Maria Lage Barca

Oslo University Hospital

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Knut Engedal

Oslo University Hospital

Geir Selbæk

Sykehuset i Vestfold

Anne‐Brita Knapskog

Oslo University Hospital

Karin Persson

Oslo University Hospital

Jerson Laks

Universidade Federal do Rio de Janeiro

Jerson Laks

Universidade Federal do Rio de Janeiro

Rannveig Sakshaug Eldholm

St Olav's University Hospital

Anne Brækhus

Oslo University Hospital

Ingvild Saltvedt

Norwegian University of Science and Technology

Evandro Silva Freire Coutinho

Universidade do Estado do Rio de Janeiro

Cooperative Institutions

University of Oslo

Oslo University Hospital

Universidade Federal do Rio de Janeiro

Karolinska Institutet

Sykehuset i Vestfold

Columbia University

King's College London

Columbia University Irving Medical Center

Massachusetts General Hospital

Icahn School of Medicine at Mount Sinai

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THE COURSE OF DEPRESSIVE SYMPTOMS IN OLDER ADULTS RECEIVING IN-HOME CARE

Innovation in Aging (2019)

Anne‐Sofie Helvik Maria Lage Barca Sverre Bergh Jūratė Šaltytė Benth Tom Borza

Abstract The aim of the study was to describe the prevalence, incidence and persistence of depressive symptoms over a 36-month follow-up period among older people receiving in-home care, and to explore the association between cognitive function and the course of depressive symptoms. In all, 1001 older people (≥ 70 years) receiving in-home care were included in a longitudinal study over 36 months. Depressive symptoms, cognitive function, general medical health, activities of daily living, neuropsychiatric symptoms and use psychotropic drugs were assessed at three assessments. Dementia and mild cognitive impairment were diagnosed at all assessments. Baseline demographic characteristics and information on nursing home residency at follow-up were recorded. Linear mixed models were estimated. We found the prevalence and cumulative incidence of individual depressive symptoms to be higher in those with dementia at baseline than in those without. The persistence of depressive symptoms did not differ between those with or without dementia at baseline. The severity of cognitive decline and mean depressive symptom score assessed simultaneously were positively associated, but the strength of the association changed over time and was not significant at the last assessment. In conclusion: The differences in prevalence and cumulative incidence of depressive symptoms in those with and without dementia at baseline, and the association found between degree of cognitive decline and depressive symptoms over time shows that depression and dementia are interconnected. Nurses and clinicians should pay attention to cognitive status when observing or evaluating depression among older people receiving in-home care.

Depression

Longitudinal Study

Cognitive Decline

Association (psychology)

10.1093/geroni/igz038.1003

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Applicability of the locus of control of behaviour scale for people with dementia

Aging & Mental Health (2019)

Ingeborg Halse Guro Hanevold Bjørkløf Knut Engedal Anne Marie Mork Rokstad Karin Persson

To investigate the applicability of the Locus of Control of Behaviour scale (LoCB) for people with dementia.A sample of 534 participants with dementia (78.4 mean age, 58% female) were included. Assessment included the LoCB, the Montgomery-Aasberg Depression Rating Scale (MADRS), the Mini-Mental Status Examination Norwegian revised (MMSE-NR) and the Instrumental Activities of Daily Living (I-ADL). Completion percentages and internal reliability of LoCB were examined for predefined MMSE-NR groups (0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30). Factors associated with completion were analysed, and a principal component analysis (PCA) of the LoCB was performed. Sum score and component subscale scores were compared to MADRS and MMSE-NR scores.In total, 234 participants completed the LoCB. Completion percentages ranged from 74% (MMSE-NR 28-30) to 0% (MMSE-NR 0-9). Internal reliability was between 0.80 and 0.72 in groups with MMSE-NR > 9, except in MMSE-NR 20-24 (0.52). Age, MMSE-NR and education were associated with completion. The PCA yielded three components - powerful others, internal, and luck/fate - with explained variance of 41.3%. Participants with MADRS > 7 scored higher on the LoCB sum score, powerful others and internal subscale scores. No difference was found regarding the luck/fate subscale score. MMSE-NR did not affect LoCB scores.Older age, less education, and more cognitive impairment decreased the likelihood of completion. However, psychometric test results indicate that those who completed the LoCB understood the questions, even with severe cognitive impairment. We conclude, therefore, that the LoCB is applicable for investigating control orientation among people with dementia.

