Bjørn Heine Strand

Norwegian Institute of Public Health · Department of Physical Health and Ageing

Background While occupational physical hazards are related to physical decline in older adulthood, less is known about cognitive outcomes. We hypothesize that greater life course occupational physical hazards would be associated with higher mild cognitive impairment (MCI) and dementia risk. Methods Data were from the Trøndelag Health Study, a popu...

To provide accurate estimations of physical activity (PA) in epidemiological research and population studies, the use of accelerometers has skyrocketed over the past decade. However, implementation of accelerometers to accurately estimate PA in people with dementia is lagging. This population-based, cross-sectional study aimed to quantify daily PA...

INTRODUCTION It is unclear how midlife depression and anxiety affect dementia risk. We examined this in a Norwegian cohort followed for 30 years. METHODS Dementia status at age 70+ in the fourth wave of the Trøndelag Health Study (HUNT4, 2017–2019, N = 9745) was linked with anxiety and depression from HUNT1 (1984–1985), HUNT2 (1995–1997), HUNT3 (2...

Background Frailty is strongly correlated with mortality in intensive care unit patients, yet routine screening among intensive care patients is rarely performed. The aim of this study is to assess frailty and health‐related quality of life (HRQoL) in patients before intensive care admission and to compare this with outcomes after 3 and 12‐months....

Background Frailty in older people is a rising global health concern; therefore, monitoring prevalence estimates and presenting projections of future frailty are important for healthcare planning. Aim To present current prevalence estimates of frailty and pre-frailty and future projections according to both dominant frailty models in a large popul...

Paradoxical associations have been observed for leisure-time physical activity (LTPA) and occupational physical activity (OPA) and several health-related outcomes. Typically, higher LTPA is associated with health benefits and high OPA with health hazards. Using data from the Tromsø Study (2015-2016), we assessed how questionnaire-based LTPA and OPA...

More women are living with dementia than men worldwide and there is a need to investigate causes for this female preponderance. While reproductive factors have been investigated as risk factors, the results are conflicting. We aim to clarify this using a large cohort with a long observation time, adjusting for multiple health and lifestyle variable...

Background: A timely diagnosis of dementia can be beneficial for providing good support, treatment, and care, but the diagnostic rate remains unknown and is probably low. Objective: To determine the dementia diagnostic rate and to describe factors associated with diagnosed dementia. Methods: This registry linkage study linked information on researc...

Background Older adults and people with dementia were anticipated to be particularly unable to use health and care services during the lockdown period following the COVID-19 pandemic. To better prepare for future pandemics, we aimed to investigate whether the use of health and care services changed during the pandemic and whether those at older age...

Background and objectives: The cognitive reserve hypothesis posits that cognitively stimulating work delays the onset of mild cognitive impairment (MCI) and dementia. However, the effect of occupational cognitive demands across midlife on the risk of these conditions is unclear. Methods: Using a cohort study design, we evaluated the association...

Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants ( N =5739) aged 50–70 years with baseline self-reported overall health and health-related factor...

Background With the global population growing older, there is a need for more knowledge of how to improve and/or maintain functional capacities to promote healthy ageing. In this study we aimed to assess the effect of several known health-promoting behaviors in old age with intrinsic capacity ten years later. Methods This was a prospective cohort...

The cognitive reserve hypothesis posits that cognitively stimulating work may delay onset of mild cognitive impairment (MCI) and dementia. However, the impact of work histories across midlife on the risk of these conditions is unclear. We evaluated trajectories of work-related cognitive demands from ages 33-65y and their association with later clin...

Objective Age, sex, education, memory, and the APOE e4 allele are related to Alzheimer’s disease (AD) risk. Recently it was suggested that low body mass index (BMI) contributes to the development of AD. The objective of this study was to examine how delayed recall of a word list was influenced by demographic variables, APOE and BMI in people with m...

There is a well-known association between education and dementia risk. However, there is limited knowledge of the mediating mechanisms. Using data from the HUNT study linked with registries (n=9745), we examined the mediating role of occupation complexity, smoking, physical inactivity, systolic blood pressure, body mass index(BMI), cardiovascular d...

