{"id":12235,"date":"2025-02-07T19:30:44","date_gmt":"2025-02-07T17:30:44","guid":{"rendered":"https:\/\/fbhi.se\/alzheimerforskning-hyllades-vid-goodes-prize-tioarsjubileum-i-stockholm\/"},"modified":"2026-02-23T12:27:47","modified_gmt":"2026-02-23T11:27:47","slug":"att-forebygga-demens-och-kognitiv-svikt","status":"publish","type":"post","link":"https:\/\/fbhi.se\/sv\/att-forebygga-demens-och-kognitiv-svikt\/","title":{"rendered":"Om evidens och att f\u00f6rebygga kognitiv svikt"},"content":{"rendered":"[vc_row type=&#8221;full_width_background&#8221; full_screen_row_position=&#8221;middle&#8221; column_margin=&#8221;default&#8221; column_direction=&#8221;default&#8221; column_direction_tablet=&#8221;default&#8221; column_direction_phone=&#8221;default&#8221; scene_position=&#8221;center&#8221; top_padding=&#8221;30px&#8221; bottom_padding=&#8221;30px&#8221; text_color=&#8221;dark&#8221; text_align=&#8221;left&#8221; row_border_radius=&#8221;none&#8221; row_border_radius_applies=&#8221;bg&#8221; 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column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_direction_desktop=&#8221;default&#8221; column_element_spacing=&#8221;0px&#8221; desktop_text_alignment=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_backdrop_filter=&#8221;none&#8221; font_color=&#8221;#006885&#8243; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; overflow=&#8221;visible&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;1\/1&#8243; tablet_width_inherit=&#8221;default&#8221; animation_type=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221; column_padding_type=&#8221;default&#8221; gradient_type=&#8221;default&#8221;][vc_column_text]\n<h5><span style=\"color: #333333;\"><strong>FINGER-studiens metod och resultat<\/strong><\/span><\/h5>\n[\/vc_column_text][divider line_type=&#8221;No Line&#8221;][vc_column_text]\n<h3><strong>Om m\u00f6jligheterna att f\u00f6rebygga kognitiv svikt och demens<\/strong><\/h3>\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][divider line_type=&#8221;No Line&#8221;][vc_row_inner equal_height=&#8221;yes&#8221; content_placement=&#8221;top&#8221; column_margin=&#8221;60px&#8221; column_direction=&#8221;default&#8221; column_direction_tablet=&#8221;default&#8221; column_direction_phone=&#8221;default&#8221; text_align=&#8221;left&#8221; row_position=&#8221;default&#8221; row_position_tablet=&#8221;inherit&#8221; row_position_phone=&#8221;inherit&#8221; overflow=&#8221;visible&#8221; pointer_events=&#8221;all&#8221;][vc_column_inner column_padding=&#8221;no-extra-padding&#8221; column_padding_tablet=&#8221;inherit&#8221; column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_direction_desktop=&#8221;default&#8221; column_element_spacing=&#8221;default&#8221; desktop_text_alignment=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_backdrop_filter=&#8221;none&#8221; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; overflow=&#8221;visible&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;2\/3&#8243; tablet_width_inherit=&#8221;default&#8221; animation_type=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221; column_padding_type=&#8221;default&#8221; gradient_type=&#8221;default&#8221;][vc_column_text]<em><span style=\"color: #333333;\">I en <a href=\"https:\/\/www.expressen.se\/kronikorer\/agnes-wold\/jag-ar-glad-att-jag-inte-bor-pa-lidingo\/\" target=\"_blank\" rel=\"noopener\">kr\u00f6nika i Expressen<\/a> (1 februari 2025) ifr\u00e5gas\u00e4tter Agnes Wold den forskning om prevention som bl a ligger till grund f\u00f6r regeringens nya demensstrategi, och n\u00e4mner bland annat FINGER-studien. Vi vill h\u00e4r \u00f6versiktligt redog\u00f6ra f\u00f6r FINGER-studiens metod och resultat, f\u00f6r att klarg\u00f6ra fakta som tycks ha missf\u00f6rst\u00e5tts.<\/span><\/em><\/p>\n<h4>Stark evidens fr\u00e5n m\u00e5nga studier<\/h4>\n<p>F\u00f6rekomsten av kognitiv svikt och demenssjukdomar \u00f6kar snabbt i befolkningen eftersom vi lever allt l\u00e4ngre. H\u00f6g \u00e5lder och \u00e4rftlighet \u00e4r v\u00e4lk\u00e4nda riskfaktorer f\u00f6r demens. Den senaste forskningen och samlad evidens visar dock att 45% av all demens \u00e4r kopplad till livsstils-, h\u00e4lso- och milj\u00f6relaterade faktorer som g\u00e5r att p\u00e5verka (<a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)01296-0\/abstract\" target=\"_blank\" rel=\"noopener\">Lancet Commission, 2024<\/a>).<\/p>\n<p>V\u00e4rldsh\u00e4lsoorganisationen WHO bed\u00f6mer f\u00f6rebyggande \u00e5tg\u00e4rder som en central strategi f\u00f6r att hantera demensepidemin (<a href=\"https:\/\/www.who.int\/publications\/i\/item\/risk-reduction-of-cognitive-decline-and-dementia\" target=\"_blank\" rel=\"noopener\">WHO Risk Reduction Guidelines, 2019<\/a>).<\/p>\n<p>Dessa rekommendationer bygger p\u00e5 ett systematiskt och internationellt etablerat s\u00e4tt att utv\u00e4rdera evidens och tar h\u00e4nsyn till forskningens kvalitet, begr\u00e4nsningar och samst\u00e4mmighet samt det sociala sammanhanget och j\u00e4mlikhet i h\u00e4lsa. Rekommendationerna baseras inte p\u00e5 en enskild studie utan omfattar samlad evidens fr\u00e5n <a href=\"https:\/\/cdn.who.int\/media\/docs\/default-source\/mental-health\/dementia\/dementia_guidelines_evidence_profiles_web_annex.pdf?sfvrsn=e76ab070_3\">hundratals studier<\/a>.<\/p>\n<p>Det \u00e4r d\u00e4rf\u00f6r positivt att <a href=\"https:\/\/www.regeringen.se\/informationsmaterial\/2025\/01\/varje-dag-raknas-nationell-demensstrategi-20252028\/\" target=\"_blank\" rel=\"noopener\">Sveriges nya nationella demensstrategi<\/a> lyfter fram f\u00f6rebyggande \u00e5tg\u00e4rder och vikten av att st\u00f6dja preventiva insatser f\u00f6re och efter demensdiagnos, inom b\u00e5de v\u00e5rd och omsorg. M\u00e5nga andra l\u00e4nder har redan gjort dessa prioriteringar i sina nationella strategier.<\/p>\n<p>Processen som leder till kognitiva sjukdomar och demens kan b\u00f6rja 20\u201330 \u00e5r innan diagnosen st\u00e4lls. D\u00e4rf\u00f6r brukar man s\u00e4ga att det aldrig \u00e4r f\u00f6r tidigt att b\u00f6rja f\u00f6rebygga. Preventiva insatser kan f\u00f6rsena utvecklingen av kognitiv svikt och demens. Forskningsrapporter har estimerat att om demensdebuten kunde skjutas upp med fem \u00e5r, skulle antalet personer med demens halveras.<\/p>\n<h4>FINGER: Livsstilsinterventioner kan f\u00f6rb\u00e4ttra den kognitiva f\u00f6rm\u00e5gan och f\u00f6rebygga kognitiv f\u00f6rs\u00e4mring<\/h4>\n<p>I en <a href=\"https:\/\/www.expressen.se\/kronikorer\/agnes-wold\/jag-ar-glad-att-jag-inte-bor-pa-lidingo\/\" target=\"_blank\" rel=\"noopener\">kr\u00f6nika i Expressen<\/a> (1 februari 2025) ifr\u00e5gas\u00e4tter Agnes Wold den forskning om prevention som ligger till grund f\u00f6r regeringens nya demensstrategi. Hon n\u00e4mner den finsk-svenska <a href=\"https:\/\/fbhi.se\/sv\/finger-studien\/\" target=\"_blank\" rel=\"noopener\">FINGER-studien<\/a>, som <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(15)60461-5\/abstract\" target=\"_blank\" rel=\"noopener\">publicerades f\u00f6r tio \u00e5r sedan i tidskriften Lancet<\/a>. Vi vill d\u00e4rf\u00f6r \u00f6versiktligt redog\u00f6ra f\u00f6r FINGER-studiens metod och resultat, och klarg\u00f6ra vissa fakta som Agnes Wold m\u00e5ste ha missf\u00f6rst\u00e5tt.<\/p>\n<p>FINGER var den f\u00f6rsta randomiserade studien i v\u00e4rlden som visade att kognition kan f\u00f6rb\u00e4ttras, och risken f\u00f6r kognitiv f\u00f6rs\u00e4mring minskas, genom en balanserad kombination av h\u00e5llbara livsstils\u00adf\u00f6r\u00e4ndringar. Under tv\u00e5 \u00e5r leddes och st\u00f6ddes h\u00e4lften av studiedeltagarna i att genomf\u00f6ra och bibeh\u00e5lla f\u00f6r\u00e4ndringar som r\u00f6rde h\u00e4lsosam och varierad kost, regelbunden fysisk aktivitet, kognitiv tr\u00e4ning samt kontroll av blod- och k\u00e4rlrelaterade faktorer. De fick ocks\u00e5 social stimulans i samband med studiens alla delar. Resultaten i den h\u00e4r interventions\u00adgruppen j\u00e4mf\u00f6rdes l\u00f6pande med en lika stor kontrollgrupp, som fick vanlig h\u00e4lsor\u00e5dgivning.<br \/>\nId\u00e9n bakom interventionsmodellen var att \u00e4ven sm\u00e5 f\u00f6r\u00e4ndringar inom flera livsstilsdom\u00e4ner samtidigt kan ge nytta.