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This study will examine which impact lockdown strategies intending to prevent the spread of COVID-19 had on people with cognitive impairment and dementia.
Comprehensive data from two large health studies in Norway, conducted before and after the COVID-19 outbreak, will be linked with health register data on the use of health care services and medication. Further, it will be conducted a survey addressing questions on social isolation and use of communicative technology, from March 2020 to January 2021. The knowledge gained from this study can improve the health care system's ability to respond more adequately to pandemics and other unforeseen events, so that the negative consequences for older adults with dementia and cognitive impairment can be reduced.
Introduction: To prevent the spread of COVID-19 societies around the world have implemented various levels of lockdown strategies. Norway locked down major parts of the society from March 2020. Specifically, this meant that public services were closed (e.g. most in-home healthcare services, day care centres, group exercise/gyms and services that offer physiotherapy, medical and psychological consultation). For people with cognitive impairment and dementia, social distancing and self-isolation may have limited the use of normal strategies (e.g., distraction, stimulation, and social interaction) that are routinely adopted to manage some of the dementia symptoms, such as neuropsychiatric symptoms. A lack of daily routines may change the clinical conditions of patients with dementia. Worsening of preexisting and/or the onset of new neuropsychiatric symptoms may occur, in addition to a possible decline of cognitive and functional capacities
Aim: The overarching aim of this project is to provide decision makers with vital information to improve the healthcare of people with dementia and cognitive impairment in the context of an epidemic.
Method: We will use four data sources:1) The fourth wave of the Trøndelag Health study (HUNT, HUNT4 70+), 2) Three national health registries (The Norwegian Patient Registry (NPR), the Norwegian Registry for Primary Health Care (NRPHC) and the Norwegian Prescription Database (NorPD)), 3) A postal questionnaire concerning social isolation during the COVID-19 epidemic, and 4) The Ageing in Trøndelag study (AiT), which is a follow-up of the HUNT4 70+ study.
With this linkage of cohort data and national health registry data, we can identify factors that may make people with cognitive impairment and dementia vulnerable to loss of healthcare services because of COVID-19 and subsequently to negative health consequences.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inhabitants in Nord-Trøndelag 70 years of age and older | All inhabitants in Nord-Trøndelag 70 years of age and older, who participated in the HUNT4 70+-study, between 2017 and 2019. | ||
| Inhabitants in one area in Trondheim, 70 years of age and older | All inhabitants one area in Trondheim, 70 years of age and older, who participated in the HUNT4 70+-study, between 2017 and 2019. |
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| Measure | Description | Time Frame |
|---|---|---|
| Use of Health care services | Information from the Norwegian Patient Registry (NPR) and the Norwegian Registry for Primary Health Care (NRPHC) | The participants' use of health care services from the period 2017-2019 |
| Use of Health care services | Information from the Norwegian Patient Registry (NPR) and the Norwegian Registry for Primary Health Care (NRPHC) | The participants' use of health care services in 2020 |
| Use of Health care services | Information from the Norwegian Patient Registry (NPR) and the Norwegian Registry for Primary Health Care (NRPHC) | The participants' use of health care services from the period 2021-2022 |
| Use of psychotropic medications | Information from the Norwegian Prescription Database (NorPD) | The participants' use of psychotropic medication from the period 2017-2019 |
| Use of psychotropic medications | Information from the Norwegian Prescription Database (NorPD) | The participants' use of psychotropic medication in 2020 |
| Use of psychotropic medications | Information from the Norwegian Prescription Database (NorPD) | The participants' use of psychotropic medication from the period 2021-2022 |
| Measure | Description | Time Frame |
|---|---|---|
| Montreal Cognitive Assessment scale | Tests cognitive function in the domain's memory, visuospatial and executive functions, attention, concentration, language and orientation. Scores from 0 - 30 where 30 indicates best function. impairment or dementia, and questions on subjective memory decline | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Measure | Description | Time Frame |
|---|---|---|
| Short Physical Performance Battery | The test combines the results of the gait speed, chair stand and balance test | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022. |
| Grip strength |
Inclusion Criteria:
Exclusion Criteria:
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Inhabitants living in the designated areas that volunteered to participation in the HUNT4 health survey
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tanja Louise Ibsen | Contact | +95881287 | tanja.ibsen@aldringoghelse.no |
| Name | Affiliation | Role |
|---|---|---|
