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The association between depression, anxiety, and cognitive function in the elderly general population--the Hordaland Health Study.

https://arctichealth.org/en/permalink/ahliterature45650
Source
Int J Geriatr Psychiatry. 2005 Oct;20(10):989-97
Publication Type
Article
Date
Oct-2005
Author
Eva Biringer
Arnstein Mykletun
Alv A Dahl
A David Smith
Knut Engedal
Harald A Nygaard
Anders Lund
Author Affiliation
Institute of Clinical Medicine, University of Bergen, Norway. eva.biringer@psyk.uib.no
Source
Int J Geriatr Psychiatry. 2005 Oct;20(10):989-97
Date
Oct-2005
Language
English
Publication Type
Article
Keywords
Aged
Anxiety - epidemiology - psychology
Cognition Disorders - epidemiology - psychology
Comorbidity
Depression - epidemiology - psychology
Female
Humans
Male
Neuropsychological Tests
Norway - epidemiology
Research Support, Non-U.S. Gov't
Sex Distribution
Abstract
OBJECTIVES: To examine the association between depression and/or anxiety and cognitive function in the elderly general population. SUBJECTS: Non-demented participants from the general population (n = 1,930) aged 72-74 years. METHODS: Symptoms and caseness of depression and anxiety disorder were assessed using the Hospital Anxiety and Depression Scale (HADS). Cognitive function was assessed by the Digit Symbol Test (modified version), the Kendrick Object Learning Test, and the 'S'-task from the Controlled Oral Word Association Test. RESULTS: There was a significant association between depression and reduced cognitive function. The inverse association between anxiety and reduced cognitive performance was explained by adjustment for co-morbid depression. The inverse association between depressive symptoms and cognitive function was found to be close to linear, and was also present in the sub-clinical symptom range. Males were more affected cognitively by depressive symptoms than females. CONCLUSION: The inverse association between depression and cognitive function is not only a finding restricted to severely ill patient samples, but it can also be found in the elderly general population.
PubMed ID
16163751 View in PubMed
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Association between self-reported care needs and the allocation of care in Norwegian home nursing care recipients.

https://arctichealth.org/en/permalink/ahliterature134023
Source
Int J Older People Nurs. 2012 Mar;7(1):20-8
Publication Type
Article
Date
Mar-2012
Author
Hans Inge Saevareid
Elin Thygesen
Torill Christine Lindstrom
Harald A Nygaard
Author Affiliation
Faculty of Health and Sport Sciences, University of Agder, Arendal, Norway. hans.i.savareid@uia.no
Source
Int J Older People Nurs. 2012 Mar;7(1):20-8
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adaptation, Psychological
Aged
Aged, 80 and over
Aging - psychology
Community Health Nursing - methods - standards
Cross-Sectional Studies
Female
Geriatric Nursing - methods - standards
Housing for the Elderly
Humans
Male
Needs Assessment
Norway
Outpatients - psychology
Self Report
Social Support
Socioeconomic Factors
Abstract
This study investigated the relationship between patients' self-reported illness, daily afflictions, and the frequency of home nursing care, and whether patients' coping resources influenced the allocation of care. DESIGN, SAMPLE AND MEASUREMENTS: A cross-sectional survey was adopted. Two hundred and forty-two people aged 75 years and above receiving home nursing care participated in the study. Binary logistic regression model was used to test the effects of the independent variables on home nursing care.
Poor capacity to perform activities of daily living and high level of education were directly associated with a high frequency of home nursing care. Lack of perceived social support affected the amount of home nursing care allocated only when feelings of loneliness were connected with poor activities of daily living functioning. Interaction effects revealed that perceived social support influenced the amount of home nursing care in persons with higher education, in persons with low education, no such association were found. No associations were found between coping resources and home nursing care.
Impaired capacity to perform activities of daily living was the main reason for care allocation. Education was associated with more formal care. Patients with low perceived social support combined with a low education level was a particularly vulnerable group.
PubMed ID
21631880 View in PubMed
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[Cholinesterase inhibitors in Norway--effectiveness and side effects in clinical practice].