<\/p>\n<h4>F\u00f6rb\u00e4ttring av b\u00e5de kognition och allm\u00e4n h\u00e4lsa<\/h4>\n<p>I FINGER-studien utv\u00e4rderades effekten med ett kognitivt testbatteri (sammansatt z-po\u00e4ng) som inkluderar 14 olika kognitiva tester, som \u00e4r k\u00e4nsliga b\u00e5de f\u00f6r tidig Alzheimers sjukdom och vaskul\u00e4r kognitiv svikt. Ett kognitivt testbatteri \u00e4r ett standardm\u00e5tt f\u00f6r vetenskaplig utv\u00e4rdering i f\u00f6rebyggande studier, b\u00e5de inom livsstil och farmakologi.<\/p>\n<p>Studien visade en positiv interventionseffekt p\u00e5 den totala kognitionen (f\u00f6r\u00e4ndring i z-po\u00e4ng 0.20 f\u00f6r inter\u00adventions\u00adgruppen och 0.16 f\u00f6r kontrollgruppen) och p\u00e5 olika kognitiva funktioner. B\u00e5da gruppernas kognition blev b\u00e4ttre, vilket ofta h\u00e4nder i f\u00f6rebyggande studier, men interventionsgruppen hade<\/p>\n<ul>\n<li>25% st\u00f6rre f\u00f6rb\u00e4ttring i den globala kognitionen (prim\u00e4rt utfallsm\u00e5tt),<\/li>\n<li>83% st\u00f6rre f\u00f6rb\u00e4ttring i exekutiv funktion (planering, probleml\u00f6sning),\u00a0 och<\/li>\n<li>150% st\u00f6rre f\u00f6rb\u00e4ttring i psykomotorisk snabbhet (hur snabbt och smidigt man kan utf\u00f6ra olika uppgifter).<\/li>\n<\/ul>\n<p>De totala minnesfunktionerna f\u00f6rb\u00e4ttrades inte. Dock hade interventionsgruppen 40% st\u00f6rre f\u00f6rb\u00e4ttring i komplexa minnesuppgifter j\u00e4mf\u00f6rt med kontrollgruppen. Personer med genetisk risk (b\u00e4rare av den mest k\u00e4nda riskgenen, APOE4) fick tydlig nytta av interventionen.<\/p>\n<p>Kontrollgruppen hade dessutom 30% st\u00f6rre risk att utveckla kognitiv f\u00f6rs\u00e4mring efter tv\u00e5 \u00e5r, j\u00e4mf\u00f6rt med interventionsgruppen.<\/p>\n<p>F\u00f6rutom de kognitiva effekterna hade deltagarna i interventionsgruppen en f\u00f6rb\u00e4ttring eller stabilisering i funktionsniv\u00e5 i dagliga aktiviteter (Activities of Daily Living; ADL-och IADL-skala) medan kontrollgruppen blev s\u00e4mre. De hade \u00e4ven b\u00e4ttre h\u00e4lsorelaterad livskvalitet, utv\u00e4rderad med etablerade skalor.<\/p>\n<p>Risken f\u00f6r stroke och kardiovaskul\u00e4ra sjukdomar minskade med 20% i interventionsgruppen j\u00e4mf\u00f6rt med kontrollgruppen (50% hos dem som tidigare hade haft hj\u00e4rt-k\u00e4rlsjukdom) och risken f\u00f6r multisjuklighet (att utveckla tre eller fler sjukdomar) minskade med hela 60%. Alla dessa resultat \u00e4r publicerade i granskade vetenskapliga tidskrifter.<\/p>\n<h4>Utfallsm\u00e5tt: F\u00f6r\u00e4ndring<\/h4>\n<p>Agnes Wold verkar ha misstolkat viktiga delar av FINGER-studiens resultat. Det f\u00f6rbest\u00e4mda prim\u00e4ra utfallsm\u00e5ttet var <strong><em>f\u00f6r\u00e4ndring<\/em><\/strong><em> i det kognitiva testbatteriet<\/em> efter 2 \u00e5r. F\u00f6r\u00e4ndring \u00f6ver tid \u00e4r ett standardm\u00e5tt i randomiserade kliniska studier d\u00e4r man m\u00e4ter kognitiva funktioner.<\/p>\n<p>Metod och utfallsm\u00e5tt specificerades noggrant i f\u00f6rv\u00e4g. Forskargruppen f\u00e5r sedan inte avvika fr\u00e5n protokollet. De statistiska analyser vi anv\u00e4nde i FINGER-studien \u00e4r allts\u00e5 standardanalyser f\u00f6r en randomiserad studie och j\u00e4mf\u00f6rde f\u00f6r\u00e4ndring i kognition mellan grupperna. Interventionsgruppen f\u00f6rb\u00e4ttrades signifikant mer i det prim\u00e4ra utfallet (p v\u00e4rde 0.022) och i flera kognitiva subdom\u00e4ner.<\/p>\n<p>I randomiserade studier som FINGER testas interventionsgruppen och kontrollgruppen lika ofta. I FINGER gjordes tester i b\u00f6rjan samt efter ett och tv\u00e5 \u00e5r. Det var allts\u00e5 ingen skillnad i hur ofta de b\u00e5da grupperna exponerades f\u00f6r testerna. De kognitiva testerna var dessutom olika den kognitiva tr\u00e4ningen i utformning och inneh\u00e5ll, just f\u00f6r att undvika denna typ av p\u00e5verkan. Den kognitiva tr\u00e4ningen, som ingick i interventionsgruppens program, gjordes\u00a0 med hj\u00e4lp av digitala tr\u00e4ningsprogram. De kognitiva testerna var inte digitala.<\/p>\n<p>Det \u00e4r ocks\u00e5 viktigt att notera att det inte \u00e4r m\u00f6jligt att ha en ren placebogrupp i en livsstilsintervention. Av etiska sk\u00e4l fick \u00e4ven kontrollgruppen i FINGER-studien r\u00e5dgivning om risk- och skyddsfaktorer och tr\u00e4ffade studiepersonalen ca 14 g\u00e5nger under den tv\u00e5\u00e5riga studieperioden.<\/p>\n<h4>Stor effekt p\u00e5 befolkningsniv\u00e5<\/h4>\n<p>Agnes Wold p\u00e5pekar att effektstorleken \u00e4r liten men \u2019effect size\u2019 (Cohens d v\u00e4rde) m\u00e5ste tolkas i r\u00e4tt sammanhang. Effektstorlek i FINGER-studien \u00e4r relativt liten, s\u00e5som kan f\u00f6rv\u00e4ntas vid kroniska multifaktoriella sjukdomar.<\/p>\n<p>Inom f\u00f6rebyggande arbete talar man om <em>prevention paradox<\/em>, det vill s\u00e4ga att \u00e4ven en relativt m\u00e5ttlig effekt p\u00e5 individniv\u00e5 kan leda till stora effekter p\u00e5 befolkningsniv\u00e5. I Sverige finns redan idag rapporter som visar att den relativa risken f\u00f6r demens har minskat, till stor del p\u00e5 grund av livsstilsrelaterade faktorer som f\u00f6rb\u00e4ttrats under de senaste decennierna, \u00e4ven om det totala antalet fall \u00f6kar p\u00e5 grund av en \u00e5ldrande befolkning. Det finns allts\u00e5 stor potential att f\u00f6rb\u00e4ttra hj\u00e4rnh\u00e4lsan i Sverige med f\u00f6rebyggande insatser.<\/p>\n<h4>F\u00f6ljsamhet gav effekt<\/h4>\n<p>F\u00f6ljsamhet har stor betydelse f\u00f6r resultat. Effekten var betydligt starkare hos de deltagare i interventionsgruppen som gjorde minst h\u00e4lften av vad som f\u00f6reskrevs i programmet, j\u00e4mf\u00f6rt med deltagare som inte f\u00f6ljde programmet eller med kontrollgruppen. En central fr\u00e5ga \u00e4r allts\u00e5 hur en tillr\u00e4cklig niv\u00e5 av h\u00e4lsosamma livsstilsf\u00f6r\u00e4ndringar b\u00e4st kan underl\u00e4ttas och st\u00f6djas. I m\u00e5nga nya interventions- och implementeringsstudier har man tagit fasta p\u00e5 dessa l\u00e4rdomar fr\u00e5n FINGER-studien.<\/p>\n<h4>Preventionsstudier kr\u00e4ver l\u00e5ng uppf\u00f6ljningstid<\/h4>\n<p>Demenssjukdomar utvecklas under m\u00e5nga \u00e5r. I FINGER-studien hade deltagarna inga tydliga kognitiva symptom n\u00e4r studien startade och demens var inte ett prim\u00e4rt utfallsm\u00e5tt. Det kr\u00e4vs en studietid p\u00e5 minst 15 \u00e5r f\u00f6r att dra s\u00e5dana vetenskapliga slutsatser. Det prim\u00e4ra utfallsm\u00e5ttet i FINGER var som sagt <em>f\u00f6r\u00e4ndring i kognitiv f\u00f6rm\u00e5ga<\/em>. Dessutom uppskattades risken att utveckla demens med hj\u00e4lp av olika, vetenskapligt bepr\u00f6vade, skalor, exempelvis riskpo\u00e4ngsystemet CAIDE. Resultatet visade att den uppskattade risken f\u00f6r demens minskade i interventionsgruppen. Deltagarna har hittills f\u00f6ljts upp under elva \u00e5r, vilket kommer att ge v\u00e4rdefull information om f\u00f6ljsamhet efter interventionen och hur den p\u00e5verkar kognitionen och h\u00e4lsan.<\/p>\n<p>Agnes Wold n\u00e4mner, utan att namnge dem, tv\u00e5 studier som hade <em>demensdiagnos<\/em> som utfallsm\u00e5tt och d\u00e4r livsstilsinterventioner inte hade effekt. Vi vet inte vilka studier hon syftar p\u00e5, men det \u00e4r som sagt om\u00f6jligt att ha demens som ett meningsfullt utfallsm\u00e5tt i preventiva randomiserade studier, eftersom det kr\u00e4vs s\u00e5 l\u00e5ng studietid. Det \u00e4r inte metodologiskt, resursm\u00e4ssigt eller etiskt genomf\u00f6rbart. D\u00e4rf\u00f6r rekommenderas inte l\u00e4ngre demens som utfallsm\u00e5tt f\u00f6r pr\u00f6vningsutfall.<\/p>\n<p>D\u00e4remot har m\u00e5nga observationsstudier visat p\u00e5 starka samband mellan livsstil och demensrisk \u00f6ver l\u00e5ng tid. Skillnaden mellan en interventionsstudie med kontrollgrupp (som FINGER) och en observationsstudie (d\u00e5 man studerar den livsstil folk sj\u00e4lva v\u00e4ljer) ligger just i kontroll och en slumpm\u00e4ssig f\u00f6rdelning mellan grupperna. Evidensen fr\u00e5n en stor m\u00e4ngd observationsstudier \u00e4r s\u00e5 stark att h\u00f6gt ansedda Lancet Commission menar att antalet personer med demens skulle kunna halveras genom en optimal livsstil.<\/p>\n<h4>Sm\u00e5 f\u00f6r\u00e4ndringar kan ge stora effekter<\/h4>\n<p>N\u00e4r forskare beskriver att risken f\u00f6r sjukdom kan p\u00e5verkas, inneb\u00e4r det att en viss aktivitet kan reducera sannolikheten f\u00f6r att en individ utvecklar sjukdomen. Vad g\u00e4ller demensprevention kan sm\u00e5 f\u00f6r\u00e4ndringar ge stora positiva effekter, s\u00e4rskilt om insatserna s\u00e4tts in i ett tidigt skede. Det finns dock inga garantier f\u00f6r att undvika kognitiv svikt, \u00e4ven om en individ saknar k\u00e4nda genetiska riskfaktorer eller har vidtagit alla h\u00e4lsosamma livsstils\u00e5tg\u00e4rder som kan minska risken. En anledning till detta \u00e4r att forskningsresultaten \u00e4r baserade p\u00e5 gruppniv\u00e5 och att effekten kan variera mellan individer. Forskning p\u00e5g\u00e5r intensivt f\u00f6r att utveckla mer individanpassade rekommendationer och optimera kombinationen av livsstils\u00e5tg\u00e4rder och l\u00e4kemedelsbehandling n\u00e4r det beh\u00f6vs.<\/p>\n<h4>Kunskap m\u00f6jligg\u00f6r val<\/h4>\n<p>Agnes Wold menar att forskares och myndigheters livsstilsr\u00e5d kan orsaka skuldk\u00e4nslor och oro, och s\u00e5 kan det vara. Det g\u00e4ller r\u00e5d kring demensrisk s\u00e5 v\u00e4l som hj\u00e4rt-och k\u00e4rlsjukdomar och andra kroniska tillst\u00e5nd. Alla dessa sjukdomar \u00e4r komplexa och p\u00e5verkas genom livet av s\u00e5v\u00e4l genetiska som milj\u00f6relaterade faktorer. N\u00e4r forskningen g\u00f6r uppt\u00e4ckter \u00e4r det dock en skyldighet att sprida kunskapen, s\u00e5 att samh\u00e4lle och individer har m\u00f6jlighet att f\u00f6rh\u00e5lla sig till den.<\/p>\n<p>Enligt v\u00e5ra studier, som involverat b\u00e5de \u00e4ldre individer med \u00f6kad risk och personer med kognitiv svikt eller demenssjukdom, och de kommunala program vi har insikt i, finns dock en tydlig allm\u00e4n efterfr\u00e5gan p\u00e5 mer st\u00f6d kring livsstil samt hantering av p\u00e5verkbara risk- och friskfaktorer. \u00d6kad kunskap om f\u00f6rebyggande \u00e5tg\u00e4rder kan ocks\u00e5 s\u00e4nka tr\u00f6skeln f\u00f6r att s\u00f6ka v\u00e5rd, d\u00e5 individer blir medvetna om att det finns m\u00f6jligheter att p\u00e5verka sin kognitiva h\u00e4lsa. Den ofta ospecifika och sena diagnostiken av kognitiva sjukdomar \u00e4r en utmaning i nul\u00e4get.<\/p>\n<h4>Nytta f\u00f6r individen och samh\u00e4llet<\/h4>\n<p>F\u00f6r den enskilda individen och hela befolkningen kan kunskap och f\u00f6rebyggande insatser allts\u00e5 g\u00f6ra stor skillnad, och p\u00e5 samh\u00e4llsniv\u00e5 kan FINGER-baserade program ge h\u00e4lsoekonomiska f\u00f6rdelar. I en <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39577838\/\" target=\"_blank\" rel=\"noopener\">registeruppf\u00f6ljning som gjordes efter \u00e5tta \u00e5r<\/a> s\u00e5g FINGER-forskarna att deltagarna i interventionsgruppen hade haft betydligt l\u00e4gre behov av v\u00e5rd, gjort f\u00e4rre bes\u00f6k p\u00e5 akutmottagningar och varit inlagda f\u00e4rre n\u00e4tter p\u00e5 sjukhus.\u00a0 Totalt var samh\u00e4llets v\u00e5rdkostnader f\u00f6r denna grupp ca 45 000 kronor l\u00e4gre per person sedan studiens b\u00f6rjan, j\u00e4mf\u00f6rt med kontrollgruppen. Detta kan ha stor betydelse f\u00f6r ett samh\u00e4lles ekonomi, eftersom riskgruppen \u00e4r s\u00e5 stor.<\/p>\n<p>De individuella och samh\u00e4lleliga vinsterna har varit incitament n\u00e4r svenska kommuner, och andra akt\u00f6rer, b\u00f6rjat intressera sig f\u00f6r f\u00f6rebyggande arbete inom kognitiv h\u00e4lsa. <a href=\"https:\/\/lidingo.se\/toppmeny\/kulturfritid\/aktivsenior\/tranahjarnaforenbattrehjarnhalsa.4.7eae984b178b3edbb9514b2.html\" target=\"_blank\" rel=\"noopener\">Den f\u00f6rsta kommunen som initierade ett FINGER-baserat livsstilsprogram var Liding\u00f6 stad<\/a>. Programmet utvecklades till ett forskningsprojekt hos Karolinska Institutet, som unders\u00f6ker effekterna av implementeringen, f\u00f6r att utv\u00e4rdera processen och samla information inf\u00f6r bredare implementering. Programmet, Tr\u00e4na hj\u00e4rna, \u00e4r nu inne p\u00e5 sitt tredje \u00e5r och snart p\u00e5b\u00f6rjas den forskningsm\u00e4ssiga analysen av dess data. Redan nu kan vi konstatera att programmet haft mycket positiv inverkan p\u00e5 deltagarnas m\u00e5ende och livskvalitet. Vissa uttrycker rent av att de f\u00e5tt livet tillbaka. <a href=\"https:\/\/lidingo.se\/toppmeny\/omsorgstod\/aktuellt\/arkivfornyheter\/lidingostadsforebyggandearbeteforaldre.5.60ea025419490fb12f473e.html\" target=\"_blank\" rel=\"noopener\">Det finns deltagare som kunnat sluta med blodtrycksmedicin, antidepressiv medicin och behandling av typ 2-diabetes.<\/a><\/p>\n<p>Inf\u00f6r Tr\u00e4na hj\u00e4rna-satsningen omf\u00f6rdelade Liding\u00f6 stad resurser. Livsstilsprogrammet har inte \u00f6kat kommunens kostnader. Tv\u00e4rtom r\u00e4knar man med att snart kunna se resultat i form av minskade kostnader f\u00f6r v\u00e5rd och omsorg, och i st\u00e4llet kunna allokera dessa medel d\u00e4r de g\u00f6r b\u00e4sta nytta f\u00f6r inv\u00e5narna. Samma resonemang f\u00f6rs i andra kommuner som vi kommer i kontakt med. Flera har startat liknande program och m\u00e5nga planerar f\u00f6r att utveckla sitt f\u00f6rebyggande arbete.<\/p>\n<h4>Fortsatt intensiv forskning<\/h4>\n<p>Forskningen om riskfaktorer f\u00f6r demens utvecklas snabbt. Den h\u00f6gt rankade tidskriften <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(24)01296-0\/abstract\" target=\"_blank\" rel=\"noopener\">Lancet uppdaterade 2024 sin sammantagna rapport och lista<\/a>, som nu \u00e4ven inkluderar okorrigerad h\u00f6rsel- och synneds\u00e4ttning. M\u00e5nga av faktorerna g\u00e5r att behandla och m\u00e5ste d\u00e4rf\u00f6r uppm\u00e4rksammas i f\u00f6rebyggande arbete.<\/p>\n<p>Den ursprungliga FINGER-studien var \u2019proof of concept\u2019, och modellen har utvecklats och anpassats till olika geografiska och kulturella f\u00f6rh\u00e5llanden inom <a href=\"https:\/\/fbhi.se\/sv\/om-world-wide-fingers-natverket\/\" target=\"_blank\" rel=\"noopener\">World-Wide FINGERS-n\u00e4tverket<\/a>, som nu inkluderar \u00f6ver 70 l\u00e4nder. Det finns m\u00e5nga positiva studieresultat fr\u00e5n olika l\u00e4nder, exempelvis Spanien, USA, Japan, Malaysia och Australien, som f\u00f6rst\u00e4rker att den multimodala modellen fungerar och kan anpassas till olika grupper. Studierna och implementering bygger vidare p\u00e5 evidensen fr\u00e5n FINGER-studien. Forskning handlar om utveckling och l\u00e4rande och att utg\u00e5 ifr\u00e5n den evidens som finns. Det har dessutom tillkommit mycket ny evidens kring sambandet mellan livsstil och hj\u00e4rnh\u00e4lsa sedan vi gjorde FINGER-studien, och det har ocks\u00e5 p\u00e5verkat hur vi arbetar i dag, b\u00e5de i nya studier och implementering.<\/p>\n<p>Tack vare intensiv forskning har vi nu nya m\u00f6jligheter att f\u00f6rebygga, tidigt uppt\u00e4cka och behandla kognitiva sjukdomar. Implementering av f\u00f6rebyggande och personcentrerade arbetss\u00e4tt \u00e4r avg\u00f6rande f\u00f6r att optimera hj\u00e4rnh\u00e4lsa hos alla individer. Vi v\u00e4lkomnar d\u00e4rf\u00f6r den nya demensstrategin som lyfter fram dessa omr\u00e5den.[\/vc_column_text][nectar_btn size=&#8221;large&#8221; open_new_tab=&#8221;true&#8221; button_style=&#8221;regular&#8221; button_color_2=&#8221;Accent-Color&#8221; icon_family=&#8221;none&#8221; text=&#8221;Referenser&#8221; url=&#8221;https:\/\/fbhi.se\/sv\/referenser\/&#8221;][\/vc_column_inner][vc_column_inner column_padding=&#8221;no-extra-padding&#8221; column_padding_tablet=&#8221;inherit&#8221; column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_direction_desktop=&#8221;default&#8221; column_element_spacing=&#8221;default&#8221; desktop_text_alignment=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_backdrop_filter=&#8221;none&#8221; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; overflow=&#8221;visible&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;1\/3&#8243; tablet_width_inherit=&#8221;default&#8221; animation_type=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221;][vc_column_text css=&#8221;.vc_custom_1739017240085{padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: #e29e73 !important;border-radius: 5px !important;}&#8221;]<span style=\"color: #ffffff;\"><strong>La<span style=\"color: #ffffff;\">ncet Co<\/span>mmission:<\/strong> 45% av all demens \u00e4r kopplad till livsstils-, h\u00e4lso- och milj\u00f6relaterade faktorer som g\u00e5r att p\u00e5verka<\/span>[\/vc_column_text][image_with_animation image_url=&#8221;9588&#8243; image_size=&#8221;full&#8221; animation_type=&#8221;entrance&#8221; animation=&#8221;None&#8221; animation_movement_type=&#8221;transform_y&#8221; hover_animation=&#8221;none&#8221; alignment=&#8221;&#8221; border_radius=&#8221;10px&#8221; box_shadow=&#8221;small_depth&#8221; image_loading=&#8221;default&#8221; max_width=&#8221;100%&#8221; max_width_mobile=&#8221;default&#8221;][divider line_type=&#8221;No Line&#8221;][vc_column_text css=&#8221;.vc_custom_1738892447195{border-top-width: 3px !important;border-right-width: 3px !important;border-bottom-width: 3px !important;border-left-width: 3px !important;padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: rgba(255,255,255,0.17) !important;*background-color: rgb(255,255,255) !important;border-left-color: #8ebb95 !important;border-left-style: solid !important;border-right-color: #8ebb95 !important;border-right-style: solid !important;border-top-color: #8ebb95 !important;border-top-style: solid !important;border-bottom-color: #8ebb95 !important;border-bottom-style: solid !important;border-radius: 10px !important;}&#8221;]\n<h6><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9505\" src=\"https:\/\/fbhi.se\/wp-content\/uploads\/2023\/04\/icon1.png\" alt=\"\" width=\"63\" height=\"67\" \/>Fakta om demens<\/strong><br \/>\nSviktande hj\u00e4rnh\u00e4lsa \u00e4r en snabbt v\u00e4xande utmaning som p\u00e5verkar b\u00e5de individen, n\u00e4rst\u00e5ende, h\u00e4lso- och sjukv\u00e5rden samt hela samh\u00e4llet och samh\u00e4llsekonomin.<\/h6>\n<ul>\n<li>I Sverige finns cirka <strong>160 000 personer <\/strong>med demens, och antalet ber\u00e4knas ha f\u00f6rdubblats \u00e5r 2050.<\/li>\n<li>Varje \u00e5r insjuknar cirka <strong>25 000 nya personer<\/strong>.<\/li>\n<li>Internationella studier visar att <strong>15% av befolkningen <\/strong>\u00f6ver 60 \u00e5r har lindrig kognitiv svikt, och ungef\u00e4r h\u00e4lften av dessa fall orsakas av Alzheimers sjukdom. Detta motsvarar cirka 200 000 personer i Sverige.<\/li>\n<li>En \u00e4nnu st\u00f6rre andel av befolkningen befinner sig i riskzonen. Internationella uppskattningar tyder p\u00e5 att <strong>cirka 1,6 miljoner svenskar har onormala niv\u00e5er av amyloid-protein i hj\u00e4rnan<\/strong>, vilket inneb\u00e4r en \u00f6kad risk f\u00f6r Alzheimers sjukdom.<\/li>\n<\/ul>\n[\/vc_column_text][divider line_type=&#8221;No Line&#8221;][vc_column_text css=&#8221;.vc_custom_1738913546326{border-top-width: 3px !important;border-right-width: 3px !important;border-bottom-width: 3px !important;border-left-width: 3px !important;padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: rgba(255,255,255,0.44) !important;*background-color: rgb(255,255,255) !important;border-left-color: #e3a883 !important;border-left-style: solid !important;border-right-color: #e3a883 !important;border-right-style: solid !important;border-top-color: #e3a883 !important;border-top-style: solid !important;border-bottom-color: #e3a883 !important;border-bottom-style: solid !important;border-radius: 10px !important;}&#8221;]<strong><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-9509 alignleft\" src=\"https:\/\/fbhi.se\/wp-content\/uploads\/2023\/04\/icon5.png\" alt=\"\" width=\"67\" height=\"66\" \/><\/strong><\/p>\n<p><strong>Demens inneb\u00e4r stora kostnader f\u00f6r samh\u00e4llet<\/strong><\/p>\n<p>2019 uppgick kostnaderna f\u00f6r demenssjukdomar i Sverige till <strong>81,6 miljarder kronor<\/strong>, varav:<\/p>\n<ul>\n<li>Kommuner (s\u00e4rskilt boende, hemtj\u00e4nst): <strong>66,8 miljarder kr<\/strong><\/li>\n<li>Regioner (l\u00e4kemedel, l\u00e4karbes\u00f6k): <strong>1,3 miljarder kr<\/strong><\/li>\n<li>Informell v\u00e5rd (anh\u00f6rigas obetalda v\u00e5rd): <strong>12,5 miljarder kr<\/strong><\/li>\n<li>Andra indirekta kostnader: <strong>1 miljard kr<\/strong><\/li>\n<\/ul>\n<p>M\u00e5nga \u00e4ldre personer har f\u00f6rutom kognitiv svikt \u00e4ven andra kroniska sjukdomar. <strong>Multisjuklighet<\/strong> \u00e4r mycket vanligt och inneb\u00e4r en stor b\u00f6rda f\u00f6r individen och h\u00e4lso-och sjukv\u00e5rden och omsorgen.<\/p>\n<p>Det \u00e4r d\u00e4rf\u00f6r naturligt och gl\u00e4djande att kommuner och v\u00e5rdgivare visar stort intresse f\u00f6r f\u00f6rebyggande \u00e5tg\u00e4rder. Om vi kan f\u00f6rl\u00e4nga tiden innan kognitiv och funktionell f\u00f6rs\u00e4mring debuterar, samt minska behovet av st\u00f6dinsatser och flytt till s\u00e4rskilt boende, kan detta ge betydande positiva effekter b\u00e5de p\u00e5 individ- och samh\u00e4llsniv\u00e5.[\/vc_column_text][divider line_type=&#8221;No Line&#8221;][vc_column_text css=&#8221;.vc_custom_1738930911196{padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: rgba(227,168,131,0.58) !important;*background-color: rgb(227,168,131) !important;border-radius: 10px !important;}&#8221;]<strong>I Liding\u00f6 stads livsstilsprogram Tr\u00e4na hj\u00e4rna f\u00e5r seniorer st\u00f6d i livsstilsf\u00f6r\u00e4ndringar.<\/strong><br \/>\n<a href=\"https:\/\/lidingo.se\/toppmeny\/omsorgstod\/aktuellt\/arkivfornyheter\/lidingostadsforebyggandearbeteforaldre.5.60ea025419490fb12f473e.html\" target=\"_blank\" rel=\"noopener\"><strong>L\u00e4s mer h\u00e4r<\/strong><\/a>[\/vc_column_text][image_with_animation image_url=&#8221;11137&#8243; image_size=&#8221;portfolio-thumb&#8221; animation_type=&#8221;entrance&#8221; animation=&#8221;None&#8221; animation_movement_type=&#8221;transform_y&#8221; hover_animation=&#8221;none&#8221; alignment=&#8221;&#8221; border_radius=&#8221;5px&#8221; box_shadow=&#8221;none&#8221; image_loading=&#8221;default&#8221; max_width=&#8221;100%&#8221; max_width_mobile=&#8221;default&#8221;][vc_column_text css=&#8221;.vc_custom_1738913729360{border-top-width: 3px !important;border-right-width: 3px !important;border-bottom-width: 3px !important;border-left-width: 3px !important;padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: rgba(255,255,255,0.52) !important;*background-color: rgb(255,255,255) !important;border-left-color: rgba(0,104,133,0.52) !important;border-left-style: solid !important;border-right-color: rgba(0,104,133,0.52) !important;border-right-style: solid !important;border-top-color: rgba(0,104,133,0.52) !important;border-top-style: solid !important;border-bottom-color: rgba(0,104,133,0.52) !important;border-bottom-style: solid !important;border-radius: 10px !important;}&#8221;]&#8221;Det sociala livet \u00e4r s\u00e5 viktigt. Att kunna komma till M\u00f6tesplats centrum \u00e4r s\u00e5 viktigt. D\u00e4r kan jag spela schack b\u00e5de f\u00f6r att h\u00e5lla hj\u00e4rnan ig\u00e5ng men ocks\u00e5 f\u00f6r det relationella.&#8221;<\/p>\n<p>Jag upplever mig starkare, hittar nya muskler och g\u00f6r r\u00f6relser varje dag som v\u00e5r tr\u00e4nare visat s\u00e5 fint.&#8221;<br \/>\n<em>Anna p\u00e5 Liding\u00f6<\/em>[\/vc_column_text][divider line_type=&#8221;No Line&#8221;][image_with_animation image_url=&#8221;12216&#8243; image_size=&#8221;portfolio-thumb&#8221; animation_type=&#8221;entrance&#8221; animation=&#8221;None&#8221; animation_movement_type=&#8221;transform_y&#8221; hover_animation=&#8221;none&#8221; alignment=&#8221;&#8221; border_radius=&#8221;5px&#8221; box_shadow=&#8221;none&#8221; image_loading=&#8221;default&#8221; max_width=&#8221;100%&#8221; max_width_mobile=&#8221;default&#8221;][vc_column_text css=&#8221;.vc_custom_1738913861416{border-top-width: 3px !important;border-right-width: 3px !important;border-bottom-width: 3px !important;border-left-width: 3px !important;padding-top: 10px !important;padding-right: 10px !important;padding-bottom: 10px !important;padding-left: 10px !important;background-color: rgba(255,255,255,0.52) !important;*background-color: rgb(255,255,255) !important;border-left-color: rgba(0,104,133,0.52) !important;border-left-style: solid !important;border-right-color: rgba(0,104,133,0.52) !important;border-right-style: solid !important;border-top-color: rgba(0,104,133,0.52) !important;border-top-style: solid !important;border-bottom-color: rgba(0,104,133,0.52) !important;border-bottom-style: solid !important;border-radius: 10px !important;}&#8221;]&#8221;Jag har uppn\u00e5tt en betydande f\u00f6rb\u00e4ttring i min livskvalitet och har kunnat sluta med diabetesmedicin. Finger-modellen har bidragit till en positiv f\u00f6r\u00e4ndring genom att ge mig lugn, kunskap och insikt. Detta har resulterat i en mer st\u00e4rkande och kreativ vardag i mitt \u00e5ldrande.&#8221;<\/p>\n<p>Genom att l\u00e4gga om kosth\u00e5llningen och tr\u00e4na regelbundet lyckades jag g\u00e5 ner 14 kg under programmets g\u00e5ng. 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I dag \u00e4r jag volont\u00e4r och inspirat\u00f6r till nya deltagare och kan forts\u00e4tta bidra och sprida kunskaper till andra. Den svackan jag befann mig i finns inte l\u00e4ngre. 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