Blood Pressure in Different Dementia Disorders, Mild Cognitive Impairment, and Subjective Cognitive Decline

The aim of the study was to investigate whether blood pressure (BP) differed among people with different dementia diagnoses, mild cognitive impairment, and subjective cognitive decline and whether BP differences were observed across age and sex. Our study population comprised clinical data from 6,236 patients (53.5% women) aged 45–97 years (Mean = 73.9, SD = 9.6) referred to dementia assessment in 42 outpatient clinics across Norway during 2009–2019. Patients with the following diagnoses were included: Subjective cognitive decline (SCD), Mild cognitive impairment (MCI), dementia due to Alzheimer’s disease (AD), Vascular dementia (VaD), mixed AD and VaD, and dementia in Parkinson’s disease/Lewy body disease (PDD/LBD). For all diagnostic groups, SBP increased with age until about 80 years, after which it trended downward, whereas DBP declined after 60 years of age for all diagnostic groups. Patients aged 65 years and younger with SCD had lower SBP compared to AD patients at the same age, but SBP increased rapidly with increasing age, resulting in a substantially higher SBP at 80 + years compared with all other diagnostic groups. No other differences in SBP or diastolic blood pressure (DBP) were found among patients with the different dementia diagnosis. Neither SBP nor DBP differed between MCI and AD groups. An interaction between age and gender was found for SBP at younger ages, as women started out with a lower pressure than men did but ended up with higher SBP. Conclusion: Among 80+ patients, blood pressure did not differ as a function of the various dementia disorders. The SBP for the SCD patients of various age groups differed from all other diagnostic groups, indicating either that internal regulation of BP in older people is a risk factor for dementia or that brain damage causing dementia or MCI may led to changes in blood pressure. Brain aging seems to influence SBP differently in men and womenpublishedVersio

Comparison of anxiety symptoms in spouses of persons suffering from dementia, geriatric in-patients and healthy older persons

Fagfellevurdert, vitenskapelig tidsskriftartikkelObjective:To describe and compare anxiety symptoms in spouses of persons suffering from dementia, geriatric in-patients and healthy controls, and to study possible risk factors associated with anxiety in these groups of older people. Method: The participants were 70 years and above: 1) 76 spouses of persons with dementia recruited from a memory clinic, 2) 98 in-patients without dementia but suffering from one or more chronic diseases, who were admitted to a geriatric department of an acute hospital, and 3) 68 healthy elderly people recruited from day-centres. The State-Trait Anxiety Inventory (STAI-X-1, 12-item) was used to tap anxiety symptoms. Results: Spouses of persons suffering from dementia expressed the same degree of anxiety symptoms as geriatric patients, and anxiety in these two groups differed significantly from the healthy elderly persons. In an adjusted linear regression analysis, anxiety, expressed as a high score on STAI-X-1, was associated with female gender (ß 0.16, p=0.01); being a spousal carer (ß 0.49, p <0.001) and being a geriatric patient (ß 0.57, p<0.001). Conclusion: Spouses of persons suffering from dementia reported as much anxiety symptoms as geriatric in-patients and both groups reported significantly more symptoms of anxiety than healthy older persons without caring obligations. The mental health nurses should include assessment of carers’ anxiety as routine

A Psychometric Evaluation of the Threadgold Communication Tool for Persons with Dementia

The objective of this study was to investigate the psychometric properties of the Threadgold Communication Tool (TCT). Method: Internal consistency reliability was measured using Cronbach’s α coefficient and inter-item correlation. Test-retest was performed to examine the instrument’s stability. Exploratory principal component analysis (PCA) with oblimin rotation was carried out to evaluate construct validity. Finally, the score on each item of the TCT was correlated with the person’s Mini Mental State Examination (MMSE) and Barthel Index of activities of daily living scores. Results: A total of 51 persons participated, with a mean age of 86.7 (SD 6.6) years, of whom 46 were women with moderate-to-severe dementia [mean MMSE score 7.5 (SD 6.7)]. There were two measurement points 2 weeks apart. The results showed a satisfactory level for internal consistency and a high test-retest reliability (r = 0.76). The corrected item-total correlation ranged between 0.50 and 0.87, and a two-factor structure was revealed at the PCA. ‘Vocalizing’ seemed to measure another aspect of communication and was the only item which was negatively loaded. Conclusion: Despite the low sample size in this study, the results revealed the TCT as a reliable and valid instrument, suitable for measuring communication among people with dementia. We suggest clarifying the understanding of ‘vocalizing’ before considering removing it from the scale

Factors Associated with a Depressive Disorder in Alzheimer's Disease Are Different from Those Found for Other Dementia Disorders

Background: This study explores factors associated with depression in Alzheimer’s disease (AD) compared with mild cognitive impairment (MCI) and other dementia disorders. Method: In a prospective study we included 195 patients: 31 with MCI, 112 with AD and 52 with other dementias. Results: According to the ICD-10 and the DSM-IV criteria, 88 (44.1%) and 59 (30.3%), respectively, had a depressive disorder. An adjusted multiple regression analysis showed that previous depression (p Conclusion: We found different factors associated with a depressive disorder in AD compared to those found for other dementia disorders

Register til nytte eller besvær, hva vet vi etter fem år? Etablering av et kvalitets- og forskningsregister for hukommelsesklinikker i spesialisthelsetjenesten

Patient Registry, useful or not? What have we learned after five years?Background and aims: A patient registry was established in January 2009 to improve the quality of assessment and treatment of dementia at memory clinics in the South-Eastern and Western Health Regions of Norway. Further aims were to examine the validity of cognitive tests used in the assessment of dementia, to obtain new knowledge about risk factors and the course of dementia, treatment with and without antidementia medication, and to identify risk factors for developing neuropsychiatric symptoms and severe carer burden and burn-out. Data was also collected for epidemiological and clinical research.. In this article we will present our experiences regarding the process of developing and establishing the register. Methods: To evaluate the process of developing the register we have used The Wheel of Continuous Improvement, as it is presented the Norwegian strategy plan for quality improvement in the social and health service with the steps: plan, do, check and action (Veileder IS-1162. SHdir 2005). Results: In 2013 we have included 2220 patients in the register. The number of participating memory clinics has increased from 7 in 2007 to 15 in 2013. The participating memory clinics have included data from patients with different characteristics with regard to age, diagnoses and degree of cognitive impairment. Data from the register is used in ten research studies. Conclusions: It has been possible to establish a dementia register with patients data from 15 memory clinics in Norway that have  agreed to use a standard assessment battery for dementia. To motivate personal from the memory clinics to maintain collecting data, meetings, seminars and presenting results from each unit are of importance

The effect of ApoE e4 on blood pressure in patients with and without depression

This is an Open Access article licensed under the Creative Commons Attribution License 3.0 (CC BY 3.0) and originally published in Neuropsychiatric Disease and Treatment. You can access the article by following this link: https://dx.doi.org/10.2147/NDT.S106933Dette er en vitenskapelig, fagfellevurdert artikkel som opprinnelig ble publisert i Neuropsychiatric Disease and Treatment. Artikkelen er publisert under lisensen Creative Commons Attribution License 3.0 (CC BY 3.0). Du kan også få tilgang til artikkelen ved å følge denne lenken: https://dx.doi.org/10.2147/NDT.S106933Introduction: Depression is considered an independent risk factor for hypertension, particularly for people with recurrent episodes or a long history of depression. Another risk factor for cardiovascular disease is the Apolipoprotein E e4 allele (ApoE e4). The aim of this study was to examine how ApoE e4 was related to blood pressure (BP) in patients with depression and a control group. Methods: A total of 78 patients, 49 with depression and 29 without, all recruited from the same hospital, underwent ApoE e genotyping (24 had at least one ApoE e4 allele) and examination of BP. Results: In the depression group, but not in the control group, both systolic and diastolic BP were significantly higher in patients with ApoE e4 than in those without. The effect of ApoE e4 on BP differed significantly between the two groups. Conclusion: Our findings showed that the effect of ApoE e4 on BP differed between the patients with depression and the control group. In patients with depression, ApoE e4 was associated with an increase in BP. We suggest that patients with depression and ApoE e4-positive status are particularly prone to develop BP elevation

The lived experience of stroke survivors with early depressive symptoms: A longitudinal perspective

The aim of the study was to describe the lived experience as it develops over time in stroke survivors suffering from early depressive symptoms.This paper presents a phenomenological hermeneutical interview-study of nine participants at 6, 12, and 18 months after stroke.The participants related the depressive symptoms to the consequences of the stroke, and the experience of loss was crucial. Depressive symptoms was not meaningful on its own, but formed the backdrop of the experience of stroke. Our findings revealed three patterns of experience: (1) finding a restored self; (2) trapped in a different life; and (3) fighting to regain self. Two groups of stroke survivors are particularly vulnerable and should receive special attention: (a) old adults living alone; and (b) adults experiencing serious threats to their commitments such as to work, family, and children.Depressive symptoms have a severe impact on life after stroke. Life circumstances, degree of residual impairment from a stroke, and social context were found to influence people to move along different paths. Older adults living alone and adults experiencing serious threat to their commitments should receive special attention, in terms of further research and in terms of follow-up in clinical practice.More studies investigating the experience of post-stroke depression (PSD) over time and the association between depressive symptoms and loss/grieving are needed. There is also a need for continued empirical research on the identification of effective interventions aimed at prevention or improved coping with PSD