https://arctichealth.org/en/permalink/ahliterature184801
Source
Tidsskr Nor Laegeforen. 2003 May 29;123(11):1500-3
Publication Type
Article
Date
May-29-2003
Author
Dag Arsland
Knut A Engedal
Harald A Nygaard
Jukka Louhija
Ingun Ulstein
Marianne Holm
Author Affiliation
Alderspsykiatrisk seksjon, Psykiatrisk klinikk, Sentralsjukehuset i Rogaland, 4095 Stavanger, og, Psykiatrisk Institutt, Universitetet i Bergen. daa@post.rps.no
Source
Tidsskr Nor Laegeforen. 2003 May 29;123(11):1500-3
Date
May-29-2003
Language
Norwegian
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis - drug therapy - psychology
Cholinesterase Inhibitors - adverse effects - therapeutic use
Female
Humans
Male
Mental Status Schedule
Norway
Practice Guidelines as Topic
Questionnaires
Retrospective Studies
Time Factors
Treatment Outcome
Abstract
Naturalistic trials are needed to evaluate whether the results obtained in randomised trials of cholinesterase inhibitors (CEI) can be generalised to clinical practice. We conducted two studies in Norway to address this issue.
We included patients with dementia from 16 centres in Norway who had received treatment with a CEI until November 2001 (study 1, n = 1,167, retrospective case review) or who came to the first evaluation after onset of treatment (study 2; n = 252; prospective enrollment). Adverse events, global effectiveness, and Mini-Mental State Exam scores were recorded.
In study 1, 56% of the patients were rated as mildly or markedly improved two to four months after onset of treatment. Side effects were recorded in 23%; 8% discontinued treatment due to side effects. In study 2, 49% were rated as mildly or markedly improved on at least one of the items cognition, psychiatric symptoms, activities of daily living or behaviour. Treatment was discontinued due to lack of effectiveness in 12%.
CEI were found to be useful in clinical practice in Norway. The open and uncontrolled design of the study limits the generalisability of the study.
PubMed ID
12822007 View in PubMed
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Clinically important renal impairment in various groups of old persons.

https://arctichealth.org/en/permalink/ahliterature178353
Source
Scand J Prim Health Care. 2004 Sep;22(3):152-6
Publication Type
Article
Date
Sep-2004
Author
Harald A Nygaard
Mala Naik
Sabine Ruths
Kjell Krüger
Author Affiliation
Section for Geriatric Medicine, Department of Public Health and Primary Health Care, University of Bergen, NO-5018 Bergen, Norway.
Source
Scand J Prim Health Care. 2004 Sep;22(3):152-6
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Drug Utilization - standards - statistics & numerical data
Drug-Related Side Effects and Adverse Reactions
Female
Glomerular Filtration Rate - drug effects - physiology
Hospitalization
Humans
Male
Medication Errors - statistics & numerical data
Norway - epidemiology
Nursing Homes
Outpatient Clinics, Hospital
Pharmaceutical Preparations - administration & dosage
Renal Insufficiency - chemically induced - epidemiology - physiopathology
Abstract
To assess renal function in various groups of elderly persons, and to determine the proportion of patients with clinically important renal impairment.
Cross-sectional study.
Three geriatric populations aged 70 years and over, representing increasing levels of care/treatment: community-dwelling elderly referred to a geriatric outpatient department, inpatients on a geriatric ward, and nursing home patients.
Cockroft and Gault's formula was applied to calculate glomerular filtration rate (GFR). Differences in GFR between age groups and between care levels were explored.
Altogether 288 elderly persons were included in the study. We observed a general age-related decline of renal function. Only 2% of the participants had normal renal function (GFR >90 ml/min), 13% had light (GFR 60-89 ml/min), 68% moderate (GFR 30-59 ml/min), and 17% severe (GFR 15-29 ml/min) impairment in GFR. Moderate or severely decreased GFR was observed in 75% of the outpatients, 78% of the patients from the geriatric ward, and 91% of the nursing home patients. Altogether 99% of patients aged 85+ had renal impairment necessitating dosing adjustment for drugs that are mainly eliminated through renal excretion.
Clinically important renal impairment is common in old age, especially in the frailest elderly living in nursing homes. This finding underlines the necessity for close supervision of drug treatment based on renal function in old age.
PubMed ID
15370791 View in PubMed
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Cognitive function in an elderly population: interaction between vitamin B12 status, depression, and apolipoprotein E e4: the Hordaland Homocysteine Study.