Clinical Dementia Rating

10.1080/13607863.2019.1652244

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Cortisol levels among older people with and without depression and dementia

International Psychogeriatrics (2018)

Maria Lage Barca Rannveig Sakshaug Eldholm Karin Persson Guro Hanevold Bjørkløf Tom Borza

ABSTRACT Cortisol dysregulation has been reported in dementia and depression. Cortisol levels and its associates were investigated among older people living at home and in nursing homes, in a cross-sectional study. A sample of 650 older people, from the community (home and nursing homes) and specialized care (memory clinics and old age psychiatry wards), mean age 76.8 (SD = 10.3) (dementia n = 319, depression, n = 154, dementia plus depression n = 53, and reference group n = 124), was included. Assessment included the Mini Mental State Examination (MMSE), Cornell scale for depression in dementia, activities of daily living scales, and salivary cortisol. Number of drugs was registered. The results showed that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. Characteristics significantly associated with cortisol levels were higher MMSE score (in patients with dementia and co-morbid depression), male gender (in people with dementia), and number of medications (in the reference group). We conclude that the cortisol ratio was highest among patients with dementia and co-morbid depression in comparison to those with either depression or dementia and the reference group. The association of cortisol level with MMSE score among patients with dementia and depression could further indicate that increased stress is related to cognitive function.

Depression

Geriatric Depression Scale

10.1017/s1041610218001199

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Neuropsychiatric symptoms and brain morphology in patients with mild cognitive impairment and Alzheimer’s disease with dementia

International Psychogeriatrics (2021)

Nikias Siafarikas Dag Alnæs Jennifer Monereo‐Sánchez Martina J. Lund Geir Selbæk

SUMMARY We present associations between neuropsychiatric symptoms (NPS) and brain morphology in a large sample of patients with mild cognitive impairment (MCI) and Alzheimer’s disease with dementia (AD dementia). Several studies assessed NPS factor structure in MCI and AD dementia, but we know of no study that tested for associations between NPS factors and brain morphology. The use of factor scores increases parsimony and power. For transparency, we performed an additional analysis with selected Neuropsychiatric Inventory – Questionnaire (NPI-Q) items. Including regional cortical thickness, cortical and subcortical volumes, we examined associations between NPS and brain morphology across the whole brain in an unbiased fashion. We reported both statistical significance and effect sizes, using linear models adjusted for multiple comparisons by false discovery rate (FDR). Moreover, we included an interaction term for diagnosis and could thereby compare associations of NPS and brain morphology between MCI and AD dementia. We found an association between the factor elation and thicker right anterior cingulate cortex across MCI and AD dementia. Associations between the factors depression to thickness of the banks of the left superior temporal sulcus and psychosis to the left post-central volume depended on diagnosis: in MCI these associations were positive, in AD dementia negative. Our findings indicate that NPS in MCI and AD dementia are not exclusively associated with atrophy and support previous findings of associations between NPS and mainly frontotemporal brain structures.

Brain morphometry

10.1017/s1041610221000934

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Fully automated structural MRI of the brain in clinical dementia workup

Acta Radiologica (2016)

Karin Persson Geir Selbæk Anne Brækhus Mona K. Beyer Maria Lage Barca

Background The dementia syndrome has been regarded a clinical diagnosis but the focus on supplemental biomarkers is increasing. An automatic magnetic resonance imaging (MRI) volumetry method, NeuroQuant® (NQ), has been developed for use in clinical settings. Purpose To evaluate the clinical usefulness of NQ in distinguishing Alzheimer’s disease dementia (AD) from non-dementia and non-AD dementia. Material and Methods NQ was performed in 275 patients diagnosed according to the criteria of ICD-10 for AD, vascular dementia and Parkinson’s disease dementia (PDD); the Winblad criteria for mild cognitive impairment; the Lund-Manchester criteria for frontotemporal dementia; and the revised consensus criteria for Lewy body dementia (LBD). Receiver operating curve (ROC) analyses with calculation of area under the curve (AUC) and regression analyses were carried out. Results Forebrain parenchyma (AUC 0.82), hippocampus (AUC 0.80), and inferior lateral ventricles (AUC 0.78) yielded the highest AUCs for AD/non-dementia discrimination. Only hippocampus (AUC 0.62) and cerebellum (AUC 0.67) separated AD from non-AD dementia. Cerebellum separated AD from PDD-LBD (AUC 0.83). Separate multiple regression analyses adjusted for age and gender, showed that memory (CERAD 10-word delayed recall) (beta 0.502, P < 0.001) was more strongly associated to the hippocampus volume than the diagnostic distinction of AD versus non-dementia (beta −0.392, P < 0.001). Conclusion NQ measures could separate AD from non-dementia fairly well but generally poorer from non-AD dementia. Degree of memory impairment, age, and gender, but not diagnostic distinction, were associated to the hippocampus volume in adjusted analyses. Surprisingly, cerebellum was found relevant in separating AD from PDD-LBD.

Vascular dementia

10.1177/0284185116669874

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Citations (28)

Author response for "Regional MRI volumetry using NeuroQuant versus visual rating scales in patients with cognitive impairment and dementia"

Karin Persson Maria Lage Barca Trine Holt Edwin Lena Cavallin‐Eklund Gro Gujord Tangen

10.1002/brb3.3397/v2/response1

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COVID-19 pandemic: a multinational report providing professional experiences in the management of mental health of elderly

International Psychogeriatrics (2020)

Renato Sobral Monteiro-Júnior Lara Carneiro Maria Lage Barca Kari Midtbø Kristiansen Cristina Andrade Sampaio

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the 'Save PDF' action button.

Pandemic

Content (measure theory)

2019-20 coronavirus outbreak

10.1017/s1041610220001027

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Citations (15)

Differences in Awareness of Disease Between Young-onset and Late-onset Dementia

Alzheimer Disease & Associated Disorders (2019)

Maria Alice Tourinho Baptista Raquel Luiza Santos Nathália Kimura Valeska Marinho José Pedro Simões Neto

Awareness of disease is the ability to acknowledge changes caused by deficits related to the disease process. We aimed to investigate whether there are differences in awareness of disease between young-onset dementia (YOD) and late-onset dementia (LOD) and examined how awareness interacts with cognitive and clinical variables.Using a cross-sectional design, 49 people with YOD and 83 with LOD and their caregivers were included. We assessed awareness of disease, cognition, functionality, stage of dementia, mood, neuropsychiatric symptoms, and caregivers' quality of life (QoL) and burden.We found that people with YOD were more aware of the disease than people with LOD (P<0.005). Multivariate linear regression revealed that higher impairment in functional level was associated with unawareness in both groups (YOD=P<0.001; LOD=P<0.001). In the YOD group, preserved awareness was related to worse self-reported QoL (P<0.05), whereas, in LOD, deficits in awareness were related to caregivers' worst perceptions about people with dementia QoL (P<0.001).The findings highlight the distinct nature of awareness between YOD and LOD. The YOD group had higher levels of disease awareness compared with the LOD group, even though the first group had a greater impairment in functionality.

10.1097/wad.0000000000000299

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The course of depressive symptoms with decline in cognitive function - a longitudinal study of older adults receiving in-home care at baseline

BMC Geriatrics (2019)

Anne‐Sofie Helvik Maria Lage Barca Sverre Bergh Jūratė Šaltytė Benth Øyvind Kirkevold

Depressive symptoms in old age are common, but the prevalence, persistence, and incidence of depressive symptoms in older adults with and without dementia receiving in-home care is less well studied, and descriptions of the relationship between severity of cognitive decline and depressive symptoms over time is, to our knowledge, lacking. The aim of the present study was to describe the prevalence, incidence and persistence of depressive symptoms over a 36-month follow-up period among older adults receiving in-home care at baseline, and to explore the association between cognitive function and the course of depressive symptoms over time. In all, 1001 older people (≥ 70 years) receiving in-home care were included in a longitudinal study with three assessments over 36 months. Depressive symptoms were assessed using the Cornell Scale for Depression in Dementia. Clinical Dementia Rating Scale, diagnosis of dementia and mild cognitive impairment, general medical health, personal and instrumental activities of daily living, neuropsychiatric symptoms and the use of psychotropic medication were evaluated during the three assessments. Baseline demographic characteristics and information on nursing home residency at follow-up were recorded. Linear mixed models were estimated. The baseline prevalence and cumulative incidence of single depressive symptoms were higher in those with dementia at baseline than in those without dementia. The persistence of depressive symptoms did not differ between those with or without dementia at baseline. The severity of cognitive impairment and mean depressive symptom score assessed simultaneously were positively associated, but the strength of the association changed over time and was not significant at the last assessment. Furthermore, being younger, female, in very poor physical health, with neuropsychiatric symptoms and not becoming a nursing home resident were associated with more depressive symptoms when assessed simultaneously. The baseline prevalence and cumulative incidence of depressive symptoms in those with and without dementia at baseline, as well as the relationship we found between the degree of cognitive decline and depressive symptoms over time show that depression and dementia are interconnected. Nurses and clinicians should pay attention to cognitive status when observing or evaluating depression among older adults receiving in-home care.

Depression

Longitudinal Study

Clinical Dementia Rating

10.1186/s12877-019-1226-8

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Citations (30)

Front & Back Matter

Dementia and Geriatric Cognitive Disorders (2011)

C. Annweiler Y. Rolland Anne‐Marie Schott Hubert Blain B. Vellas

10.1159/000337015

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Citations (0)