Hopp til hovedinnhold

Demens ved Alzheimers sykdom

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Kliniske kriterier oppfylt for både demenssyndromet og Alzheimers demens. Histopatologi karakterisert ved amyloide (senile) plakk, nervefibriller (tau-protein) og nevrontap
Forekomst:
Den hyppigste formen for demens i Norge. Prevalens ca. 60 000 personer. De fleste er eldre enn 65 år 
Symptomer:
Typiske demenssymptomer er betydelig redusert hukommelse i ≥ 6 måneder ved normal bevissthet, reduserte evner til orientering, logisk tenkning, planlegging, språk og kommunikasjon. Dessuten generell handlingssvikt, atferdsendringer og funksjonstap. Nedsatt bevissthet forekommer ved alvorlig demens 
Funn:
Det påvises kognitiv svikt ved standardiserte kognitive tester, svikt av emosjonell kontroll og sviktende funksjonsevne i forhold til dagliglivets funksjoner
Diagnostikk:
Klinisk diagnose. Viktig med komparentopplysninger. Cerebral bildediagnostikk og laboratorieundersøkelser brukes for å utelukke reversible årsaker til kognitiv svikt. Dessuten benyttes funksjonell bildediagnostikk og biomarkører til forskning på Alzheimers sykdom 
Behandling:
Organisering av støttetiltak er hovedbehandlingen. Selv om effekten er begrenset, bør alle pasienter vurderes for medikamentell behandling mot (vanlige) symptomer ved Alzheimers demens, med enten kolinesterasehemmer eller memantin. Bortsett fra alvorlige tilfeller anbefales det hovedsakelig ikke-medikamentell behandling mot atferdsforstyrrelser eller psykiatriske symptomer ved demens (APSD) 
  • Helsedirektoratet. Demens . Nasjonal faglig retningslinje. Først publisert 16.08.2017. Sist faglig oppdatert 03.01.2020. 
  1. Helsedirektoratet. Demens. Nasjonal faglig retningslinje. Først publisert 16.08.2017. Sist faglig oppdatert 31.10.2022. www.helsedirektoratet.no  
  2. McKhann GM, Knopman DS, Chertkow H, et al.. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7(3): 263-9. pmid:21514250 PubMed  
  3. Hyman BT, Phelps CH, Beach TG, et al. National Institute on Aging-Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease. Alzheimers Dement. 2012 Jan;8(1):1-13. doi: 10.1016/j.jalz.2011.10.007. PMID: 22265587 PubMed  
  4. Rongve A, Årsland D, Graff C. Alzheimers sykdom og genetikk. Tidsskr Nor Legeforen 2013; 133: 1449-52. doi:10.4045/tidsskr.12.0873 DOI  
  5. Raulin AC, Doss SV, Trottier ZA, Ikezu TC, Bu G, Liu CC. ApoE in Alzheimer's disease: pathophysiology and therapeutic strategies. Mol Neurodegener. 2022 Nov 8;17(1):72. doi: 10.1186/s13024-022-00574-4. PMID: 36348357; PMCID: PMC9644639.
  6. Alzheimer A. Uber eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift fur Psychiatrie und Psychisch-Gerichtliche Medizin. 1907. 64: 146-148.
  7. Bowler JV. Modern concept of vascular cognitive impairment. Br Med Bull 2007; 83: 291-305. pmid:17675645 PubMed  
  8. Gjøra L, Kjelvik G, Strand BH, et al. Forekomst av demens i Norge. Utgitt av Forlaget aldring og helse 2020. ISBN 978-82-8061-579-4 (PDF). butikk.aldringoghelse.no  
  9. Seshadri, S, Beiser, A, Kelly-Hayes, M, Kase, CS, Au, R et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke 2006; 37(2): 345-50. PMID: 16397184 PubMed  
  10. Nasjonalt senter for aldring og helse. Demens. Fakta om demens. Siden lest 31.01.2023. www.aldringoghelse.no  
  11. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer's disease. Lancet. 2016 Jul 30;388(10043):505-17. Epub 2016 Feb 24.pmid: 26921134 PubMed  
  12. Small GW, Siddarth P, Ercoli LM, et al.. Healthy behavior and memory self-reports in young, middle-aged, and older adults. Int Psychogeriatr 2013; 25(6): 981-9. pmid:23425438 PubMed  