Background Hearing impairment is strongly associated with future dementia. No studies have reported objectively measured hearing impairment in a cohort with a long period of follow-up (>20 years), and few have reported follow-up over 10 years. Hence, there is a need for high quality studies with sufficient follow-up time and data to account for rev...

Hand grip strength (HGS) is a key indicator of intrinsic capacity and has shown good predictive ability for morbidity and mortality. Reference values from normative populations are valuable, and such data from the Norwegian population are scarce. Normative values for the digital Jamar+ dynamometer are largely lacking.HGS was assessed in the Norwegi...

Background: Widely adopted criteria suggest using either low handgrip strength or poor chair stand performance to identify probable sarcopenia. However, there are limited direct comparisons of these measures in relation to important clinical endpoints. We aimed to compare associations between these two measures of probable sarcopenia and all-cause...

Background With rapidly rising life expectancy and ageing populations, interest has grown in the survival patterns and ages at death at the highest ages. In Scandinavia, the accumulation of very old population segments coupled with long-established, high-quality population registers permit meaningful analysis. Methods This study is based on indivi...

The aging population and increasing evidence of the detrimental health impacts of loneliness emphasize the importance of studying and predicting changes in loneliness prevalence among older adults. To understand and project changes in loneliness over time, we examined 35-year trends in adults aged 70 and older, considering factors such as sex, age,...

Background High levels of occupational physical activity (PA) have been linked to an increased risk of dementia. We assessed the association of trajectories of occupational PA at ages 33–65 with risk of dementia and mild cognitive impairment (MCI) at ages 70+. Methods We included 7005 participants (49.8% were women, 3488/7005) from the HUNT4 70+ S...

Background Pre-frailty is an intermediate, potentially reversible state before the onset of frailty. Healthy dietary choices may prevent pre-frailty. Fish is included in most healthy diets, but little is known about the association between long-term habitual fish intake and pre-frailty. We aimed to elucidate the longitudinal association between the...

Background: Research shows that retirement age is associated with later-life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later-life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior...

Background: The number of people with dementia is expected to triple by 2050. We present figures showing the prevalence of dementia and mild cognitive impairment in Trondheim, and show how weighting for non-response and nursing home residency affects these figures when comparing Trondheim with Nord-Trøndelag. Material and method: In the fourth d...

Physical activity (PA) might influence the risk or progression of chronic pain through pain tolerance. Hence, we aimed to assess whether habitual leisure-time PA level and PA change affects pain tolerance longitudinally in the population. Our sample (n = 10,732; 51% women) was gathered from the sixth (Tromsø6, 2007–08) and seventh (Tromsø7, 2015–16...

Background: Older age is associated with poorer outcomes to COVID-19 infection. The Norwegian Institute of Public Health established a longitudinal cohort of adults aged 65-80 years to study the effects of the COVID-19 pandemic. Here we describe the characteristics of the cohort in general, and specifically the immune responses at baseline and aft...

Background: Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. Aim: We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. Methods: T...

This study investigates the relationships between subjective age, intrinsic capacity, functional ability and health among Norwegians aged 60 years and older. The Norwegian Survey of Health and Ageing (NORSE) is a population-based, cross-sectional study of home-dwelling individuals aged 60–96 years in the former county of Oppland. Age- and sex-adjus...

Despite evidence suggesting that insomnia is associated with the risk of dementia and cognitive dysfunction, studies have shown mixed results. Dementia has a long prodromal phase, and studies with long follow‐up are required to avoid reverse causality. In our 11‐year follow‐up study, we assessed whether probable insomnia disorder (PID) based on dia...

Introduction Among older adults who are living alone, social isolation, and physical and cognitive impairment are more common than among those who do not live alone. The proportion of older adults who live alone is expected to increase further. The current study investigated the disability and formal care service use among older adults living alone...

Introduction Life expectancy (LE) is increasing worldwide, while there is a lack of information on years of home-based formal care use among the aging population. The current study examined the trend of LE for formal care use among Norwegian older adults over three decades 1995-2016 in Norway. Methods A total of 25,263 participants aged 70+ were i...