https://arctichealth.org/en/permalink/ahliterature118401
Source
Psychosom Med. 2013 Jan;75(1):20-9
Publication Type
Article
Date
Jan-2013
Author
Anna Vogiatzoglou
A David Smith
Eha Nurk
Christian A Drevon
Per M Ueland
Stein E Vollset
Harald A Nygaard
Knut Engedal
Grethe S Tell
Helga Refsum
Author Affiliation
OPTIMA, Department of Pharmacology, University of Oxford, Oxford, UK. a.vogiatzoglou@reading.ac.uk
Source
Psychosom Med. 2013 Jan;75(1):20-9
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Aged
Apolipoprotein E4 - blood
Cognition - physiology
Cognition Disorders - blood - complications - physiopathology
Cross-Sectional Studies
Depression - blood - physiopathology - psychology
Female
Homocysteine - blood
Humans
Linear Models
Male
Methylmalonic Acid - blood
Neuropsychological Tests
Norway
Regression Analysis
Transcobalamins - analysis
Vitamin B 12 - blood
Vitamin B 12 Deficiency - blood - complications - physiopathology
Abstract
To investigate the cross-sectional relation between metabolic markers of vitamin B(12) status and cognitive performance, and possible effect modification by the presence of depression and apolipoprotein E (ApoE) e4.
This is a population-based study of 1935 participants, aged 71 to 74 years, from Norway. Participants were administered a cognitive test battery, and vitamin B(12) status was assessed by measurements of plasma vitamin B(12), holotranscobalamin (holoTC), methylmalonic acid (MMA), and total homocysteine.
The geometric mean (95% confidence interval) for vitamin B(12) was 348 pM (341-354), whereas 5.9% of participants had vitamin B(12) levels lower than 200 pM. In linear regression analyses, holoTC (p = .039) and the holoTC/vitamin B(12) ratio (p = .013) were positively related, whereas MMA (p = .010) was inversely related, to global cognition, after adjustment for sex, education, ApoE status, plasma creatinine, and history of diabetes, cardiovascular disease, hypertension, and depression. Among those positive for ApoE e4, but not among those without the e4 allele, plasma vitamin B(12) was positively associated with global cognition (p = .015), whereas MMA was inversely related to global cognition (p = .036) and executive function (p = .014). In participants with depression, MMA was inversely associated with global cognition (p
PubMed ID
23213264 View in PubMed
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Cognitive performance among the elderly in relation to the intake of plant foods. The Hordaland Health Study.

https://arctichealth.org/en/permalink/ahliterature96666
Source
Br J Nutr. 2010 Jun 16;:1-12
Publication Type
Article
Date
Jun-16-2010
Author
Eha Nurk
Helga Refsum
Christian A Drevon
Grethe S Tell
Harald A Nygaard
Knut Engedal
A David Smith
Author Affiliation
Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
Source
Br J Nutr. 2010 Jun 16;:1-12
Date
Jun-16-2010
Language
English
Publication Type
Article
Abstract
Fruits and vegetables are among the most nutritious and healthy of foods, and are related to the prevention of many chronic diseases. The aim of the study was to examine the relationship between intake of different plant foods and cognitive performance in elderly individuals in a cross-sectional study. Two thousand and thirty-one elderly subjects (aged 70-74 years; 55 % women) recruited from the general population in Western Norway underwent extensive cognitive testing and completed a comprehensive FFQ. The cognitive test battery covered several domains (Kendrick Object Learning Test, Trail Making Test - part A, modified versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination and Controlled Oral Word Association Test). A validated and self-reported FFQ was used to assess habitual food intake. Subjects with intakes of>10th percentile of fruits, vegetables, grain products and mushrooms performed significantly better in cognitive tests than those with very low or no intake. The associations were strongest between cognition and the combined intake of fruits and vegetables, with a marked dose-dependent relationship up to about 500 g/d. The dose-related increase of intakes of grain products and potatoes reached a plateau at about 100-150 g/d, levelling off or decreasing thereafter, whereas the associations were linear for mushrooms. For individual plant foods, the positive cognitive associations of carrots, cruciferous vegetables, citrus fruits and high-fibre bread were most pronounced. The only negative cognitive association was with increased intake of white bread. In the elderly, a diet rich in plant foods is associated with better performance in several cognitive abilities in a dose-dependent manner.
PubMed ID
20550741 View in PubMed
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Effect of antipsychotic withdrawal on behavior and sleep/wake activity in nursing home residents with dementia: a randomized, placebo-controlled, double-blinded study. The Bergen District Nursing Home Study.

https://arctichealth.org/en/permalink/ahliterature178204
Source
J Am Geriatr Soc. 2004 Oct;52(10):1737-43
Publication Type
Article
Date
Oct-2004
Author
Sabine Ruths
Jørund Straand
Harald A Nygaard
Bjørn Bjorvatn
Ståle Pallesen
Author Affiliation
Section for Geriatric Medicine, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. sabine.ruths@isf.uib.no
Source
J Am Geriatr Soc. 2004 Oct;52(10):1737-43
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Aged
Antipsychotic Agents - adverse effects
Dementia - drug therapy
Double-Blind Method
Female
Humans
Leisure Activities
Male
Mental Disorders - chemically induced
Norway
Nursing Homes
Sleep Disorders - chemically induced
Substance Withdrawal Syndrome
Abstract
To explore the effect on sleep/wake activity and on behavioral and psychological symptoms of the withdrawal of antipsychotic medications from nursing home (NH) patients with dementia.
Randomized, placebo-controlled, double-blind trial.
NHs in Bergen, Norway.
Thirty patients (mean age 83.5) taking haloperidol, risperidone, or olanzapine for nonpsychotic symptoms.
Study participants were randomly assigned to withdrawal (intervention group) or continued treatment with antipsychotic medications (reference group) for 4 consecutive weeks.
Behavioral rating using the Neuropsychiatric Inventory Questionnaire (NPI-Q) and actigraphy.
After antipsychotic withdrawal, behavioral scores remained stable or improved in 11 of 15 patients, whereas four had worsening scores. Actigraphy revealed decreased sleep efficiency after drug discontinuation and increased 24-hour and night activity in both groups. Actigraphy records of nighttime and daytime activity indicated sleep problems and restlessness, in terms of the NPI-Q. One patient was restarted on antipsychotics.
Antipsychotic drug withdrawal affected activity and sleep efficiency over the short term. Increases in total activity and impaired sleep quality after drug discontinuation should be monitored, because the long-term effect of these changes is not known. The NPI-Q and actigraphy are feasible tools that disclose relevant changes occurring during antipsychotic withdrawal in NH patients with dementia. Their use in clinical practice should be substantiated by larger studies.
PubMed ID
15450054 View in PubMed
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Factors determining performance of bronchodilator reversibility tests in middle-aged and elderly.

https://arctichealth.org/en/permalink/ahliterature15120
Source
Respir Med. 2004 Nov;98(11):1071-9
Publication Type
Article
Date
Nov-2004
Author
Sverre Lehmann
Stein E Vollset
Harald A Nygaard
Amund Gulsvik
Author Affiliation
Department of Thoracic Medicine, Haukeland University Hospital, University of Bergen, Bergen N-5021, Norway. sverre.lehmann@helse-bergen.no
Source
Respir Med. 2004 Nov;98(11):1071-9
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Agonists - adverse effects - diagnostic use
Aged
Anthropometry
Asthma - diagnosis
Bronchodilator Agents - adverse effects - diagnostic use
Cross-Sectional Studies
Diagnosis, Differential
Educational Status
Female
Forced Expiratory Volume - drug effects
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive - diagnosis
Research Support, Non-U.S. Gov't
Risk factors
Smoking - physiopathology
Spirometry - methods
Abstract
Knowledge of the factors determining the performance of bronchodilator reversibility testing in a general population is lacking. Random samples of all adults aged 47-48 and 71-73 years living in Bergen, Norway, were invited to a cross-sectional study. Altogether 3506 subjects attended (69%). Test quality predictors were examined through multiple logistic regression analyses including gender, age, body mass, educational level, smoking history, respiratory symptoms, and in the elderly cohort cognitive level. Among the participants, 1.6% refused to inhale salbutamol, 2.5% failed the initial spirometry according to the ATS guidelines, and 1.3% failed the post-bronchodilator spirometry. Old age and body mass index > 30 kg/m2 were independent risk factors for an unsuccessful initial spirometry, and never smoking and respiratory symptoms were risk factors for failing the post-bronchodilator spirometry. Cognitive impairment in the elderly was a risk factor for failing both the initial- and post-bronchodilator spirometry. The median number of forced expirations was 7 in subjects obtaining an acceptable reversibility test. One third of these participants needed > or = 8 attempts, with independent predicting factors being old age, Little formal education and never smoking. Although reversibility testing becomes increasingly difficult with age, reliable data are obtained in a vast majority (94%) of subjects in our community study.
PubMed ID
15526807 View in PubMed
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Missing the diagnosis: senile dementia in patients admitted to nursing homes.

https://arctichealth.org/en/permalink/ahliterature71244
Source
Scand J Prim Health Care. 2003 Sep;21(3):148-52
Publication Type
Article
Date
Sep-2003
Author
Harald A Nygaard
Sabine Ruths
Author Affiliation
University of Bergen, Section for Geriatric Medicine, Department of Public Health and Primary Health Care, Bergen, Norway. harald.nygaard@isf.uib.no
Source
Scand J Prim Health Care. 2003 Sep;21(3):148-52
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Dementia - diagnosis
Diagnosis, Differential
Diagnostic Errors
Female
Geriatric Assessment
Humans
Male
Neuropsychological Tests
Norway
Nursing Homes
Predictive value of tests
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To establish dementia diagnoses in patients recently admitted to a nursing home by a geriatrician, and to compare the agreement with diagnoses recorded in the nursing home's medical records and with short screening instruments. DESIGN: Descriptive study. Geriatric work-up of the individual patient, information obtained from the medical records of nursing homes, structured interviews with nurses and a short cognitive test. SETTING: Nursing homes in Bergen, Norway, with 123 long-term care patients. MAIN OUTCOME MEASURES: Dementia diagnosis according to the International Classification of Diseases (ICD-10), Clinical Dementia Rating and the Short Portable Mental Status Questionnaire. RESULTS: Fifty-nine percent of the patients were diagnosed as demented according to the ICD-10. One-third of cases were not formerly diagnosed according to nursing home medical records. Clinical Dementia Rating and the Short Portable Mental Status Questionnaire detected "dementia/non-dementia" cases correctly in 93% and 94%, respectively. CONCLUSION: Geriatric work-up indicates under-diagnosing of dementia among recently admitted nursing home patients. This may have serious consequences for the treatment. Dementia diagnostics in primary health care must be improved. The knowledge of the attending nurses should be better incorporated in the medical work-up of nursing home patients.
PubMed ID
14531505 View in PubMed
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Not less but different: psychotropic drug utilization trends in Norwegian nursing homes during a 12-year period. The Bergen District Nursing Home (BEDNURS) Study.

https://arctichealth.org/en/permalink/ahliterature177129
Source
Aging Clin Exp Res. 2004 Aug;16(4):277-82
Publication Type
Article
Date
Aug-2004
Author
Harald A Nygaard
Sabine Ruths
Jørund Straand
Mala Naik
Author Affiliation
Section for Geriatric Medicine, Department of Public Health and Primary Health Care, University of Bergen, Norway. harald.nygaard@isf.uib.no
Source
Aging Clin Exp Res. 2004 Aug;16(4):277-82
Date
Aug-2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Anxiety Agents - therapeutic use
Antidepressive Agents - therapeutic use
Drug Utilization - statistics & numerical data - trends
Female
Humans
Hypnotics and Sedatives - therapeutic use
Male
Norway
Nursing Homes - statistics & numerical data - trends
Psychotropic Drugs - therapeutic use
Abstract
The use of psychotropic drugs in nursing homes is generally considered to be inappropriately high. The aim of the present survey was to compare psychotropic drug use in nursing homes (NHs) in 1985 relative to 1996/97, and to explore predictors for this drug use.
Cross-sectional study. Mental capacity was assessed by means of the Clinical Dementia Rating scale (CDR), and behavior registered by trained nurses. Scheduled, daily use of psychotropic drugs among long-term care residents in 1985 (N=1247) and 1996/97 (N=1035) was recorded. Bivariate analyses and logistic regression analyses were applied to establish predictors for psychoactive drug use.
From 1985 to 1996/97, the proportion of residents using any psychotropic drug increased from 52 to 57%. Antipsychotic drug use decreased from 33 to 22%, while anxiolytics increased from 11 to 16%, hypnotics from 11 to 14%, and antidepressants from 12 to 31%. Psychotropic drug use was predominantly associated with behavioral symptoms and not with mental impairment. Concurrent use of two or more psychotropic drugs increased from 23 to 32% of all psychotropic users.
During the study period, a substantial decline in the use of antipsychotics was observed, but a generally increased overall use of psychotropic drugs, particularly antidepressants. Psychotropic drug treatment was mainly associated with behavioral symptoms.
PubMed ID
15575121 View in PubMed
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14 records – page 1 of 2.