  13. Hunskår S (red.). Allmennmedisin. S. 419. Gyldendal Norsk Forlag AS. Gyldendal Akademisk, 2003.
  14. Breijyeh Z, Karaman R. Comprehensive Review on Alzheimer's Disease: Causes and Treatment. Molecules. 2020 Dec 8;25(24):5789. doi: 10.3390/molecules25245789. PMID: 33302541 PubMed  
  15. Serrano-Pozo A, Frosch MP, Masliah E, Hyman BT. Neuropathological alterations in Alzheimer disease. Cold Spring Harb Perspect Biol. 2011 Sep. 3(9):a006189.
  16. Haass C, De Strooper B. Review: neurobiology - the presenilins in Alzheimer's disease - proteolysis holds the key. Science 1999; 286: 916-19. PubMed  
  17. Green RC, Schneider LS, Amato DA, et al. Effect of tarenflurbil on cognitive decline and activities of daily living in patients with mild Alzheimer disease: A randomized controlled trial. JAMA 2009; 302: 2557-64. Journal of the American Medical Association  
  18. Shea YF, Chu LW, Chan AO, et al.. A systematic review of familial Alzheimer's disease: Differences in presentation of clinical features among three mutated genes and potential ethnic differences. J Fomos Med Assoc 2016 Feb; 115(2): 67-75. pmid:26337232 PubMed  
  19. Knapskog A-B, Engedal K, Selbæk G, Øksengård A-R. Alzheimers sykdom – diagnostikk og behandling. Tidsskr Nor Legeforen 2021. doi:10.4045/tidsskr.20.0919 DOI  
  20. Serrano-Pozo A, Betensky RA, Frosch MP, Hyman BT. Plaque-Associated Local Toxicity Increases over the Clinical Course of Alzheimer Disease. Am J Pathol. 2016 Feb;186(2):375-84. doi: 10.1016/j.ajpath.2015.10.010. Epub 2015 Dec 11. PMID: 26687817; PMCID: PMC4729270.
  21. Gao Y, Tan L, Yu JT, Tan L. Tau in Alzheimer's Disease: Mechanisms and Therapeutic Strategies. Curr Alzheimer Res. 2018;15(3):283-300. doi: 10.2174/1567205014666170417111859. PMID: 28413986. PubMed  
  22. Hampel H, Mesulam MM, Cuello AC, Farlow MR, Giacobini E, Grossberg GT, Khachaturian AS, Vergallo A, Cavedo E, Snyder PJ, Khachaturian ZS. The cholinergic system in the pathophysiology and treatment of Alzheimer's disease. Brain. 2018 Jul 1;141(7):1917-1933. doi: 10.1093/brain/awy132. PMID: 29850777; PMCID: PMC6022632.
  23. Strac DS, Muck-Seler D, Pivac N. Neurotransmitter measures in the cerebrospinal fluid of patients with Alzheimer's disease: a review. Psychiatr Danub. 2015 Mar;27(1):14-24. PMID: 25751428 PubMed  
  24. Scheltens P, De Strooper B, Kivipelto M, et al. Alzheimer's disease. Lancet. 2021 Apr 24;397(10284):1577-1590. doi: 10.1016/S0140-6736(20)32205-4. Epub 2021 Mar 2. PMID: 33667416 PubMed  
  25. Escott-Price V, Shoai M, Pither R, Williams J, Hardy J. Polygenic score prediction captures nearly all common genetic risk for Alzheimer's disease. Neurobiol Aging. 2017 Jan;49:214.e7-214.e11. doi: 10.1016/j.neurobiolaging.2016.07.018. Epub 2016 Aug 5. PMID: 27595457. PubMed  
  26. Jones EL, Mok K, Hanney M, et al. Evidence that PICALM affects age at onset of Alzheimer's dementia in Down syndrome. Neurobiol Aging 2013; 34(10): 2441.e1-5. pmid:23601808 PubMed  
  27. Livingston G, Huntley J, et.al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet 2020 Aug 8;396(10248):413-446. Pmid: 32738937.
