Gro Gujord Tangen

• Hamre, Charlotta; Fure, Brynjar; Helbostad, Jorunn L.; Wyller, Torgeir Bruun; Ihle-Hansen, Hege; Vlachos, Georgios; Ursin, Marie Helene & Tangen, Gro Gujord (2021). Factors Associated with Level of Physical Activity After Minor Stroke. Journal of Stroke & Cerebrovascular Diseases.  ISSN 1052-3057.  30(4) . doi: 10.1016/j.jstrokecerebrovasdis.2021.105628 Vis sammendrag

  Objectives: To explore factors from the acute phase, and after three and 12 months, associated with level of self-reported physical activity 12 months after a minor ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) score ≤ 3 in persons 70 years or younger. Materials and method: In this longitudinal cohort study patients were recruited consecutively from two stroke units. Activity level were measured with three sets of questions addressing the average number of frequency (times exercising each week), the average intensity, and duration (the average time), and a sum score was constructed. The association between physical activity 12 months after stroke and sociodemographic factors, NIHSS, body mass index, balance, and neuropsychiatric symptoms were explored using multiple linear regression. Results: This study included 101 patients, with mean age (SD) 55.5 (11.4) years, NIHSS median (Q1, Q3) 0.0 (0.0, 1.0), and 20 % were female. Multiple linear regression analyses showed sick leave status at stroke onset, balance at three and 12 months, and anxiety, depression, apathy, and fatigue at 12 months to be factors associated with physical activity at 12 months after stroke. Conclusion: We found that pre-stroke sick leave, post-stroke balance, and neuropsychiatric symptoms were associated with the level of physical activity one year after minor stroke. This might be of importance when giving information about physical activity and deciding about post-stroke follow-up.

• Hamre, Sophia Charlotta; Fure, Brynjar; Helbostad, Jorunn L.; Wyller, Torgeir Bruun; Ihle-Hansen, Hege; Vlachos, Georgios; Ursin, Marie Helene & Tangen, Gro Gujord (2020). Balance and Gait After First Minor Ischemic Stroke in People 70 Years of Age or Younger: A Prospective Observational Cohort Study. Physical Therapy.  ISSN 0031-9023.  100(5), s 798- 806 . doi: 10.1093/ptj/pzaa010 Fulltekst i vitenarkiv. Vis sammendrag

  BACKGROUND: Two-thirds of patients with stroke experience only mild impairments in the acute phase, and the proportion of patients <70 years is increasing. Knowledge about balance and gait and predictive factors are scarce for this group. OBJECTIVE: The objective of this study was to explore balance and gait in the acute phase and after 3 and 12 months in patients <=70 years with minor ischemic stroke (National Institutes of Health Stroke Scale score <=3). This study also explored factors predicting impaired balance after 12 months. DESIGN: This study was designed as an explorative longitudinal cohort study. METHODS: Patients were recruited consecutively from 2 stroke units. Balance and gait were assessed with the Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go, and preferred gait speed. Predictors for impaired balance were explored using logistic regression. RESULTS: This study included 101 patients. Mean (SD) age was 55.5 (11.4) years, 20% were female, and mean (SD) National Institutes of Health Stroke Scale score was 0.6 (0.9) points. The Mini-BESTest, gait speed, and Timed Up and Go improved significantly from the acute phase to 3 months, and gait speed also improved from 3 to 12 months. At 12 months, 26% had balance impairments and 33% walked slower than 1.0 m/s. Poor balance in the acute phase (odds ratio = 0.92, 95% confidence interval = 0.85-0.95) was the only predictor of balance impairments (Mini-BESTest score <=22) at 12 months poststroke. LIMITATIONS: Limitations include lack of information about pre-stroke balance and gait impairment and poststroke exercise. Few women limited the generalizability. CONCLUSION: This study observed improvements in both balance and gait during the follow-up; still, about one-third had balance or gait impairments at 12 months poststroke. Balance in the acute phase predicted impaired balance at 12 months.

