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1. Influence of social support on cognitive change and mortality in old age: results from the prospective multicentre cohort study AgeCoDe

Author

Eisele, Marion, Zimmermann, Thomas, Weyerer, Siegfried, Schumacher, Andre, Flettner, Tim Oliver, Thraen, Winfried, Siegmund, Harald, Levacher, Claus, Blankenstein, Tim, Lamborelle, Eliane, Hollstein, Ralf, Hoffmann, Edna, Ghane, Ingeborg, Werle, Jochen, Claß, Regine, Meier, Stefan-Wolfgang, Moers, Leo W, Wundram, Udo, Schmitt, Klaus, Missghian, Rastin, Spallek, Karin, Schlösser, Christiane, Groß, Kathrin, Bouché, Winfried, Leicht, Hanna, Linn, Ursula, Bormann, Gundula, Schulze, Gerhard, Stelter, Klaus, Gatermann, Heike, Fischer-Radizi, Doris, Witt, Otto-Peter, Kavka, Stefanie, Klötzl, Günther, Münter, Karl-Christian, König, Hans-Helmut, Baumhöfener, Michael, Oberländer, Maren, Schiewe, Cornelia, Hufnagel, Jörg, Kressel, Anne-Marei, Kebschull, Michael, Wagner, Christine, Burkhardt, Fridolin, Hase, Martina, Büttner, Matthias, Luppa, Melanie, Houcken, Karl-Heinz, Zebidi, Christiane, Bröhan, Johann, Russ, Christiane, Bethge, Frank, Lorenzen, Margret, Elsen, Arne, Stiller, Lerke, Giovanopoulos, Angelika, Korte, Daniela, Maier, Wolfgang, Jedicke, Ursula, Müller-Mette, Rosemarie, Richter, Andrea, Rauhala-Parrey, Sanna, Zoras, Constantin, Pfeil-Woltmann, Gabriele, Knöppel-Frenz, Annett, Kaiser, Martin, Bruns, Johannes, Homann, Joachim, Scherer, Martin, Gorgon, Georg, Middendorf, Niklas, Menschke, Kay, Stöver, Hans Heiner, Bayer, Hans H, Quandt, Rüdiger, Rughase-Block, Gisela, Köllner, Hans-Michael, Strohbehn, Enno, Haller, Thomas, Group, AgeCoDe Study, Jesse, Nadine, Domsch, Martin, Dahlke, Marcus, Lipp, Thomas, Lipp, Ina, Rauchmaul, Gabriele, Ebert, Hans Jochen, Gabriel-Müller, Angelika, Taut, Hans-Christian, Voß, Hella, Abholz, Heinz-Harald, Mühlmann, Ute, Schmidt, Holger, Müller, Gabi, Hager, Eva, Tunze, Bettina, Bräutigam, Barbara, Paschke, Thomas, Schmalbruch, Ina, Kässner, Gunter, Pförtzsch, Iris, Bachmann, Cadja, Ernst-Brennecke, Brigitte, Rahnefeld, Uwe, Striegler, Petra, Gierth, Marga, Krügel, Anselm, Boehm, Margret, Harnisch, Dagmar, Kornisch-Koch, Simone, Höne, Birgit, Schönherr, Lutz, Köhler, Mirjam, Bickel, Horst, Hambsch, Frank, Meitsch, Katrin, Krägelin-Nobahar, Britta, Herzig, Cornelia, Georgi, Astrid, Schwarzmann, Erhard, Schinagl, Gerd, Pehnke, Ulrike, Dayab, Mohammed, Müller, Sabine, Blank, Wolfgang, Onnasch, Jörg-Friedrich, Brosig, Michael, Frydetzki, Dorothea, Abschke, Uwe, Sperling, Volkmar, Gläser, Ulrich, Lebuser, Frank, Hagert, Detlef, Bauer, Viet-Harold, Becker, Hartwig, van den Bussche, Hendrik, Becker, Hermine, Besier, Werner, Böttcher-Schmidt, Hanna, Füllgraf-Horst, Susanne, Göry, Enikö, Grella, Hartmut, Grimm, Hans Heinrich, Heck, Petra, Hemler, Werner, Henn, Eric, Eifflaender-Gorfer, Sandra, Löb, Violetta, Maaßen-Kalweit, Grid, Mühlig, Hubertus, Müller, Arndt, Orlovius, Gerhard, Perleberg, Helmut, Radon, Brigitte, Renz, Helmut, Rieder, Carsten, Rosen, Michael, Ernst, Annette, Scheer, Georg, Schilp, Michael, Schmid, Angela, Schneider, Matthias, Schneider, Christian, Stahl, Rüdiger, Uhle, Christian, Wachter, Jürgen, Weihs, Necla, Weingärtner, Brigitte, Jessen, Frank, Werner, Monika, Willhauck, Hans-Georg, Wochele, Eberhard, Wolfram, Bernhard, Ruile, Helmut, Koeppel, Andreas, Dick, Peter, Holtz, Karl-Friedrich, Schmidt, Gabriel, Fischer, Lutz-Ingo, Kaduszkiewicz, Hanna, Thaller, Johann, Bloß, Guntram, Kreuzer, Franz, Holthausen, Günther, Maier, Karl Ludwig, Krebs, Walter, Mohr, Christoph, Koschine, Heinz, Ellersdorfer, Richard, Speth, Michael, Kaufeler, Teresa, Kleinhans, Maria, Koutsouva-Sack, Panagiota, Staudinger, Gabriele, Eiber, Johann, Thiel, Stephan, Gold, Cornelia, Nalbach, Andrea, Reichert, Kai, Rückgauer, Markus, Neef, Martin, Koppara, Alexander, Fleischmann, Viktor, Mayer, Natalija, Spiegl, Andreas, Renner, Fritz, Weishappel-Ketisch, Eva, Kochems, Thomas, Hunger, Hartmut, Hofbeck, Marianne, Neumeier, Alfred, Goldhofer, Elfriede, Lange, Carolin, Bommer, Thomas, Vollmuth, Reinhold, Lanzinger, Klaus, Bustami-Löber, Simone, Pauli, Ramona, Lindner, Jutta, Brandt, Gerlinde, Hohentanner, Otto, Urban-Hüttner, Rosita, Porz, Peter, Wiese, Birgitt, Luck, Tobias, Zimmerhackl, Bernd, Naumann, Barbara, Vach, Margarete, Hallwachs, Alexander, Haseke, Claudia, Ploch, Andreas, Bürkle-Grasse, Paula, Swobodnik, Monika, Tröger, Corina, Jost, Detlev, Mayer, Manfred, Steinhuber, Roman, Narr, Renate, Nehmann-Hörwick, Gabriele, Pillin, Helmut, Loth, Frank, Rücker, Beate, Fritz, Nicola, Rafferzeder, Michael, Zirpel, Dietmar, Romberg, Heinz-Peter, Mösch, Edelgard, Marx, Manfred, Prechtel, Eberhard, Alfen, Theodor, Fliedner, Michael, Hodgson, Binjamin, Schiller, Gerhard, Hoff, Bernhard, Kirsch, Michael, Miasnikov, Vladimir, Lüttringhaus, Dieter, Prokein, Jana, Krug, Bernd-Uwe, Hütter, Petra, Lau, Dietrich, Schröder-Höch, Ursula, Herzog, Wolfgang, Weidner, Klaus, Titova, Ljudmila, Moritz, Andrea, Amm, Martina, Bauer, Horst, Schumacher, Anna, Ziehbold, Sabine, Assmann, Heinz-Michael, Arnold, Gerhard, Ludwig, Ingrid, Noky, Adolf, Kunzendorf, Gerhard, Herbst, Helga, Hofmann, Andreas, Allwein, Eugen, Friedrich, Peter, Riedel-Heller, Steffi, Kirchner, Hans-Georg, Kirchner, Elke, Kahmann, Ulf, Eimers-Kleene, Jörg, Reich, Paul, Stahl, Eberhard, Lunow, Reinhold, Undritz, Klaus, Voss, Bernd, Spreer, Achim, Steinmann, Susanne, Brenig, Oliver, Müller, Bernhard G, Eich, Ralf, Vossel, Angelika, Leggewie, Dieter, Schmidt, Angelika, Aghdai-Heuser, Nahid, Witten, Lutz, Igel, Michael, Hodgson, Benjamin, Wagner, Michael, Hamkens, Werner, Ackermann, Angela, Wirtz, Clemens, Opitz, Rolf, Bausch, Jürgen, Mecking, Dirk, Ganßauge, Friederike, Peters, Elmar, Wester, Alfons, Petersen, Werner, Weckbecker, Klaus, Daase, Martin, Rüsing, Martin, von Sethe, Christoph, Borngräber, Wilmhard, Colling-Pook, Brigitte, Weidner, Ullrich, Rieger, Peter, Witte, Lutz, Busch, Hans-Wilhelm, Unger, Jürgen, Wolfsgruber, Steffen, Preis, Angela, Mann, Michael, Haeberle, Ernst, Köhler, Horst, Schäfer, Ruth, Sliwiok, Helmut, Brühl, Volker L, Stöver, Hans-Heiner, Deest, Harald, Ackermann-Körner, Margret, Heser, Kathrin, Adrian, Claudia, Reinstorff, Dieter, Schlüter, Christamaria, Heinrichs, Henrik, Dankwarth, Ole, Böse, Michael, Ryll, Ulricke, Bauer, Reinhard, Möltgen, Dieter, Schnakenbeck, Sven, Beckmann, Karin, Liese, Hanna, Callsen, Annegret, Schiewe, Ewa, Gehm, Holger, Lambert, Volker, Hinkel-Reineke, Karin, Stolzenbach, Carl-Otto, Berdin, Peter, Windler, Friedhelm, Weidnitzer, Sabine, Rosenkranz, Erika, Bürfent, Inge, Letzien, Norbert, Klossek, Doris, Liebsch, Martin, Zwicker, Andrea, Hantel, Ulrike, Pilz, Monika, Kirschner, Volker, Arnold, Rainer, Poser, Ulrich, Barthel, Wolfgang, von Aswege, Johann, Blechinger, Fritz, Fähnle, Marcus, Fritz, Reiner Walter, Jünemann, Susanne, Kirsch, Gabriele, Kulinna, Jürgen, Legner-Görke, Andreas, Lehr, Christa, Meer, Wolfgang, Panzer, Christina, Honig, Wolf-Dietrich, Raabe, Achim, Schmidt-Back, Helga, Schürmann, Ralf, Stieglitz, Hans-Günter, von der Heide, Marie-Luise, Knauer, Luitpold, Schmid, Elmar, Kastner, Jörg, Janssen, Ulrike, Standl, Albert, Gülle, Peter, Göttl, Clemens, Franze, Marianne, Moser, Gerhard, Blümm, Almut, Weber, Petra, Poetsch, Wolfgang, Puppe, Heinrich, Specht, Gerd, Badmann, Leonard, Leveringhaus, May, Schützendorf, Heribert, Posern, Michael, Huber, Christoph, Potkowski, Ralph, Eder, Christiane, Schwandner, Michael, Weigert, Rudolf, Benz, Elisabeth, Straimer, Annemarie, Uhlenbrock, Arndt, Tebarth, Franziska, Werner, Klaus-Michael, Göbel-Schlatholt, Maria, Kaschell, Hans-Jürgen, Stahlschmidt, Markus, Fischer, Klaus, Weisbach, Wolf-Rüdiger, Tschoke, Martin, Dorn, Jürgen, Menke, Helmut, Sievert, Erik, Weeg, Dagmar, Kröckert, Ulrich, Salingré, Gabriele, Mörchen, Christian, Raab, Peter, Baszenski, Angela, Loth, Clärli, Knaak, Christian, Hötte, Peter, Pieper, Jörg, Wassermann, Dirk, Olbrich, Julia, Leyendecker, Hans Josef, Gohde, Gerhard, Simons, Barbara, Brünger, Achim, Petersen, Uwe, Wahl, Heike, Tewes, Rainer, Junghans-Kullmann, Doris, Grimm-Kraft, Angela, Bohnau, Harald, Pentzek, Michael, Pinsdorf, Ursula, Busch, Thomas, Keller, Gisela, Fuchs-Römer, Susanne, Beisel, Wolfgang, Richter-Polynice, Birgitt, Cupsa, Florinela, Unkelbach, Roland Matthias, Damanakis, Barbara, Frenkel, Michael, Fuchs, Angela, Ebeling, Klaus-Wolfgang, Berger, Pauline, Gillhausen, Kurt, Hellmessen, Uwe, Hümmerich, Helga, Heede, Hans-Christian, Kormann, Boguslaw-Marian, Peters, Wolfgang Josef, Schott, Ulrich, and Matzies, Dirk

Subjects
Gerontology, Male, Aging, psychology [Cognition Disorders], lcsh:Geriatrics, Neuropsychological Tests, Cohort Studies, Social support, medicine, Dementia, psychology [Aging], Humans, ddc:610, Longitudinal Studies, Prospective Studies, Prospective cohort study, Aged, diagnosis [Cognition Disorders], Aged, 80 and over, mortality [Cognition Disorders], medicine.diagnostic_test, Proportional hazards model, business.industry, Social Support, Cognition, Neuropsychological test, medicine.disease, lcsh:RC952-954.6, Structured interview, Female, Geriatrics and Gerontology, Cognition Disorders, business, Research Article, Cohort study, Demography, Follow-Up Studies
Abstract

Background Social support has been suggested to positively influence cognition and mortality in old age. However, this suggestion has been questioned due to inconsistent operationalisations of social support among studies and the small number of longitudinal studies available. This study aims to investigate the influence of perceived social support, understood as the emotional component of social support, on cognition and mortality in old age as part of a prospective longitudinal multicentre study in Germany. Methods A national subsample of 2,367 primary care patients was assessed twice over an observation period of 18 months regarding the influence of social support on cognitive function and mortality. Perceived social support was assessed using the 14-item version of the FSozU, which is a standardised and validated questionnaire of social support. Cognition was tested by the neuropsychological test battery of the Structured Interview for the Diagnosis of Dementia (SIDAM). The influence of perceived support on cognitive change was analysed by multivariate ANCOVA; mortality was analysed by multivariate logistic and cox regression. Results Sample cognitive change (N = 1,869): Mean age was 82.4 years (SD 3.3) at the beginning of the observation period, 65.9% were female, mean cognition was 49 (SD 4.4) in the SIDAM. Over the observation period cognitive function declined in 47.2% by a mean of 3.4 points. Sample mortality (N = 2,367): Mean age was 82.5 years (SD 3.4), 65.7% were female and 185 patients died during the observation period. Perceived social support showed no longitudinal association with cognitive change (F = 2.235; p = 0.135) and mortality (p = 0.332; CI 0.829-1.743). Conclusions Perceived social support did not influence cognition and mortality over an 18 months observation period. However, previous studies using different operationalisations of social support and longer observation periods indicate that such an influence may exist. This influence is rather small and the result of complex interaction mechanisms between different components of social support; the emotional component seems to have no or only a limited effect. Further research is needed to describe the complex interactions between components of social support. Longer observation periods are necessary and standardised operationalisations of social support should be applied.

Published
2012
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2. Prediction of Dementia in Primary Care Patients

Author

Jessen, Frank, Wiese, Birgitt, Riedel-Heller, Steffi G, Ebert, Jochen, Gabriel, Angelika, Hager, Eva, Kässner, Gunter, Lipp, Ina, Lipp, Thomas, Mühlmann, Ute, Müller, Gabi, Paschke, Thomas, Rauchmaul, Gabriele, Wagner, Michael, Schmalbruch, Ina, Schmidt, Holger, Taut, Hans-Christian, Voss, Ute, Winkler, Bettina, Ziehbold, Sabine, Allwein, Eugen, Bloss, Guntram, Dick, Peter, Eiber, Johann, Weyerer, Siegfried, Fischer, Lutz-Ingo, Friedrich, Peter, Herbst, Helga, Hofmann, Andreas, Holthausen, Günther, Holtz, Karl-Friedrich, Kahmann, Ulf, Kirchner, Elke, Kirchner, Hans Georg, Knauer, Luitpold, Maier, Wolfgang, Koeppel, Andreas, Koschine, Heinz, Krebs, Walter, Kreuzer, Franz, Maier, Karl Ludwig, Mohr, Christoph, Schmid, Elmar, Schmidt, Gabriel, Thaller, Johann, Ellersdorfer, Richard, van den Bussche, Hendrik, Speth, Michael, Ackermann, Angela, Berger, Pauline, Cupsa, Florinela, Damanakis, Barbara, Ebeling, Klaus-Wolfgang, Flettner, Tim Oliver, Frenkel, Michael, Ganssauge, Friederike, Gillhausen, Kurt, Group, AgeCoDe Study, Heede, Hans-Christian, Hellmessen, Uwe, Hodgson, Benjamin, Hoff, Bernhard, Hümmerich, Helga, Korman, Boguslaw-Marian, Lüttringhaus, Dieter, Matzies, Dirk, Miasnikov, Vladimir, Peters, Wolfgang Josef, Abholz, Heinz-Harald, Richter-Polynice, Birgitt, Schiller, Gerhard Erich Richard, Schott, Ulrich, Schumacher, Andre, Siegmund, Harald, Thraen, Winfried, Unkelbach, Roland Matthias, Wirtz, Clemens, Angermeyer, Matthias, Bachmann, Cadja, Dichgans, Martin, Bickel, Horst, Finckh, Ulrich, Frenzen, Anja, Tebarth, Franziska, Kaufeler, Teresa, Luppa, Melanie, Mayer, Manfred, Romberg, Heinz-Peter, Sandholzer, Hagen, Wollny, Anja, Bormann, Gundula, Eiffländer-Gorfer, Sandra, Bouché, Winfried, Fischer-Radizi, Doris, Funke, Michael, Gatermann, Heike, Herzog, Wolfgang, Hütter, Petra, Kavka-Ziegenhagen, Stefanie, Klötzl, Günther, Krug, Bernd-Uwe, Lau, Dietrich, Fuchs, Angela, Linn, Ursula, Moritz, Andrea, Münter, Karl-Christian, Niemann, Detlef, Richard-Klein, Klaus, Schreiber, Walter, Schröder-Höch, Ursula, Schulze, Gerhard, Stelter, Klaus, Stolzenbach, Carl-Otto, Kaduszkiewicz, Hanna, Titova, Ljudmila, Weidner, Klaus, Witt, Otto-Peter, Zeigert, Eckehard, Arnold, Gerhard, Bauer, Veit-Harold, Besnier, Werner, Böttcher-Schmidt, Hanna, Grella, Hartmut, Kunzendorf, Gernot, Köhler, Mirjam, Ludwig, Ingrid, Mühlig, Hubert, Müller, Arnt, Noky, Adolf, Perleberg, Helmut, Rieder, Carsten, Rosen, Michael, Scheer, Georg, Schilp, Michael, Luck, Tobias, Schneider, Matthias, Wachter, Jürgen, Weingärtner, Brigitte, Willhauck, Hans-Georg, Eimers-Kleene, Jörg, Fischer, Klaus, Goebel-Schlatholt, Maria, Gülle, Peter, Honig, Wolf-Dietrich, Kaschell, Hans Jürgen, Mösch, Edelgard, Liese, Hanna, Marx, Manfred, Prechtel, Eberhard, Schützendorf, Heribert, Straimer, Annemarie, Tschoke, Martin, Werner, Karl-Michael, Mayen, Herrmut, Alfen, Theodor, Pentzek, Michael, Honnef, Bad, Weckbecker, Klaus, Bürfent, Inge, von Aswege, Johann, Uhlenbrock, Arndt, Weisbach, Wolf-Rüdiger, Amm, Martina, Assmann, Heinz-Michael, Bauer, Horst, and Bräutigam, Barbara

Subjects
Male, Pediatrics, medicine.medical_specialty, Activities of daily living, Genotype, Population, Psychological intervention, lcsh:Medicine, Neuropsychological Tests, Sensitivity and Specificity, Health Services Accessibility, Cohort Studies, genetics [Dementia], Alzheimer Disease, Humans, Medicine, Dementia, Verbal fluency test, ddc:610, Longitudinal Studies, lcsh:Science, education, Psychiatry, Primary Care, Aged, Aged, 80 and over, education.field_of_study, Multidisciplinary, Framingham Risk Score, methods [Primary Health Care], Primary Health Care, business.industry, lcsh:R, Prognosis, medicine.disease, diagnosis [Dementia], Mental Health, Neurology, Geriatrics, Cohort, lcsh:Q, Female, business, Research Article, Cohort study
Abstract

BACKGROUND: Current approaches for AD prediction are based on biomarkers, which are however of restricted availability in primary care. AD prediction tools for primary care are therefore needed. We present a prediction score based on information that can be obtained in the primary care setting. METHODOLOGY/PRINCIPAL FINDINGS: We performed a longitudinal cohort study in 3.055 non-demented individuals above 75 years recruited via primary care chart registries (Study on Aging, Cognition and Dementia, AgeCoDe). After the baseline investigation we performed three follow-up investigations at 18 months intervals with incident dementia as the primary outcome. The best set of predictors was extracted from the baseline variables in one randomly selected half of the sample. This set included age, subjective memory impairment, performance on delayed verbal recall and verbal fluency, on the Mini-Mental-State-Examination, and on an instrumental activities of daily living scale. These variables were aggregated to a prediction score, which achieved a prediction accuracy of 0.84 for AD. The score was applied to the second half of the sample (test cohort). Here, the prediction accuracy was 0.79. With a cut-off of at least 80% sensitivity in the first cohort, 79.6% sensitivity, 66.4% specificity, 14.7% positive predictive value (PPV) and 97.8% negative predictive value of (NPV) for AD were achieved in the test cohort. At a cut-off for a high risk population (5% of individuals with the highest risk score in the first cohort) the PPV for AD was 39.1% (52% for any dementia) in the test cohort. CONCLUSIONS: The prediction score has useful prediction accuracy. It can define individuals (1) sensitively for low cost-low risk interventions, or (2) more specific and with increased PPV for measures of prevention with greater costs or risks. As it is independent of technical aids, it may be used within large scale prevention programs.

Published
2011
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