  28. Marinelli JP, Lohse CM, Fussell WL, et al. Association between hearing loss and development of dementia using formal behavioural audiometric testing within the Mayo Clinic Study of Aging (MCSA): a prospective population-based study. Lancet Healthy Longev 2022. pmid:36410368 PubMed  
  29. Jiang F, Mishra SR, Shrestha N, et al. Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort. Lancet Public Health 2023; 8: e329-e338. pmid:37062296 PubMed  
  30. Coupland CAC, Hill T, Dening T, et al. Anticholinergic Drug Exposure and the Risk of Dementia A Nested Case-Control Study. JAMA Intern Med 2019; 179: 1084-93. pmid:31233095 PubMed  
  31. Jayadevappa R, Chhatre S, Malkowicz B, et al. Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer. JAMA Netw Open 2019; 2: e196562. pmid:31268539 PubMed  
  32. Sochocka M, Zwolińska K, Leszek J. The Infectious Etiology of Alzheimer's Disease. Curr Neuropharmacol. 2017;15(7):996-1009. PMID: 28294067 PubMed  
  33. Athanasopoulos D, Karagiannis G, Tsolaki M. Recent Findings in Alzheimer Disease and Nutrition Focusing on Epigenetics. Adv Nutr. 2016 Sep 15;7(5):917-27. doi: 10.3945/an.116.012229. PMID: 27633107 PubMed  
  34. Huat TJ, Camats-Perna J, Newcombe EA, et al. Metal Toxicity Links to Alzheimer's Disease and Neuroinflammation. J Mol Biol. 2019 Apr 19;431(9):1843-1868. doi: 10.1016/j.jmb.2019.01.018. Epub 2019 Jan 18. PMID: 30664867 PubMed  
  35. Sachdeva A, Chandra M, Choudhary M, et al. Alcohol-Related Dementia and Neurocognitive Impairment: A Review Study. Int J High Risk Behav Addict 2016 ; 5(3): e27976. pmid:27818965 PubMed  
  36. Hill NL, Mogle J. Alzheimer's disease risk factors as mediators of subjective memory impairment and objective memory decline: protocol for a construct-level replication analysis. BMC Geriatr 2018; 18(1): 260. pmid:30373526 PubMed  
  37. Snowden JS, Thompson JC, Stopford CL, et al. The clinical dianosis of early-onset dementias: diagnostic accuracy and clinicopathological relationships. Brain 2011; : doi: 10.1093/brain/awr189.
  38. Palmer K, Bäckman L, Winblad B, Fratiglioni L. Detection of Alzheimer's disease and dementia in the preclinical phase: population based cohort stud. BMJ 2003; 326: 245-50. British Medical Journal  
  39. Pietroboni AM, Scarioni M, Carandini T, et al.. CSF β-amyloid and white matter damage: a new perspective on Alzheimer's disease. J Neurol Neurosurg Psychiatry 2017 ; Epub Oct 20: jnnp-2017-316603. pmid:29054920 PubMed  
  40. Øksengård AR, Haakonsen M, Dullerud R, Babovic A, Laake K, Engedal K. Bildediagnostiske metoder ved demensutredning. Tidsskr Nor Lægeforen 2002; 122: 710-4. Tidsskrift for Den norske legeforening  
  41. Arevalo-Rodriguez I, Smailagic N, Roque I Figuls M, et al. Mini-Mental State Examination (MMSE) for the detection of Alzheimer`s disease and other dementias in people with mild cognitive impairment (MCI). Cochrane Database Syst Rev. 2015 Mar 5;3:CD010783. doi: 10.1002/14651858.CD010783.pub2 DOI  
  42. Creavin ST, Wisniewski S, Noel-Storr AH, Trevelyan CM, Hampton T, Rayment D, Thom VM, Nash KJE, Elhamoui H, Milligan R, Patel AS, Tsivos DV, Wing T, Phillips E, Kellman SM, Shackleton HL, Singleton GF, Neale BE, Watton ME, Cullum S. Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD011145. DOI: 10.1002/14651858.CD011145.pub2 DOI  
  43. Johnson KA, Schultz A, Betensky RA, et al. Tau positron emission tomographic imaging in aging and early Alzheimer disease. Ann Neurol 2016 Jan; 79(1): 110-9. pmid:26505746 PubMed  
  44. Goldman JS. Genetic testing and counseling in the diagnosis and management of young-onset dementias. Psychiatr Clin North Am 2015; 38(2): 295-308. pmid:25998117 PubMed  
  45. National Institute for Health and Care Excellence (NICE). Dementia: assessment, management and support for people living with dementia and their carers. NICE guideline [NG97] Published date: June 2018 www.nice.org.uk  
  46. Merkuri N, Croy A, Henry S, et al. Comparing and benchmarking national dementia strategies and policies European Dementia Monitor 2017. Alzheimer Europe, 2017
  47. Walsh S, King E, Brayne C. France removes state funding for dementia drugs. BMJ 2019; 367: I6930. doi:10.1136/bmj.l6930 DOI  
  48. Husebo BS, Ballard C, Sandvik R, Nilsen OB, Aarsland D. Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial. BMJ 2012; 343: d4065. BMJ (DOI)  
  49. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database of Systematic Reviews 2012; 9: CD009132. Cochrane (DOI)  
  50. Tricco AC, Soobiah C, Berliner S, et al. Efficacy and safety of cognitive enhancers for patients with mild cognitive impairment: a systematic review and meta-analysis. CMAJ 2013; 185: 1393-401. pmid:24043661 PubMed  
  51. Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database of Systematic Reviews 2006; 1: CD005593. Cochrane (DOI)  
  52. Raina P, Santaguida P, Ismaila A, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: evidence review for a clinical practice guideline. Ann Intern Med 2008; 148: 379-97. Annals of Internal Medicine  
  53. Soysal P, Isik AT, Stubbs B, et al. Acetylcholinesterase inhibitors are associated with weight loss in older people with dementia: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2016 Jun 3 . pmid:27261502 PubMed  
  54. Årsland D, Engedal KA, Nygaard HA, Louhija J, Ulstein I, Holm M. Bruk av kolinesterasehemmere. Tidsskr Nor Lægeforen 2003; 123: 1500-3. PubMed  
  55. Landmark K, Reikvam Å. Kolinesterasehemmere mot demens - nyttig i klinisk praksis?. Tidsskr Nor Legeforen 2008; 128: 294-7. tidsskriftet.no  
  56. Howard RJ, Juszczak E, Ballard CG, et al. Donepezil for the treatment of agitation in Alzheimer's disease. N Engl J Med 2007; 357: 1382-92. PubMed  
  57. Howard R, McShane R, Lindesay J, et al. Donepezil and memantine for moderate-to-severe Alzheimer's disease. N Engl J Med 2012; 366: 957-9. New England Journal of Medicine  
  58. Truong C, Recto C, Lafont C, et al. Effect of Cholinesterase Inhibitors on Mortality in Patients With Dementia: A Systematic Review of Randomized and Nonrandomized Trials. Neurology 2022. PMID: 36096687 PubMed  
  59. Qizilbash N. Treatment of Alzheimer's disease. I: Qizilbash N, Schneider L, Chui H, Tariot P, Brodaty H, Kaye J et al. Evidence-based dementia practice. Oxford: Blackwell Science, 2002: 467 - 588.