| Geir Selbaek, PhD | Norwegian National Advisory Unit on Ageing and Health | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Norwegian National Advisory Unit of Ageing and Health | Recruiting | Tønsberg | Norway |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41006671 | Derived | Ibsen TL, Zotcheva E, Bergh S, Gerritsen D, Livingston G, Luras H, Mamelund SE, Rokstad AMM, Strand BH, Voshaar RCO, Selbaek G. Cognitive function, physical function, and mental health in older adults amid reduced primary and specialist healthcare service use during COVID-19: the HUNT study. Geroscience. 2025 Sep 27. doi: 10.1007/s11357-025-01909-x. Online ahead of print. | |
| 40338168 |
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| Type | Date | Date Unknown |
|---|---|---|
| Release | Apr 23, 2026 | |
| Reset | May 14, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Apr 23, 2026 | May 14, 2026 |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D060825 | Cognitive Dysfunction |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D019965 | Neurocognitive Disorders |
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| CERAD Ten-words test | Tests immediate and delayed memory. Scores from 0 - 30 in immediate memory and 0-10 in delayed recall, higher scores indicates better function. | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Incidence of dementia diagnosis | Two clinical and scientific experts will independently set at diagnosis of cognitive impairment or dementia based on all available information applying standard diagnostic criteria DSM-5 | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Incidence of mild cognitive impairment | Two clinical and scientific experts will independently set at diagnosis of cognitive impairment or dementia based on all available information applying standard diagnostic criteria DSM-5 | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
Measured in both hands with a Jamar and digital dynamometer |
| The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022. |
| Blood Pressure | Systolic blood pressure | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Body mass index | Weight and height will be combined to report BMI in kg/m^2 | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Upper arm circumference | The circumference Is measured in centimeters | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| The Hospital Anxiety and Depression scale | Gathers information on anxiety and depression, scores from 0 - 42 where 0 indicates best function | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Alcohol consumption | Innhouse made questionnaire about average alcohol units per week and/or month | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Physical Self-Maintenance scale | Assess problems with personal activities of daily living. Assessed in proxy interview and by health personnel for participants in institutions, scores function in 6 personal activities, lower scores indicates better function | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Instrumental Activities of daily function | Assess problems with instrumental activities of daily living, scores function in 8 instrumental activities, lower scores indicates better function | The participants were assessed when attending the HUNT4 70+-study, and will be assessed with the same measures in the followup study in 2021/2022 |
| Social isolation | Questions on the experience of social isolation as a result of containment measures due to covid-19, including information on the level of isolation; accepting visits from friends, family or health care services, and restrictions about outdoor activities | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 |
| Fear of Covid-19 | A seven-item scale on fear of covid-19, rated on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree) with scores ranging from 7 to 35. The higher the score, the greater the fear of COVID-19 | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 |
| The use of information and communicative technology (ICT) | Questions on the use of ICT, including questions on keeping contact with familly, friend and health care personnel | The participants receive a postal questionnaire in Januar 2021, regarding the period from March 2020-January 20201 |
| Derived |
| Ibsen TL, Zotcheva E, Bergh S, Gerritsen D, Livingston G, Luras H, Mamelund SE, Mork Rokstad AM, Strand BH, Thingstad P, Oude Voshaar RC, Selbaek G. The Role of Social Media in Mitigating the Long-Term Impact of Social Isolation on Mental and Cognitive Health in Older Adults During the COVID-19 Pandemic: The HUNT Study. Int J Geriatr Psychiatry. 2025 May;40(5):e70097. doi: 10.1002/gps.70097. |
| 39920618 | Derived | Ibsen TL, Zotcheva E, Bergh S, Gerritsen D, Livingston G, Luras H, Mamelund SE, Rokstad AMM, Strand BH, Oude Voshaar RC, Selbaek G. A longitudinal cohort study on dispensed analgesic and psychotropic medications in older adults before, during, and after the COVID-19 pandemic: the HUNT study. BMC Geriatr. 2025 Feb 7;25(1):85. doi: 10.1186/s12877-025-05745-8. |
| 38641570 | Derived | Ibsen TL, Strand BH, Bergh S, Livingston G, Luras H, Mamelund SE, Voshaar RO, Rokstad AMM, Thingstad P, Gerritsen D, Selbaek G. A longitudinal cohort study on the use of health and care services by older adults living at home with/without dementia before and during the COVID-19 pandemic: the HUNT study. BMC Health Serv Res. 2024 Apr 19;24(1):485. doi: 10.1186/s12913-024-10846-y. |
| D001523 | Mental Disorders |
| D003072 | Cognition Disorders |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |