 Jun;66(3):189-97
Publication Type
Article
Date
Jun-2012
Author
Anne-Sofie Helvik
Knut Engedal
Steinar Krokstad
Eystein Stordal
Geir Selbæk
Author Affiliation
Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway. Anne-Sofi e.Helvik@ntnu.no
Source
Nord J Psychiatry. 2012 Jun;66(3):189-97
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Anxiety - epidemiology
Anxiety Disorders - complications - diagnosis - epidemiology
Cross-Sectional Studies
Depression - epidemiology
Depressive Disorder - diagnosis - epidemiology
Depressive Disorder, Major - complications
Female
Health status
Humans
Inpatients - statistics & numerical data
Male
Norway - epidemiology
Odds Ratio
Prevalence
Risk
Rural Population
Urban Population
Abstract
To compare depression in a sample of the medically hospitalized elderly with elderly people participating in a population-based health study in Norway and further to study the odds for depression, controlling for demographic and health differences between the two samples.
This cross-sectional observational study evaluated 484 medical inpatients from rural areas and 10,765 drawn from the Nord-Trøndelag Health Study 3 (HUNT-3 Study) including participants from rural and urban areas. All participants were elderly (=65 years) with a mean (± standard deviation) age of 80.7 ± 7.4 and 73.3 ± 6.3 years, respectively. Symptoms of depression were screened by the Hospital Anxiety and Depression Scale (HAD).
The prevalence of symptoms indicating mild, moderate or more severe depression (depression score =8) was about the same in both groups. In regression analyses, adjusting demographic and health differences, the odds for depression was lower for the elderly in the hospital sample than in the HUNT-3 Study. Older age, male gender, perceiving general health as poor, having impaired ability to function in daily life, previous consultation or treatment for emotional problems and anxiety (anxiety score =8) were associated with increased odds for depression in the elderly independent of being hospitalized or not.
Surprisingly, we found the odds for depression after controlling for demographic and health variables to be lower in the hospitalized elderly individuals than in the elderly participating in the population-based health study. The health variables that were most strongly associated with an increased risk of depression were poor physical health and anxiety.
PubMed ID
21958367 View in PubMed
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55 records – page 1 of 6.