  60. Birks JS, Grimley Evans J. Rivastigmine for Alzheimer's disease. Cochrane Database Syst Rev. 2015 ;4:CD001191. PMID: 25858345. PubMed  
  61. Statens legemiddelverk. Terapianbefaling. Nytt om legemidler 2003; 26, nr. 6: 10-6.
  62. O'Brien JT, Ballard CG. Drugs for Alzheimer's disease (ed). BMJ 2001; 323: 123-4. PubMed  
  63. Engedal K, Brækhus A, Gjerstad L. Effekt av legemidler mot demens. Tidsskr Nor Lægeforen 2004; 124: 1641-2. PubMed  
  64. Wilkinson D, Wirth Y, Goebel C. Memantine in patients with moderate to severe Alzheimer's disease: meta-analyses using realistic definitions of response. Dement Geriatr Cogn Disord. 2014;37(1-2):71-85. doi: 10.1159/000353801 DOI  
  65. Winblad B, Poritis N. Memantine in severe dementia: result of the 9M-best study. Int J Geriatr Psychiatry 1999; 14: 135 - 46. PubMed  
  66. McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database of Systematic Reviews 2006, Issue 2. Art. No.: CD003154. DOI: 10.1002/14651858.CD003154.pub5. DOI  
  67. Schneider LS, Dagerman KS, Higgins JPT, McShane R. Lack of evidence for the efficacy of memantine in mild Alzheimer disease. Arch Neurol 2011; e-pub.
  68. Lopez OL, Becker JT, Wahed AS. Long-term effects of the concomitant use of memantine with cholinesterase inhibition in Alzheimer disease. J Neurol Neurosurg Psychiatry 2009; 80: 600-7. PubMed  
  69. Farrimond LE, Roberts E, McShane R. Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review. BMJ 2012; 2: e000917. doi:10.1136/bmjopen-2012-000917 DOI  
  70. Birks J, Grimley Evans J. Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD003120. DOI: 10.1002/14651858.CD003120.pub3. DOI  
  71. Vellas B, Coley N, Ousset PJ, et al. Long-term use of standardised ginkgo biloba extract for the prevention of Alzheimer's disease (GuidAge): a randomised placebo-controlled trial. Lancet Neurol 2012. doi:10.1016/S1474-4422(12)70206-5 DOI  
  72. DeKosky ST, Williamson JD, Fitzpatrick AL et al. Ginkgo biloba for prevention of dementia. JAMA 2008; 300:2253-62. Journal of the American Medical Association  
  73. Snitz BE, O'Meara ES, Carlson MC, et al. Ginkgo biloba for preventing cognitive decline in older adults. JAMA 2009; 302: 2663-70. Journal of the American Medical Association  
  74. Ruths S, Straand J. Antipsykotiske midler mot uro ved demens - medisinsk behandling eller kjemisk atferdsregulering?. Tidsskr Nor Lægeforen 2005; 125: 1672-5. PubMed  
  75. Schneider LS, Dagerman KS, Insel P. Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials. JAMA 2005; 294: 1934-43. Journal of the American Medical Association  
  76. Schneider LS, Tariot PN, Dagerman KS, et al. Effectiveness of atypical antipsychotic drugs in patients with Alzheimer`s disease. N Engl J Med. 2006; 355: 1525-38. PubMed  
  77. Douglas IJ, Smeeth L. Exposure to antipsychotics and risk of stroke: self controlled case series study. BMJ 2008; 337: a1227. BMJ (DOI)  
  78. Ray WA, Chung CP, Murray KT, et al. Atypical antipsychotic drugs and the risk of sudden cardiac death. N Engl J Med 2009; 360: 225-35. New England Journal of Medicine  
  79. Ooms S, Ju YE. Treatment of Sleep Disorders in Dementia. Curr Treat Options Neurol 2016; 18(9): 40. pmid:27476067 PubMed  
  80. Cao B, Rosenblat JD, Brietzke E, et al. Comparative efficacy and acceptability of antidiabetic agents for Alzheimer`s disease and mild cognitive impairment: A systematic review and network meta-analysis. Diabetes Obes Metab. 2018. PMID: 29790638 PubMed  
