Ingrid Beate Ringstad

• Ringstad, Ingrid Beate; Skovlund, Eva; Santervas, Leonor Roa; Kersten, Hege; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 9 contributors for this article] (2026). Association Between Anticholinergic Burden and Dry Mouth Severity in Acutely Ill Older Adults. Drugs & Aging. ISSN 1170-229X. 43(4), p. 361–371. doi: 10.1007/s40266-026-01286-w. Full text in Research Archive Show summary

  Background: Dry mouth is a common and burdensome condition in older adults and its severity may increase with use of anticholinergic medications. The aims were to describe anticholinergic medication use among acutely ill older adults, examine the association between anticholinergic burden and dry mouth severity using the composite Dry Mouth Severity Points (DMSP) measure and investigate whether the association differs by sex. Methods: Patients ≥70 years admitted to Oslo municipal inpatient acute care unit were eligible. Anticholinergic burden (ACB) was assessed using the ACB calculator and classified as 0, lower (ACB = 1-2) or high (ACB = ≥ 3). Dry mouth severity was quantified with DMSP, range 0-4, assigning one point for each indicator above cut-off: General Xerostomia Question ≥ 3, Summated Xerostomia Inventory ≥ 11, Clinical Oral Dryness Score ≥ 6 and unstimulated whole saliva secretion rate ≤ 0.1 mL/min. Associations were examined with ordinal logistic regression. Results: Of 382 examined patients, 256 (mean age 84 ± 7 years, 70% women) had complete data. Mean [standard deviation (SD)] ACB score was 2.0 (1.7); 18% had ACB = 0, 50% had ACB = 1-2 and 32% had ACB = ≥ 3. DMSP scores of 0, 1, 2 and ≥ 3 were present in 29%, 36%, 23% and 12%, respectively. Compared with patients with ACB = 0, those with ACB = 1-2 [odds ratio (OR) = 2.06, 95% confidence interval (CI) 1.07-3.97) and ACB = ≥ 3 (OR = 2.25, 95% CI 1.09-4.63) had higher odds of more severe dry mouth. Women had significantly higher ACB and DMSP scores than men. Conclusions: Even lower anticholinergic burden was associated with greater dry mouth severity, highlighting the need for early recognition and proactive management in acutely ill older adults.

• Santervas, Leonor Roa; Skovlund, Eva; Kristoffersen, Espen Saxhaug; Ringstad, Ingrid Beate; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 9 contributors for this article] (2026). Collaborative medication reviews during acute primary care admissions for older adults with polypharmacy: a randomised controlled trial. Age and Ageing. ISSN 0002-0729. 55(2). doi: 10.1093/ageing/afag029. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Santervas, Leonor Roa; Fjeld, Katrine Gahre; Hove, Lene Hystad & Skovlund, Eva [Show all 8 contributors for this article] (2025). Oral Health, Xerogenic Medications, and Frailty in Acutely Ill Older Adults. Journal of The American Geriatrics Society. ISSN 0002-8614. 73(8), p. 2466–2474. doi: 10.1111/jgs.19564. Full text in Research Archive Show summary

  Background Oral health is an essential part of overall health and well-being in older adults and may be influenced by medications and frailty. This study aimed to describe the prevalence of xerostomia and hyposalivation and examine their associations with xerogenic medications and frailty in acutely ill older adults. Methods This cross-sectional study included patients aged ≥ 70 years admitted to the Municipal In-Patient Acute Care unit in Oslo, Norway. General xerostomia was defined as a score ≥ 3 on the General Xerostomia Question (GXQ). Specific xerostomia was measured with the Summated Xerostomia Inventory (SXI). Objective dry mouth measures included unstimulated whole saliva (UWS) secretion rate and the Clinical Oral Dryness Score (CODS), with hyposalivation defined as UWS ≤ 0.1 mL/min. Examination of dentition included numbers of missing teeth and posterior occluding pairs of teeth. Medication data included total drug burden and number of xerogenic medications. Frailty was assessed using the Clinical Frailty Scale (CFS). Associations were analyzed using logistic regression models. Results Among 382 patients (mean age 84 years, 72% women), general xerostomia was present in 30% and hyposalivation in 56%. Mean number (SD) of xerogenic medications was 3.7 (±2.2). The number of xerogenic medications used was significantly associated with general xerostomia in both unadjusted (OR: 1.17, 95% CI: 1.05–1.29) and adjusted models (OR: 1.13, 95% CI: 1.01–1.26). Median UWS declined numerically with increasing number of xerogenic medications. Higher CFS scores were associated with increased subjective xerostomia scores (GXQ and SXI), elevated CODS, more missing teeth, and reduced occlusion, but not with general xerostomia or hyposalivation when predefined cut-off values were applied. Conclusion Xerostomia and hyposalivation were common among acutely ill older adults. General xerostomia was associated with xerogenic medication use and frailty. Our findings highlight the need to incorporate oral health assessments into routine geriatric care and emphasize the importance of interdisciplinary collaborations.

• Borge, Hanne; Ringstad, Ingrid Beate; Aqrawi, Lara A.; Fromreide, Siren; Dongre, Harsh Nitin & Galtung, Hilde [Show all 8 contributors for this article] (2024). Increased expression of CXCL10 and CCL3 salivary gland chemokines in primary Sjögren’s syndrome detected and systematically quantified using RNAscope® in situ hybridization. Clinical and Experimental Immunology. ISSN 0009-9104. 219(1). doi: 10.1093/cei/uxae087. Full text in Research Archive Show summary

  Primary Sjögren’s syndrome is a chronic inflammatory disease characterized by the destruction of exocrine glands. We have previously shown significantly upregulated levels of CXCL10 and CCL3 chemokines in saliva from Sjögren’s syndrome patients. In this study, we examined the expression pattern and localization of these chemokines at the site of inflammation in patients’ minor salivary glands using novel RNAscope® in situ hybridization. Minor salivary glands from 33 primary Sjögren’s syndrome patients and 22 non-Sjögren’s syndrome (non-SS) sicca controls were included. The biopsies were formalin-fixed, paraffin-embedded, and histopathologically evaluated. The CXCL10 and CCL3 mRNA expression in the glandular tissue was investigated using reverse transcription quantitative real-time polymerase chain reaction followed by an RNAscope® in situ hybridization. The mRNA expression of CXCL10 was higher than CCL3 in all patients. Significantly elevated expression of CXCL10 and CCL3 was detected in patients that also expressed autoantibody positivity and a positive biopsy for mononuclear cell infiltrates when compared with non-SS sicca controls. CXCL10 was localized as clusters within focal infiltrates as well as adjacent to acinar and ductal epithelium, while CCL3 was expressed as scattered single mRNA molecules in focal infiltrates and in acinar cells. Our findings suggest CXCL10 as a possible disease biomarker in primary Sjögren’s syndrome due to its upregulated expression in both saliva and minor salivary glands of patients and the localization in the tissue. This should be re-assessed in a larger primary Sjögren’s syndrome patient cohort, followed by additional functional studies to further validate its potential as a disease biomarker.

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• Herlofson, Bente Brokstad; Tanem, Kristine Eidal & Ringstad, Ingrid Beate (2025). Munnhelse - viktigere enn noensinne, i alle livsfaser. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Exploring Associations Between Medication Use, Frailty and Oral Health in Acutely Ill Older Adults. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Dry Mouth, Frailty and Polypharmacy in Acutely Ill Older Adults. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Preliminary data from the COOP II study - exploring oral and general health among older people in need of acute care. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2024). Preliminary data from the COOP II study – exploring oral and general health among older people in need of short-time acute care. Full text in Research Archive
• Ringstad, Ingrid Beate (2024). Forskningspris til Ingrid Beate Ringstad. [Internet]. Det Odontologiske fakultet ved Universitetet i Oslo. Full text in Research Archive Show summary

  Ingrid Beate Ringstad vann den prestisjetunge Nordic Hatton Award Competition på CED/NOF-IADR Oral Health Research Congress, som blei arrangert 12.-14. september i Genève.

• Santervas, Leonor Roa; Wyller, Torgeir Bruun; Skovlund, Eva; Kristoffersen, Espen Saxhaug; Ringstad, Ingrid Beate & Jensen, Janicke Cecilie Liaaen [Show all 9 contributors for this article] (2024). Frailty and Health-Related Quality of Life in Older Adults Admitted to Oslo Municipal In-Patient Acute Care Unit. Full text in Research Archive
• Ringstad, Ingrid Beate (2024). Oral helse hos eldre. Full text in Research Archive
• Santervas, Leonor Roa; Wyller, Torgeir Bruun; Skovlund, Eva; Jensen, Janicke Liaaen; Fjeld, Katrine Gahre & Hove, Lene Hystad [Show all 11 contributors for this article] (2024). Cooperation across healthcare service levels for medication reviews in older people with polypharmacy admitted to a municipal in-patient acute care unit (The COOP II Study): study protocol for a randomized controlled trial. Trials. 25(1). doi: 10.1186/s13063-024-08442-w. Full text in Research Archive Show summary

  Background: Polypharmacy and inappropriate drug use are associated with adverse health outcomes in older people. Collaborative interventions between geriatricians and general practitioners have demonstrated effectiveness in improving clinical outcomes for complex medication regimens in home-dwelling patients. Since 2012, Norwegian municipalities have established municipal in-patient acute care (MipAC) units, designed to contribute towards reducing the number of hospital admissions. These units predominantly serve older people who typically benefit from multidisciplinary approaches. The primary objective of this study is to evaluate the effect of cooperative medication reviews conducted by MipAC physicians, supervised by geriatricians, and in collaboration with general practitioners, on health-related quality of life and clinical outcomes in MipAC patients ≥ 70 years with polypharmacy. Additionally, the study aims to assess the carbon footprint of the intervention. Methods: This is a randomized, single-blind, controlled superiority trial with 16 weeks follow-up. Participants will be randomly assigned to either the control group, receiving usual care at the MipAC unit, or to the intervention group which in addition receive clinical medication reviews that go beyond what is considered usual care. The medication reviews will evaluate medication appropriateness using a structured but individualized framework, and the physicians will receive supervision from geriatricians. Following the clinical medication reviews, the MipAC physicians will arrange telephone meetings with the participants’ general practitioners to combine their assessments in a joint medication review. The primary outcome is health-related quality of life as measured by the 15D instrument. Secondary outcomes include physical and cognitive functioning, oral health, falls, admissions to healthcare facilities, and mortality. Discussion: This study aims to identify potential clinical benefits of collaborative, clinical medication reviews within community-level MipAC units for older patients with polypharmacy. The results may offer valuable insights into optimizing patient care in comparable municipal healthcare settings. Trial registration: The study was registered prospectively on ClinicalTrials.gov 30.08.2023 with identifier NCT06020391.

• Ringstad, Ingrid Beate; Borge, Hanne; Fromreide, Siren; Galtung, Hilde; Jensen, Janicke Cecilie Liaaen & Skarstein, Kathrine (2024). Investigating MMP7, MMP9 and TIMP1 mRNA expression patterns in minor salivary glands from patients with primary Sjögren’s syndrome (pSS) using RNAscope®. Full text in Research Archive
• Ringstad, Ingrid Beate; Borge, Hanne; Fromreide, Siren; Galtung, Hilde; Jensen, Janicke Cecilie Liaaen & Skarstein, Kathrine (2024). Undersøkelse av mRNA-uttrykksmønstre for MMP7, MMP9 og TIMP1 i små spyttkjertler hos pasienter med primær Sjögrens syndrom (pSS) ved bruk av RNAscope®. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). What happens to oral health when multimorbidity, polypharmacy and frailty comes along? Full text in Research Archive
• Ringstad, Ingrid Beate; Borge, Hanne; Fromreide, Siren; Galtung, Hilde; Skarstein, Kathrine & Jensen, Janicke Cecilie Liaaen (2023). Increased Expression of Salivary Gland Chemokines in Primary Sjögren’s Syndrome. Full text in Research Archive
• Ringstad, Ingrid Beate; Romskaug, Rita; Fjeld, Katrine Gahre; Hove, Lene Hystad; Santervas, Leonor Roa & Wyller, Torgeir Bruun [Show all 7 contributors for this article] (2023). Oral Health in Times of Frailty and Polypharmacy. Full text in Research Archive
• Ringstad, Ingrid Beate (2023). Forskningspris til Ingrid Beate Ringstad ved Universitetet i Oslo. [Journal]. Norsk Tannlegeforenings Tidende. Full text in Research Archive
• Ringstad, Ingrid Beate; Fjeld, Katrine Gahre & Hove, Lene Hystad (2023). Gerodontologiske vurderinger og behandlinger anno 2023. Full text in Research Archive

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