Background: Hand grip strength (HGS), a common proxy of whole-body muscular strength, is associated with a wide range of adverse health outcomes and mortality. However, there are limited data on the association between HGS and risk of venous thromboembolism (VTE). Objectives: We aimed to investigate the association between HGS and risk of incide...

Objectives: Earlier studies suggest that being married in later life protects against dementia, and that being single in old age increases the risk of dementia. In this study, we examine midlife marital status trajectories and their association with dementia and mild cognitive impairment (MCI) at ages 70 plus using a large population based sample f...

Background Differences in survival between groups may reflect avoidable and modifiable inequalities. This study examines the 35-year mortality risk for adults aged 25–44 years in the mid-1980s with disability due to vision, hearing, or motor impairment; physical illness; or mental health problems. Methods This Norwegian study was based on data fro...

Background Population-based studies on physical performance provide important information on older people’s health but rarely include the oldest and least-healthy segment of the population. The aim of this study was to provide representative estimates of physical performance by age, sex, and educational level based on recent data from a population-...

Epidemiological literature on the relationship between physical activity and chronic pain is scarce and inconsistent. Hence, our aim was to assess the relationship applying comprehensive methodology, including self-reported and accelerometer measures of physical activity and different severity levels of chronic pain. We used data from the Tromsø St...

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 diag...

Background: Protein intake is suggested as an important dietary factor in the prevention of frailty, however, the influence of lifelong intake remains unclear. Objectives: The present study investigated the relationship between daily protein intake and patterns of protein intake over 21 years and the risk of pre-frailty/frailty. Design: Prospe...

[This corrects the article DOI: 10.1007/s10433-022-00698-y.].

Background: Population-based studies on physical performance provide important information on older people’s health but rarely include the oldest and least-healthy segment of the population. The aim of this study was to provide representative estimates of physical performance by age, sex, and educational level based on recent data from a population...

Overall progress in life expectancy (LE) depends increasingly on survival in older ages. The birth cohorts now reaching old age have experienced considerable educational expansion, which is a driving force for the social change and social inequality. Thus, this study examines changes in old age LE by educational attainment in the Nordic countries a...

Introduction Cognitive impairment is one of the main disabilities in dementia. Physical activity (PA) has been suggested as protective for dementia. However, the findings are disparate in studies, and the question of whether this is because of reverse causality is still open. We aimed to explore the association of PA with cognition in people who la...

Background As in other countries, the COVID-19 pandemic has affected Norway’s immigrant population disproportionately, with significantly higher infection rates and hospitalisations. The reasons for this are uncertain. Methods Through the national emergency preparedness register, BeredtC19, we have studied laboratory-confirmed infections with SARS...

AimThe immigrant population continues to increase in Norway, and Somali immigrants and their descendants are presently the largest non-Western group. We have limited knowledge about the health status in this population. The aim of this study was to assess self-perceived health status among Somalis in Norway.Method We used data from a study assessin...

Purpose The Norwegian Survey of Health and Ageing (NORSE) was set up to provide internationally comparable data on ageing in Norway, which includes measured intrinsic capacity and cognitive function. Participants NORSE is a population-based health examination study of seniors aged 60+ from the 1921–1958 birth cohorts in the former Norwegian county...

Innholdsfortegnelse Forord Kapittel 1: Sammendrag og læringspunkter Av Thor Indseth, Jan-Paul Brekke, Abdi Gele, Rojan Tordhol Ezzati, Ingeborg Hess Elgersma, Marte Kjøllesdal, Line Vold, Atle Fretheim, Folkehelseinstituttet Kapittel 2: Covid-19: Påvist smitte, innleggelser, død, testing og reiseaktivitet blant innvandrere i Norge, perioden f...

Background: Patients with Alzheimer's disease (AD) show heterogeneity in clinical progression rate, and we have limited tools to predict prognosis. Amyloid burden from 18F-Flutemetamol positron emission tomography (PET), as measured by standardized uptake value ratios (SUVR), might provide prognostic information. Objective: We investigate whethe...

Background: This study investigated the completion rates, scores and factors associated with non-completion and low scores on physical capability tests in a health survey administered to adults with intellectual disabilities. Method: Assessment comprised body mass index (BMI), the Short Physical Performance Battery (SPPB), the timed up-and-go (TUG)...

Background: Identifying individuals with low grip strength is an initial step in many operational definitions of sarcopenia. As evidence indicates that contemporaneous Russian populations may have lower mean levels of grip strength than other populations in northern Europe, we aimed to: compare grip strength in Russian and Norwegian populations by...

Purpose: The Norwegian Survey of Health and Ageing (NORSE) was set up to provide internationally comparable data on ageing in Norway, which includes measured intrinsic capacity and cognitive function. Participants: NORSE is a population-based health examination study of seniors aged 60+ from the 1929-1959 birth cohorts in the former Norwegian count...

Background: how long older individuals prefer to live given hypothetical adverse changes in health and living conditions has been insufficiently studied. Objectives: the objective of this study is to investigate the relationship between six adverse health and living conditions and preferred life expectancy (PLE) after the age of 60 years. Desig...

Objective Physical capacity and cardiovascular risk profiles seem to be improving in the population. Cognition have been improving due to a birth cohort effect, but evidence is conflicting on whether this improvement remains in the latest decades, and what is causing the changes in our population over 60 years old. We aimed to investigate birth coh...

The aim of this study was to investigate whether cognitive performance was equally influenced by Apolipoprotein E (APOE, with its three alleles, e2, e3, and e4) in patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer’s disease (AD). In addition, we examined a group of patients with a combination of Vascul...

Background Sarcopenia is an age‐related muscle disease primarily characterized by reductions in muscle strength that increases the risk of falls, fractures, cognitive impairment, and mortality. Exercise is currently preferred in prevention and treatment, but it is unknown how different habitual physical activity and sedentary behaviour patterns ass...

Objective It is unknown whether systolic blood pressure (SBP) drop is part of the normal aging process or due to the onset of dementia for some people. SBP drop is referring to the decrease in blood pressure often seen before death. Thus, the aim of this study was to examine whether SBP at time of diagnosis of dementia, mild cognitive impairment, o...

Background: As in other countries, the coronavirus disease 2019 (COVID-19) pandemic has affected Norway's immigrant population disproportionately with significantly higher infection rates and hospitalizations. The reasons for this are uncertain. Methods: Through the national emergency preparedness register, BeredtC19, we have studied laboratory-con...

Aim: Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017. Method: National life table data were...

Since muscles can influence bone growth and vice versa, we examined if level of physical activity and physical capability tests can predict areal bone mineral density (aBMD). Both high activity level and good test performance were associated with higher aBMD, especially in women.IntroductionMuscle influences bone formation and vice versa. Tests of...

Objectives To examine prospectively the association between unmet needs for daytime activities and company and behavioural and psychological symptoms of dementia. Methods We included 451 people with mild or moderate dementia, from eight European countries, who were assessed three times over 12 months. Unmet needs were measured with the Camberwell...

Background: Literature on physical performance in older adults across the cognitive spectrum remains inconclusive, and knowledge on differences between dementia subtypes is lacking. We aim to identify distinct physical-performance deficits across the cognitive spectrum and between dementia subtypes. Methods: 11,466 persons were included from the 7...

Purpose The Timed Up and Go (TUG) test is used to assess a person’s mobility and balance. We aimed to provide updated reference values for TUG performance for the community-dwelling older population according to age and sex, and according to the presence of arthritis and non-communicable diseases (NCDs). Participants and Methods Cross-sectional da...

Socioeconomic inequalities in disability-free life expectancy (DFLE) exist across all European countries, yet the driving determinants of these differences are not completely known. We calculated the impact on educational inequalities in DFLE of equalizing the distribution of eight risk factors for mortality and disability using register-based mort...

Objectives Neuropsychiatric symptoms (NPS) are associated with dementia severity and progression rate. NPS clusters have different neurobiological underpinnings; therefore, their effect on dementia progression may differ. Further, little is known about whether individual comorbidities affect progression rate. We investigated the effect of NPS clust...

Background: Having accurate, up-to-date information on the epidemiology of mild cognitive impairment (MCI) and dementia is imperative. Objective: To determine the prevalence of MCI and dementia in Norway using data from a large population-based study. Methods: All people 70 + years of age, n = 19,403, in the fourth wave of the Trøndelag Health...