  81. Bentham P, Gray R, Sellwold E, et al. Aspirin in Alzheiemer's disease (AD 2000): a randomised open-label trial. Lancet Neurol 2008; 7: 41-9. PubMed  
  82. Aisen PS, Schneider LS, Sano M, et al. High-dose B vitamin supplementation and cognitive decline in Alzheimer disease. JAMA 2008; 300: 1774-83. Journal of the American Medical Association  
  83. Malouf R, Grimley Evans J. Folic acid with or without vitamin B12 for the prevention and treatment of healthy elderly and demented people. Cochrane Database Syst Rev 2008; 8: CD004514. Cochrane (DOI)  
  84. Dysken MW, Sano M, Asthana S, et al. Effect of vitamin E and memantine on functional decline in Alzheimer disease. JAMA 2014; 311: 33-44. doi:10.1001/jama.2013.282834 DOI  
  85. Farina N, Llewellyn D, Isaac MGEKN, et al. Vitamin E for Alzheimer`s dementia and mild cognitive impairment. Cochrane Database Syst Rev. 2017; 4: CD002854. PMID: 28418065 PubMed  
  86. Roy S, Weinstock JL, Ishino AS, et al.. Association of Cognitive Impairment in Patients on 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitors. J Clin Med Res 2017 Jul; 9(7): 638-649. pmid:28611866 PubMed  
  87. Burckhardt M, Herke M, Wustmann T, et al. Omega-3 fatty acids for the treatment of dementia. Cochrane Database Syst Rev 2016 11;4:CD009002 Cochrane (DOI)  
  88. Sydenham E, Dangour AD, Lim WS. Omega 3 fatty acid for the prevention of cognitive decline and dementia. Cochrane Database of Systematic Reviews 2012, Issue 6. Art. No.: CD005379. DOI: 10.1002/14651858.CD005379.pub3 DOI  
  89. Atri A, Frölich L, Ballard C, et al. Effect of Idalopirdine as Adjunct to Cholinesterase Inhibitors on Change in Cognition in Patients With Alzheimer Disease Three Randomized Clinical Trials. JAMA 2018; 319: 130-42. pmid:29318278 PubMed  
  90. Kehoe PG, Turner N, Howden B, et al. Safety and efficacy of losartan for the reduction of brain atrophy in clinically diagnosed Alzheimer's disease (the RADAR trial): a double-blind, randomised, placebo-controlled, phase 2 trial. Lancet Neurol 2021. doi:10.1016/S1474-4422(21)00263-5 DOI  
  91. Huang LK, Chao SP, Hu CJ. Clinical trials of new drugs for Alzheimer disease. J Biomed Sci. 2020 Jan 6;27(1):18. doi: 10.1186/s12929-019-0609-7. PMID: 31906949 PubMed  
  92. van Dyck CH, Swanson CJ, Aisen P, et al. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2023 Jan 5;388(1):9-21. doi: 10.1056/NEJMoa2212948. Epub 2022 Nov 29. PMID: 36449413 PubMed  
  93. Graff MJ, Vernooij-Dassen MJ, Thijssen M et al. Community based occupational therapy for patients with dementia and their care givers: randomised controlled trial. BMJ 2006; 333: 1196 201.
  94. Guure CB, Ibrahim NA, Adam MB, et al. Impact of Physical Activity on Cognitive Decline, Dementia, and Its Subtypes: Meta-Analysis of Prospective Studies. Biomed Res Int 2017; 9016924: Epub Feb 7. pmid:28271072 PubMed  
  95. Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry 2012; 169: 946-53. PMID: 22952073 PubMed  
  96. Huntley JD, Gould RL, Liu K, et al. Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ Open. 2015 Apr 2;5(4):e005247. doi: 10.1136/bmjopen-2014-005247 DOI  
  97. Woods B, Aguirre E, Spector AE, Orrell M. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD005562. DOI: 10.1002/14651858.CD005562.pub2. DOI  
  98. Brækhus A. Belastning hos pårørende til pasienter med demenssykdom. DiA, demens i allmennpraksis; 2000: 4.
  99. Waldorff FB, Buss DV, Eckermann A, et al. Efficacy of psychosocial intervention in patients with mild Alzheimer`s disease: the multicentre, rater blinded, randomised Danish Alzheimer Intervention Study (DAISY). BMJ 2012; 345: e4693. BMJ (DOI)  
  100. Livingston G, Kelly L, Lewis-Holmes E, et al. Non-pharmacological interventions for agitation in dementia: systematic review of randomised controlled trials. BJPsych 2014. doi:10.1192/bjp.bp.113.141119 DOI  
  101. Chang YS, Chu H, Yang CY, et al. The efficacy of music therapy for people with dementia: A meta-analysis of randomised controlled trials. J Clin Nurs 2015. doi:10.1111/jocn.12976 DOI  
  102. Forrester LT, Maayan N, Orrell M, et al. Aromatherapy for dementia. Cochrane Database of Syst Rev 2014; 2: CD003150. doi:10.1002/14651858.CD003150.pub2 DOI  
  103. Helsedirektoratet. Kostrådene og næringsstoffer. Inntak av næringsstoffer. 2.6. Alkohol. www.helsedirektoratet.no  
  104. Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003; 348: 2508-16. New England Journal of Medicine  
  105. Wu Z, Pandigama DH, Wrigglesworth J, et al. Lifestyle Enrichment in Later Life and Its Association With Dementia Risk. JAMA Netw Open 2023; 6: 2323690. doi:10.1001/jamanetworkopen.2023.23690 DOI  
  106. Dhana K, Evans DA, Rajan KB, Bennett DA, Morris MC. Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies. Neurology. 2020 Jun 17:10.1212/WNL.0000000000009816. doi: 10.1212/WNL.0000000000009816. PMID: 32554763. PubMed  
  107. Dhana K, Franco OH, Ritz EM, et al. Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study. BMJ 2022; 377: e068390. pmid:35418416 PubMed  
  108. Ryan J, Storey E, Murray AM, et al. Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline. Neurology. 2020 Mar 25. pii: WNL.0000000000009277 PMID: 32213642 PubMed  
  109. McGuinness B, Craig D, Bullock R, et al. Statins for the prevention of dementia. Cochrane Database Syst Rev. 2016 Jan 4;1:CD003160. doi: 10.1002/14651858.CD003160.pub3 DOI  
  110. Panegyres PK, Frencham K. Course and causes of suspected dementia in young adults: a longitudinal study. Am J Alzheimers Dis Other Demen 2007; 22(1): 48-56. pmid:17534002 PubMed  
  111. Nicastro N, Assal F, Seeck M. From here to epilepsy: the risk of seizure in patients with Alzheimer's disease. Epileptic Disord 2016 Mar; 18(1): 1-12. pmid:26907471 PubMed  
  112. Ljøstad U, Myglånd Å. Alzheimer demens. NEL Nevrologi. Sist oppdatert 24.10.2018. nevro.legehandboka.no  
  113. Peters ME, Schwartz S, Han D, et al. Neuropsychiatric Symptoms as Predictors of Progression to Severe Alzheimer's Dementia and Death: The Cache County Dementia Progression Study. Am J Psychiatry 2015. pmid:25585033 PubMed  
  114. Murphy E, Froggatt K, Connolly S, O'Shea E, Sampson EL, Casey D, Devane D. Palliative care interventions in advanced dementia. Cochrane Database Syst Rev. 2016 Dec 2;12(12):CD011513. doi: 10.1002/14651858.CD011513.pub2. Update in: Cochrane Database Syst Rev. 2021 Sep 28;9:CD011513. PMID: 27911489 PubMed  
  • Peter D. Jost, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Dag Årsland, overlege geriatrisk seksjon, Helse Stavanger HF, professor Stavanger Universitetssykehus
  • Ivar B. Mediås, spesialist i allmennmedisin, leder for NSAM referansegruppe i geriatri, Sørum legesenter, Sørumsand
  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim