The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Medical Specialist Hanneke Rhodius-Meester, Amsterdam UMC, The Netherlands
- Second opponent: Professor Kaisu Pitkälä, Department of General Practice and Primary Health Care, University of Helsinki, Finland
- Third member and chair of the evaluation committee: Professor II Christofer Lundqvist, University of Oslo
Chair of the Defence
Professor Emeritus Svein Friis, University of Oslo
Principal Supervisor
MD, PhD Anne-Brita Knapskog, Oslo University Hospital
Summary
Dementia is caused by various neurocognitive diseases leading to decline in cognitive abilities and behaviour to such a degree that it affects the capability to perform everyday tasks. There is, however, great heterogeneity in the rate of decline experienced by patients with dementia.
The aims of this thesis were to identify distinct trajectories of clinical progression rate in various dementia disorders and to assess whether factors from the time of diagnosis were associated with the clinical progression rate.
Patients from two Norwegian memory clinics were included. We assessed the clinical progression rate by applying Group-based trajectory modeling on repeated scores of the Clinical Dementia Rating Scale Sum of Boxes over three years.
Three distinct trajectory groups were identified, and almost half of the patients experienced slow progression.
Regarding factors associated with the underlying pathology of dementia, we found that cognitive impairment at time of diagnosis, neuropsychiatric symptoms (especially affective and psychotic symptoms) and higher levels of phosphorylated tau in the cerebrospinal fluid (CSF) were associated with more-rapid clinical progression rates. Higher levels of sTREM2, a neuroinflammatory marker in the CSF, was associated with slow clinical progression.
Regarding factors related to the affected person, we found that older age was related to more-rapid clinical progression. Further, the overall comorbidity burden was not predictive, but having been diagnosed with a mental disorder previously was associated with slow clinical progression. This may be due to decreased cognitive reserve capacity and early detection of dementia symptoms in patients with mental disorders.
Our results demonstrate that the clinical progression rate in patients with dementia is associated with factors associated with the underlying pathology as well as with factors associated with the affected person. Therefore, follow-up regimes should be individualized.
Additional information
Contact the research support staff.