• Hamre, Sophia Charlotta; Fure, Brynjar; Helbostad, Jorunn L.; Wyller, Torgeir Bruun; Ihle-Hansen, Hege; Vlachos, Georgios; Ursin, Marie Helene & Tangen, Gro Gujord (2020). Impairments in spatial navigation during walking in patients 70 years or younger with mild stroke. Topics in Stroke Rehabilitation.  ISSN 1074-9357.  27, s 601- 609 . doi: 10.1080/10749357.2020.1755814 Fulltekst i vitenarkiv. Vis sammendrag

  Background: Spatial navigation, the ability to determine and maintain a route from one place to another, is needed for independence in everyday life. Knowledge about impairments in spatial navigation in people with mild stroke is scarce. Objectives: To explore impairments in spatial navigation in patients ≤70 years after first-ever mild ischemic stroke (NIHSS≤3) and to explore which variables are associated with these impairments 12 months later. Methods: Patients were examined in the acute phase, and after 3 and 12 months. To assess impairments in spatial navigation, we used the Floor Maze Test (FMT), with time and FMT-errors as outcomes. Patients’ perceived navigational skills were collected using self-report. Logistic regression was used to explore which variables (sociodemographic data, stroke characteristics, cognition, and mobility) were associated with impaired navigation ability. Results: Ninety-seven patients (20 females) were included. The mean (SD) age was 55.5 (11.4) years. Timed FMT improved significantly from the acute phase to 12 months (p = <.001). At 12 months, 24 (24.7%) of the participants walked through the maze with errors, and 22 (22.7%) reported spatial navigational problems. The Trail Making Test (TMT)-B was the only variable from the acute phase associated with FMT-errors at 12 months, and being female was the only variable associated with self-reported navigational problems at 12 months. Conclusion: Nearly one in four patients experienced spatial navigation problems 12 months after a mild stroke. Executive function (TMT-B), measured in the acute phase, was associated with navigational impairments (FMT-errors) at 12 months, and being female was associated with self-reported navigational problems

• Hesseberg, Karin; Tangen, Gro Gujord; Pripp, Are Hugo & Bergland, Astrid (2020). Associations between Cognition and Hand Function in Older People Diagnosed with Mild Cognitive Impairment or Dementia. Dementia and geriatric cognitive disorders extra.  ISSN 1664-5464.  10, s 195- 204 . doi: 10.1159/000510382 Vis sammendrag

  Background/Aims: The aim of this study was to examine the associations between different cognitive domains and hand function in older people diagnosed with mild cognitive impairment (MCI) or dementia. Methods: This study is cross-sectional, including 98 community-living older people aged ≥65 years with MCI or dementia. Assessments of hand function included grip strength, the Finger Tapping Test, and the Grooved Pegboard. Cognitive assessments were the Mini-Mental State Examination, the Clock Drawing Test, and Trail Making Tests A and B, as well as a 10-word List Learning Test. Statistical analyses were based on descriptive statistics and univariable and multivariable analyses. Results: Sixty participants were diagnosed with MCI and 38 were diagnosed with dementia. The mean age was 78.8 years (SD 7.4). Analyses of hand function, cognitive tests, and demographic factors showed an association between cognitive tests, in particular executive function (EF), and hand function. Conclusions: The findings indicated an association between physical and cognitive function. Among the cognitive domains, declines in EF were most related to a reduced physical function.

• Leão, Luana Lemos; Tangen, Gro Gujord; Barca, Maria Lage; Engedal, Knut; Santos, Sérgio Henrique S.; Machado, Frederico Sander M.; de Paula, Alfredo Maurício B. & Monteiro-Junior, Renato Sobral (2020). Does hyperglycemia downregulate glucose transporters in the brain?. Medical Hypotheses.  ISSN 0306-9877.  139 . doi: 10.1016/j.mehy.2020.109614 Vis sammendrag

  Diabetes is a metabolic condition associated with hyperglycemia manifested by the elevation of blood glucose levels occurring when the pancreas decreases or stops the production of insulin, in case of insulin resistance or both. The current literature supports that insulin resistance may be responsible for the memory decline associated with diabetes. Glucose transporters (GLUTs) are a family of proteins involved in glucose transport across biological membranes. GLUT-1 and GLUT-3 are involved in glucose delivery to the brain. Evidence suggests that both transporters are downregulated in chronic peripheral hyperglycemia. Here we show the mechanisms of glucose transport and its influence on cognitive function, including a hypothesis of how peripheral hyperglycemia related genes network interactions may lead to glucose transporters downregulation and its possible consequences.

• Nilsson, Maria H.; Tangen, Gro Gujord; Palmqvist, Sebastian; van Westen, Danielle; Mattsson-Carlgren, Niklas*; Stomrud, Erik & Hansson, Oskar (2020). The effects of Tau, Amyloid, and White Matter Lesions on Mobility, Dual Tasking, and Balance in Older People. The journals of gerontology. Series A, Biological sciences and medical sciences.  ISSN 1079-5006. . doi: 10.1093/gerona/glaa143 Vis sammendrag

  Background This study aimed to investigate whether white matter lesions (WML), β-amyloid- and tau pathologies are independently associated with mobility, dual tasking and dynamic balance performance in older non-demented individuals. Methods We included 299 older people (mean, SD, age: 71.8, 5.6 years) from the Swedish BioFINDER study, whereof 175 were cognitively unimpaired and 124 had mild cognitive impairment (MCI). In multivariable regression analyses, dependent variables included mobility (Timed Up & Go, TUG), dual tasking (TUG with a simultaneous subtraction task, i.e. TUG-Cog, as well as dual task cost), and balance (Figure-of-eight). The analyses were controlled for age, sex, education, diagnosis (i.e. MCI) and comorbidity (stroke, diabetes, and ischemic heart disease). Independent variables included WML volume, and measures of β-amyloid (abnormal CSF Aβ42/40 ratio) and tau pathology (CSF phosphorylated tau, p-tau). Results Multivariable regression analyses showed that an increased WML volume was independently associated with decreased mobility, i.e. TUG (standardized β=0.247; p<0.001). Tau pathology was independently associated with dual tasking both when using the raw data of TUG-Cog (β=0.224; p=0.003) and the dual task cost (β= -0.246; p=0.001). Amyloid pathology was associated with decreased balance, i.e. Figure-of-eight (β= 0.172; p=0.028). The independent effects of WML and tau pathology were mainly observed in those with MCI, which was not the case for the effects of amyloid pathology on balance. Conclusions Common brain pathologies have different effects where WML are independently associated with mobility, tau pathology has the strongest effect on dual tasking and amyloid pathology seems to be independently associated with balance. Although these novel findings need to be confirmed in longitudinal studies, they suggest that different brain pathologies have different effects on mobility, balance and dual tasking in older non-demented individuals.

• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Saltyte Benth, Jurate; Røen, Irene Mari; Husebø, Bettina & Tangen, Gro Gujord (2020). Trajectories of physical performance in nursing home residents with dementia. Aging Clinical and Experimental Research.  ISSN 1594-0667.  32, s 2603- 2610 . doi: 10.1007/s40520-020-01499-y Fulltekst i vitenarkiv. Vis sammendrag

  Background In nursing homes (NH) the prevalence of dementia ranges from 50 to 84% and most residents have extensive physical-performance impairments. However, from time of admission, development of physical performance in NH residents with dementia remains unexplored. Aims To explore the overall trend in physical performance, associated characteristics, and groups following distinct trajectories from time of admission, in NH residents with dementia. Methods We followed newly admitted NH residents diagnosed with dementia (N=583) from 47 NHs across Norway for 3 years. Individual assessments were conducted biannually, and main outcome measure was the Short Physical Performance Battery (SPPB). Facility-level characteristics included unit size, staf-to-resident ratio, and quality of the physical environment (Special Care Unit Environmental Quality Scale, SCUEQS). Results From time of admission, NH residents with dementia showed a signifcant overall decline in physical performance. Further, we identifed three distinct trajectory groups with signifcantly diferent baseline physical-performance status (“good,” “moderate,” and “poor”), diferences between groups maintained and all declined across time. Younger age, good general medical health, less-severe dementia, and less musculoskeletal pain were associated with both an average higher overall trend and better baseline group-belonging. Additionally, less apathy and more psychosis were associated with a higher overall trend, and agitation was associated with poorer baseline group-belonging. Conclusions To prevent excessive decline in physical performance in this population, NH clinicians should focus eforts specifcally on assessment of physical performance at admission and on identifcation and management of musculoskeletal pain and neuropsychiatric symptoms. Keywords Physical performance · Trajectories · Dementia · Nursing home

• Tangen, Gro Gujord; Hurum, Jon-Håvard; Karlsen, Ragnhild; Haugan, Kjersti; Frogh, Einar; Skarbekk, Anne Kari & Robinson, Hilde Stendal (2020). Fysisk funksjon hos eldre som går til fysioterapeut i Kongsberg kommune - en tverrsnittundersøkelse. Fysioterapeuten.  ISSN 0016-3384.  8, s 70- 75
• Robinson, Hilde Stendal & Tangen, Gro Gujord (2019). Fysisk aktive eldre og treningsvaner?. Fysioterapeuten.  ISSN 0016-3384.  86(4), s 24- 28 Fulltekst i vitenarkiv.
• Tangen, Gro Gujord; Langballe, Ellen Melbye & Strand, Bjørn Heine (2019). Subjective memory impairment, instrumental activities of daily living and longitudinal effect on mortality among older adults in a population-based cohort study: The HUNT Study. Scandinavian Journal of Public Health.  ISSN 1403-4948. . doi: 10.1177/1403494819885234 Fulltekst i vitenarkiv.
• Tangen, Gro Gujord & Robinson, Hilde Stendal (2019). Measuring physical performance in highly active older adults: associations with age and gender?. Aging Clinical and Experimental Research.  ISSN 1594-0667. . doi: 10.1007/s40520-019-01190-x Fulltekst i vitenarkiv. Vis sammendrag

  Background Higher age is associated with reduced physical capability in the general population. The role of age and gender for physical performance in older adults who exercises regularly is, however, not clear, and there is also a lack of recommendations for outcomes to address physical performance for this population. Aims To explore the associations between physical performance, age and gender, and to examine the suitability and feasibility of clinical field tests for physical performance in active older adults. Methods In this cross-sectional study we included 105 persons, 70–90 years of age, who had exercised regularly for ≥ 12 months. The field tests were Short Physical Performance Battery (SPPB), Timed Up and Go and gait speed for mobility; One-leg standing (OLS) test and Mini-BESTest for balance; Stair test for endurance, 30 s sit-to-stand, and grip strength for muscle strength. Results We found associations between age and physical performance, and the associations were slightly stronger for women. Men performed better on tests of muscle strength, balance and endurance, while no gender differences were found in mobility. Grip strength was not associated with mobility tests for men. All tests were feasible, while SPPB and OLS had ceiling and floor effects that limit their suitability in this population. Conclusions Both age and gender were associated with physical performance. We recommend using the gait speed, Mini-BESTest, 30 s sit-to-stand, grip strength and stair tests to assess physical performance in physically active older adults.

• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Røen, Irene Mari; Kirkevold, Øyvind & Tangen, Gro Gujord (2018). Mobility and cognition at admission to the nursing home – a cross-sectional study. BMC Geriatrics.  ISSN 1471-2318.  18(30) . doi: 10.1186/s12877-018-0724-4 Fulltekst i vitenarkiv.
• Hamre, Charlotta; Botolfsen, Pernille; Tangen, Gro Gujord & Helbostad, Jorunn L. (2017). Interrater and test-retest reliability and validity of the Norwegian version of the BESTest and mini-BESTest in people with increased risk of falling. BMC Geriatrics.  ISSN 1471-2318.  17(92), s 1- 8 . doi: 10.1186/s12877-017-0480-x Fulltekst i vitenarkiv.
• Tangen, Gro Gujord; Bergland, Astrid; Engedal, Knut & Mengshoel, Anne Marit (2017). The importance of parkinsonian signs for gait and balance in patients with Alzheimer's disease of mild degree.. Gait & Posture.  ISSN 0966-6362.  51, s 159- 161 . doi: 10.1016/j.gaitpost.2016.10.009 Fulltekst i vitenarkiv.
• Tangen, Gro Gujord; Engedal, Knut; Bergland, Astrid; Moger, Tron Anders; Hansson, Oskar & Mengshoel, Anne Marit (2015). Spatial navigation measured by the Floor Maze Test in patients with subjective cognitive impairment, mild cognitive impairment, and mild Alzheimer's disease. International Psychogeriatrics.  ISSN 1041-6102.  27(8), s 1401- 1409 . doi: 10.1017/S1041610215000022 Fulltekst i vitenarkiv. Vis sammendrag

  Background: Impaired spatial navigation is an early sign of Alzheimer's disease (AD), but this can be difficult to assess in clinical practice. We examined how the performance on the Floor Maze Test (FMT), which combines navigation with walking, differed between patients with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and mild AD. We also explored if there was a significant relationship between the FMT and the cognitive tests or sociodemographic factors. Methods: The study included 128 patients from a memory clinic classified as having SCI (n = 19), MCI (n = 20), and mild AD (n = 89). Spatial navigation was assessed by having the patients walk through the FMT, a two-dimensional maze. Both timed measures and number of errors were recorded. Cognitive function was assessed by the Word List Memory test, the Clock Drawing test, the Trail Making tests (TMT) A and B, and the Mini Mental Status Examination (MMSE). Results: The patients with MCI were slower than those with SCI, while the patients with mild AD more frequently completed the FMT with errors or gave up than the patients with MCI. Performance on the FMT was significantly associated with executive function (measured by TMT-B). Conclusions: The performances on the FMT worsened with increasing severity of cognitive impairment, and the FMT was primarily associated with executive function. The explained variance was relatively low, which may indicate that the standard cognitive test battery does not capture impairments of spatial navigation.

• Tangen, Gro Gujord; Engedal, Knut; Bergland, Astrid; Moger, Tron Anders & Mengshoel, Anne Marit (2014). Relationships between balance and cognition in patients with subjective cognitive impairment, mild cognitive impairment, and Alzheimer disease. Physical Therapy.  ISSN 0031-9023.  94(8), s 1123- 1134 . doi: 10.2522/ptj.20130298 Fulltekst i vitenarkiv.
• Tangen, Gro Gujord; Londos, Elisabet; Olsson, Johan; Minthon, Lennart & Mengshoel, Anne Marit (2012). A Longitudinal Study of Physical Function in Patients with Early-Onset Dementia. Dementia and geriatric cognitive disorders extra.  ISSN 1664-5464.  2(1), s 622- 631 . doi: 10.1159/000345782)

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• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Thingstad, Pernille & Tangen, Gro Gujord (2019). Associations between mobility and dementia subtypes in nursing home residents.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Røen, Irene Mari; Kirkevold, Øyvind & Tangen, Gro Gujord (2018). Fysisk funksjon og grad av demens ved innleggelse i sykehjem.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Røen, Irene Mari; Kirkevold, Øyvind & Tangen, Gro Gujord (2018). Mobility and cognition at admission to the nursing home.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Thingstad, Pernille & Tangen, Gro Gujord (2018). Associations between mobility and dementia subtypes in nursing home residents.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Thingstad, Pernille & Tangen, Gro Gujord (2018). Fysisk funksjon og sammenheng med demensdiagnose i sykehjem.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Thingstad, Pernille & Tangen, Gro Gujord (2018). MOBILITY AND ASSOCIATIONS WITH DEMENTIA DIAGNOSIS IN NURSING HOME RESIDENTS.
• Tangen, Gro Gujord (2018). Motoriske symptomer, I: Knut Engedal & Per Kristian Haugen (red.),  Demens - sykdommer, diagnostikk og behandling.  Forlaget aldring og helse - akademisk.  ISBN 9788280613394.  Kapittel 3.
• Tangen, Gro Gujord; Bergland, Astrid; Engedal, Knut & Mengshoel, Anne Marit (2018). Author response to the letter “The association of bradykinesia and balance control in patients with Alzheimer’s disease?”. Gait & Posture.  ISSN 0966-6362.  60, s 48- 49 . doi: 10.1016/j.gaitpost.2017.11.013
• Tangen, Gro Gujord; Knapskog, Anne Brita; Mengshoel, Anne Marit & Selbæk, Geir (2018). Romlig orienteringsevne hos personer med kognitiv svikt - betydning for fysisk funksjon og aktivitet.
• Tangen, Gro Gujord; Langballe, Ellen Melbye & Strand, Bjørn Heine (2018). The prognostic role of problems with memory and complex ADL for mortality in the HUNT3 70+ Study.
• Tangen, Gro Gujord & Robinson, Hilde Stendal (2018). Bruk av standardiserte tester.
• Tangen, Gro Gujord & Robinson, Hilde Stendal (2018). HVILKE FYSISKE TESTER ER EGNET FOR EVALUERING AV FYSISK FUNKSJON HOS ELDRE SOM TRENER REGELMESSIG?.
• Tangen, Gro Gujord & Robinson, Hilde Stendal (2018). Physical performance in elderly who exercise regularly - associations with age and gender.
• Tangen, Gro Gujord; Selbæk, Geir; Knapskog, Anne Brita & Taraldsen, Kristin (2018). Spatial navigation in persons with cognitive impairment – an explorative study of assessment methods and the relationship to physical activity and physical function.
• Robinson, Hilde Stendal & Tangen, Gro Gujord (2017). Eldre som trener regelmessig – hvem, hva, hvor, hvorfor?.
• Sverdrup, Karen; Bergh, Sverre; Selbæk, Geir; Røen, Irene Mari; Kirkevold, Øyvind & Tangen, Gro Gujord (2017). Mobility and cognition in nursing home residents.
• Tangen, Gro Gujord (2017). No association between depressive symptoms and gait or balance in patients with cognitive impairments and Alzheimer’s disease.
• Tangen, Gro Gujord (2017). The physiotherapist in dementia diagnosis: Gait and dementia.
• Tangen, Gro Gujord & Robinson, Hilde Stendal (2017). Fysisk funksjon og sammenheng med alder og kjønn hos eldre som trener regelmessig.
• Tangen, Gro Gujord (2016). Kognitiv svikt og demens, I: Jorunn L. Helbostad; Randi Granbo & Håvard Østerås (red.),  Aldring og bevegelse. Fysioterapi for eldre.  Gyldendal Akademisk.  ISBN 9788205493957.  10.  s 259 - 276
• Tangen, Gro Gujord (2016). Spatial orientation in persons with mild cognitive impairment and Alzheimer’s disease – importance for physical function and activity.
• Tretteteig, Signe; Tangen, Gro Gujord & Storjord, May-Britt (2016). Miljøbehandling - ulike arbeidsformer og aktiviteter, I: Signe Tretteteig (red.),  Demensboka. Lærebok for helse- og omsorgspersonell.  Forlaget Aldring og helse.  ISBN 978-82-8061-260-1.  Kapittel 19.  s 325 - 365

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