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1. The value of the GP’s clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice

Author: Pentzek, Michael, Wagner, Michael, Maier, Wolfgang, Koppara, Alexander, Group, AgeCoDe Study, Scherer, Martin, van den Bussche, Hendrik, Abholz, Heinz-Harald, Brettschneider, Christian, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Fuchs, Angela, Heser, Kathrin, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, König, Hans-Helmut, Lange, Carolin, Lubisch, Diana, Luck, Tobias, Lühmann, Dagmar, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Posselt, Tina, Prokein, Jana, Riedel-Heller, Steffi, Röhr, Susanne, Schumacher, Anna, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, Wiese, Birgitt, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, Wolfsgruber, Steffen, Zimmermann, Thomas, and Riedel-Heller, Steffi G
Subjects: Male, medicine.medical_specialty, Clinical Decision-Making, General Practice, epidemiology [Germany], Judgment, 03 medical and health sciences, 0302 clinical medicine, General Practitioners, Germany, Internal medicine, Humans, Medicine, Dementia, ddc:610, Prospective Studies, 030212 general & internal medicine, Cognitive decline, statistics & numerical data [Referral and Consultation], Prospective cohort study, Referral and Consultation, Aged, Physician-Patient Relations, business.industry, Proportional hazards model, Research, standards [General Practitioners], Odds ratio, medicine.disease, Confidence interval, diagnosis [Dementia], Cognitive test, Log-rank test, Evidence-Based Practice, Female, Family Practice, business, 030217 neurology & neurosurgery
Abstract: BackgroundClinical judgement is intrinsic to diagnostic strategies in general practice; however, empirical evidence for its validity is sparse.AimTo ascertain whether a GP’s global clinical judgement of future cognitive status has an added value for predicting a patient’s likelihood of experiencing dementia.Design and settingMulticentre prospective cohort study among patients in German general practice that took place from January 2003 to October 2016.MethodPatients without baseline dementia were assessed with neuropsychological interviews over 12 years; 138 GPs rated the future cognitive decline of their participating patients. Associations of baseline predictors with follow-up incident dementia were analysed with mixed-effects logistic and Cox regression.ResultsA total of 3201 patients were analysed over the study period (mean age = 79.6 years, 65.3% females, 6.7% incident dementia in 3 years, 22.1% incident dementia in 12 years). Descriptive analyses and comparison with other cohorts identified the participants as having frequent and long-lasting doctor–patient relationships and being well known to their GPs. The GP baseline rating of future cognitive decline had significant value for 3-year dementia prediction, independent of cognitive test scores and patient’s memory complaints (GP ratings of very mild (odds ratio [OR] 1.97, 95% confidence intervals [95% CI] = 1.28 to 3.04); mild (OR 3.00, 95% CI = 1.90 to 4.76); and moderate/severe decline (OR 5.66, 95% CI = 3.29 to 9.73)). GPs’ baseline judgements were significantly associated with patients’ 12-year dementia-free survival rates (Mantel–Cox log rank testPConclusionIn this sample of patients in familiar doctor–patient relationships, the GP’s clinical judgement holds additional value for predicting dementia, complementing test performance and patients’ self-reports. Existing and emerging primary care-based dementia risk models should consider the GP’s judgement as one predictor. Results underline the importance of the GP-patient relationship.
Published: 2019
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2. Correlates of hospitalization among the oldest old: results of the AgeCoDe–AgeQualiDe prospective cohort study

Author: Hajek, André, Brettschneider, Christian, Stein, Janine, Luck, Tobias, Weeg, Dagmar, Mösch, Edelgard, Heser, Kathrin, Wagner, Michael, Scherer, Martin, Maier, Wolfgang, Riedel-Heller, Steffi G, König, Hans-Helmut, Eisele, Marion, Group, AgeCoDe and AgeQualiDe Study, Abholz, Heinz-Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Kaduszkiewicz, Hanna, Ernst, Annette, Fuchs, Angela, Kaufeler, Teresa, Köhler, Mirjam, Koppara, Alexander, Lubisch, Diana, Mamone, Silke, Lühmann, Dagmar, Luppa, Melanie, Mallon, Tina, Mayer, Manfred, Pentzek, Michael, Prokein, Jana, Ramirez, Alfredo, Röhr, Susanne, Schumacher, Anna, Wiese, Birgitt, Steinmann, Susanne, Tebarth, Franziska, van den Bussche, Hendrik, van der Leeden, Carolin, Weckbecker, Klaus, Werle, Jochen, Weyerer, Siegfried, Wolfsgruber, Steffen, and Zimmermann, Thomas
Subjects: Male, Aging, Longitudinal study, Activities of daily living, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Germany, Activities of Daily Living, Health care, Humans, Medicine, Cognitive Dysfunction, ddc:610, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, statistics & numerical data [Hospitalization], Aged, 80 and over, Primary Health Care, Depression, business.industry, Random effects model, Hospitalization, Logistic Models, Quality of Life, Marital status, Female, Geriatric Depression Scale, Geriatrics and Gerontology, business, 030217 neurology & neurosurgery, Demography
Abstract: Hospitalization is a key driver of health care costs. Thus far, there are only a few longitudinal studies investigating whether changes in explanatory variables lead to hospitalization. Moreover, these longitudinal studies did not focus on individuals in highest age. The purpose of the current study was to examine the correlates of hospitalization among the oldest old in Germany longitudinally. A multicenter prospective cohort study [“Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)”, AgeQualiDe]. Primary care patients ≥ 85 years took part [n = 861 at follow-up (FU) 7, average age of 89.0 years; 85–100 years]. Two waves were used. Hospitalization in the last 6 months was used as outcome measure. Well-established scales were used to quantify the independent variables such as Instrumental Activities of Daily Living Scale, Global Deterioration Scale or Geriatric Depression Scale. Logistic random effects regressions showed that the probability of hospitalization in the preceding 6 months significantly increased with increases in the social network, more depressive symptoms, functional decline, and increase in chronic conditions, whereas it was not significantly associated with age, sex, marital status, education, and cognitive impairment. Social networks moderate the relationship between functional decline and hospitalization. The results of the present longitudinal study emphasize the association of depressive symptoms, functional decline, more social networks, and chronic conditions with hospitalization among the oldest old. Treatments with the aim to reduce or postpone these factors might also help to reduce hospitalization.
Published: 2019
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3. Does transpersonal trust moderate the association between chronic conditions and general practitioner visits in the oldest old? Results of the AgeCoDe and AgeQualiDe study

Author: Hajek, André, Brettschneider, Christian, Stein, Janine, Luck, Tobias, Weeg, Dagmar, Mösch, Edelgard, Heser, Kathrin, Wagner, Michael, Scherer, Martin, Maier, Wolfgang, Riedel-Heller, Steffi G, König, Hans-Helmut, Eisele, Marion, Group, AgeCoDe and AgeQualiDe Study, Abholz, Heinz Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Lühmann, Dagmar, Ernst, Annette, Fuchs, Angela, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Lubisch, Diana, Mamone, Silke, Luppa, Melanie, Mallon, Tina, Mayer, Manfred, Pentzek, Michael, Prokein, Jana, Roehr, Susanne, Schumacher, Anna, Steinmann, Susanne, Wiese, Birgitt, Tebarth, Franziska, van den Bussche, Hendrik, van der Leeden, Carolin, Weckbecker, Klaus, Werle, Jochen, Weyerer, Siegfried, and Zimmermann, Thomas
Subjects: Male, epidemiology [Multiple Chronic Conditions], Health Services for the Aged, Office Visits, Rate ratio, Trust, Cohort Studies, 03 medical and health sciences, Health services, 0302 clinical medicine, Quality of life, 030502 gerontology, General Practitioners, psychology [Multiple Chronic Conditions], Germany, statistics & numerical data [Patient Acceptance of Health Care], Health care, statistics & numerical data [General Practitioners], Medicine, Humans, Spirituality, Multiple Chronic Conditions, ddc:610, statistics & numerical data [Office Visits], Prospective cohort study, Association (psychology), Aged, 80 and over, therapy [Multiple Chronic Conditions], Physician-Patient Relations, psychology [General Practitioners], psychology [Patient Acceptance of Health Care], business.industry, Transpersonal, Patient Acceptance of Health Care, Oldest old, statistics & numerical data [Health Services for the Aged], Quality of Life, Female, 0305 other medical science, business, 030217 neurology & neurosurgery, Needs Assessment, Demography
Abstract: AIM The purpose of this study was to investigate whether transpersonal trust (TPT) moderates the relationship between chronic conditions and general practitioner (GP) visits among the oldest old in Germany. METHODS The multicenter prospective cohort Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients (85+) (AgeQualiDe) was carried out. Individuals were recruited through GP offices at six study centers in Germany (follow-up wave 7). Primary care patients were aged ≥85 years (n = 861, mean age 89.0 years; range 85-100 years). The self-reported number of outpatient visits to the GP was used as the outcome measure. To explore religious and spiritual beliefs, the short form of the Transpersonal Trust scale was used. The presence or absence of 36 chronic conditions was recorded by the GP. RESULTS Multiple Poisson regressions showed that GP visits were positively associated with the number of chronic conditions (incidence rate ratio 1.03, P
Published: 2019
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4. Effect of Visual Impairment on Physical and Cognitive Function in Old Age: Findings of a Population-Based Prospective Cohort Study in Germany

Author: Hajek, André, Brettschneider, Christian, Riedel-Heller, Steffi G, Luck, Tobias, Bickel, Horst, Weeg, Dagmar, Koppara, Alexander, Wagner, Michael, Scherer, Martin, Maier, Wolfgang, König, Hans-Helmut, Study on Ageing, Cognition and Dementia in Primary Care Patients Group, Lühmann, Dagmar, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Ernst, Annette, Heser, Kathrin, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Eisele, Marion, Köhler, Mirjam, Lange, Carolin, Lubisch, Diana, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Olbrich, Julia, Posselt, Tina, Prokein, Jana, Röhr, Susanne, Mamone, Silke, Schumacher, Anna, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Wolfsgruber, Steffen, Zimmermann, Thomas, Wiese, Birgitt, Weyerer, Siegfried, Werle, Jochen, Pentzek, Michael, and Fuchs, Angela
Subjects: Male, Gerontology, Longitudinal study, Pediatrics, medicine.medical_specialty, epidemiology [Cognitive Dysfunction], Population, Visual impairment, Vision Disorders, epidemiology [Germany], Population based, Physical function, 03 medical and health sciences, 0302 clinical medicine, Germany, Activities of Daily Living, medicine, Humans, Cognitive Dysfunction, ddc:610, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, education, Geriatric Assessment, epidemiology [Vision Disorders], Aged, Aged, 80 and over, education.field_of_study, business.industry, Cognition, medicine.disease, Comorbidity, 030221 ophthalmology & optometry, Female, Geriatrics and Gerontology, medicine.symptom, business
Abstract: ObjectivesTo examine how visual impairment affects physical and cognitive function in old age. DesignA longitudinal population-based prospective cohort study. SettingGeneral practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves. ParticipantsIndividuals aged 77-101 at follow-up Wave 2 (N = 2,394). MeasurementsPhysical and cognitive function were assessed using an adapted scale that had been previously developed, and visual impairment was rated on a Likert scale (none, mild, severe or profound). ResultsAdjusting for sociodemographic factors and comorbidity, linear fixed-effects regression showed that the onset of severe visual impairment was associated with a decline in physical function score in the total sample ( = -0.15, P = .01) and in women ( = -.15, P = .03). Moreover, the onset of severe visual impairment was associated with decline in cognitive function score in the total sample ( = -0.38, P < .001) and in women ( = -0.38, P < .001) and men ( = -0.37, P = .001). ConclusionVisual impairment affects physical and cognitive function in old age. Interventional strategies to postpone visual impairment may contribute to maintaining physical and cognitive function.
Published: 2016
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5. Prevalence of pain and its associated factors among the oldest-olds in different care settings – results of the AgeQualiDe study

Author: Mallon, Tina, Ernst, Annette, Fuchs, Angela, Pentzek, Michael, Kleineidam, Luca, Heser, Kathrin, Riedel-Heller, Steffi, Maier, Wolfgang, Wiese, Birgitt, Scherer, Martin, group, AgeCoDe & AgeQualiDe study, Brettschneider, Christian, van den Bussche, Hendrik, Abholz, Heinz-Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Eisele, Marion, König, Hans-Helmut, Hajek, André, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Lubisch, Diana, Luck, Tobias, Lühmann, Dagmar, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Prokein, Jana, Riedel-Heller, Steffi G, Röhr, Susanne, Schumacher, Anna, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, van der Leeden, Carolin, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, and Zimmermann, Thomas
Subjects: Gerontology, Male, Activities of daily living, epidemiology [Cognitive Dysfunction], psychology [Pain], Comorbidity, 0302 clinical medicine, 610 Medical sciences Medicine, Residence Characteristics, Risk Factors, Germany, Impairment in daily activities, Activities of Daily Living, methods [Pain Management], Prevalence, Medicine, Care setting, Everyday life, Depression (differential diagnoses), Pain Measurement, Aged, 80 and over, lcsh:R5-920, Cognition, Primary care, Quality Improvement, statistics & numerical data [Residence Characteristics], Female, 0305 other medical science, Family Practice, lcsh:Medicine (General), Needs Assessment, Population ageing, Prevalence of pain, Pain, epidemiology [Germany], 03 medical and health sciences, Quality of life (healthcare), Ambulatory care, 030502 gerontology, Pain Management, Humans, Cognitive Dysfunction, ddc:610, Aged, business.industry, diagnosis [Pain], Quality of Life, Ordered logit, business, epidemiology [Pain], 030217 neurology & neurosurgery
Abstract: Background; The prevalence of pain is very common in the oldest age group. Managing pain successfully is a key topic in primary care, especially within the ageing population. Different care settings might have an impact on the prevalence of pain and everyday life. Methods: Participants from the German longitudinal cohort study on Needs, Health Service Use, Costs and Health-related Quality of Life in a large Sample of Oldest-old Primary Care Patients (85+) (AgeQualiDe) were asked to rate their severity of pain as well as the impairment with daily activities. Besides gender, age, education, BMI and use of analgesics we focused on the current housing situation and on cognitive state. Associations of the dependent measures were tested using four ordinal logistic regression models. Model 1 and 4 consisted of the overall sample, model 2 and 3 were divided according to no cognitive impairment (NCI) and mild cognitive impairment (MCI). Results: Results show a decline in pain at very old age but nonetheless a high prevalence among the 85+ year olds. Sixty-three per cent of the participants report mild to severe pain and 69% of the participants mild to extreme impairment due to pain with daily activities. Use of analgesics, depression and living at home with care support are significantly associated with higher and male gender with lower pain ratings. Conclusions: Sufficient pain management among the oldest age group is inevitable. Outpatient care settings are at risk of overlooking pain. Therefore focus should be set on pain management in these settings.
Published: 2018
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6. Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study

Author: Luck, Tobias, Rodriguez, Francisca S, Mallon, Tina, Wagner, Michael, Weeg, Dagmar, Fuchs, Angela, Brettschneider, Christian, Werle, Jochen, Scherer, Martin, Maier, Wolfgang, Riedel-Heller, Steffi G, group, AgeCoDe & AgeQualiDe study, Wiese, Birgitt, Abholz, Heinz-Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Eisele, Marion, van der Leeden, Carolin, Ernst, Annette, Hajek, André, Heser, Kathrin, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, König, Hans-Helmut, Koppara, Alexander, Lubisch, Diana, Lühmann, Dagmar, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Pentzek, Michael, Prokein, Jana, Ramirez, Alfredo, Roehr, Susanne, Schumacher, Anna, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, van den Bussche, Hendrik, Weckbecker, Klaus, In der Schmitten, Jürgen, Weyerer, Siegfried, Wolfsgruber, Steffen, Zimmermann, Thomas, Koenig, Hans-Helmut, and Mamone, Silke
Subjects: Aged, 80 and over, Male, Physician-Patient Relations, statistics & numerical data [Advance Directives], Decision Making, psychology [Advance Directives], legislation & jurisprudence [Advance Directives], psychology [Family Relations], Frequency, Primary care, Advance directives, Oldest-old age, Power of attorney, Germany, Personal Autonomy, Prevalence, Humans, Female, Mental Competency, ddc:610, ethics [Physician-Patient Relations], Family Relations, ethics [Advance Directives], Research Article, Advance care planning
Abstract: Background Completion of advance directives (ADs) and power of attorney (POA) documents may protect a person’s autonomy in future health care situations when the individual lacks decisional capacity. As such situations become naturally much more common in old age, we specifically aimed at providing information on (i) the frequency of ADs/POA in oldest-old individuals and (ii) factors associated with having completed ADs/POA. Methods We analyzed data of oldest-old primary care patients (85+ years; including community-dwelling and institutionalized individuals) within the German AgeQualiDe study. Patients were initially recruited via their general practitioners (GPs). We calculated frequencies of ADs and POA for health care with 95% confidence intervals (CI) and used multivariable logistic regression analysis to evaluate the association between having ADs and POA and participants’ socio-demographic, cognitive, functional, and health-related characteristics. Results Among 868 GP patients participating in AgeQualiDe (response = 90.9%), n = 161 had dementia and n = 3 were too exhausted/ill to answer the questions. Out of the remaining 704 (81.1%) dementia-free patients (mean age = 88.7 years; SD = 3.0), 69.0% (95%-CI = 65.6–72.4) stated to having ADs and 64.6% (95%-CI = 61.1–68.2) to having a POA for health care. Individual characteristics did not explain much of the variability of the presence/absence of ADs and POA (regression models: Nagelkerke’s R2 = 0.034/0.051). The most frequently stated reasons for not having ADs were that the older adults trust their relatives or physicians to make the right decisions for them when necessary (stated by 59.4% and 44.8% of those without ADs). Among the older adults with ADs, the majority had received assistance in its preparation (79.0%), most frequently from their children/grandchildren (38.3%). Children/grandchildren were also the most frequently stated group of designated persons (76.7%) for those with a POA for health care. Conclusions Our findings suggest a high dissemination of ADs and POA for health care in the oldest-old in Germany. Some adults without ADs/POA perhaps would have completed advance care documents, if they had had received more information and support. When planning programs to offer advanced care planning to the oldest old, it might be helpful to respond to these specific needs, and also to be sensitive to attitudinal differences in this target group.
Published: 2017
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7. The impact of social engagement on health-related quality of life and depressive symptoms in old age - evidence from a multicenter prospective cohort study in Germany

Author: Hajek, André, Brettschneider, Christian, Stein, Janine, Luck, Tobias, Bickel, Horst, Weeg, Dagmar, Wagner, Michael, Heser, Kathrin, Maier, Wolfgang, Scherer, Martin, Riedel-Heller, Steffi G, König, Hans-Helmut, Mallon, Tina, Group, AgeCoDe Study, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Fuchs, Angela, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Koppara, Alexander, Lange, Carolin, Mamone, Silke, Leicht, Hanna, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Olbrich, Julia, Pentzek, Michael, Prokein, Jana, Schumacher, Anna, Riedel-Heller, Steffi, Wiese, Birgitt, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Werle, Jochen, Weyerer, Siegfried, Wolfsgruber, Steffen, and Zimmermann, Thomas
Subjects: Gerontology, Male, Visual analogue scale, Health-related quality of life, Old age, lcsh:Computer applications to medicine. Medical informatics, Social Environment, EQ-VAS, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Germany, Humans, ddc:610, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Prospective cohort study, Depression (differential diagnoses), psychology [Social Participation], Aged, Aged, 80 and over, Depression, Research, Depressive symptoms, Geriatric Depression Scale, Public Health, Environmental and Occupational Health, Social environment, General Medicine, Social engagement, Social Participation, humanities, psychology [Depression], Quality of Life, lcsh:R858-859.7, Marital status, Female, Psychology, 030217 neurology & neurosurgery, Clinical psychology
Abstract: Background Thus far, only a few longitudinal studies investigated the impact of social engagement on health-related quality of life (HRQoL) and depressive symptoms in old age. Therefore, we aimed to examine the impact of social engagement on HRQoL and depressive symptoms in late life. Methods Individuals aged 75 years and over at baseline were interviewed every 1.5 years in a multicenter prospective cohort study in Germany. While HRQoL was quantified by using the Visual Analogue Scale (EQ VAS) of the EQ-5D instrument, depressive symptoms was assessed by using the Geriatric Depression Scale (GDS). Individuals reported the frequency (“never” to “every day”) of social engagement (e.g., engagement in the church, as a volunteer, in a party, or in a club) in the last four weeks. Fixed effects regressions were used to estimate the effect of social engagement on the outcome variables. Results After adjusting for age, marital status, functional status and chronic diseases, fixed effects regressions revealed that the onset of social engagement markedly increased HRQoL and considerably decreased depressive symptoms in the total sample and in women, but not men. Conclusions Our findings corroborate the relevance of social engagement for HRQoL and depressive symptoms in old age. Encouraging the individuals to start, maintain and expand social engagement in late life might help to maintain and improve HRQoL and decrease depressive symptoms.
Published: 2017
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8. Mortality in Incident Cognitive Impairment: Results of the Prospective AgeCoDe Study

Author: Luck, Tobias, Riedel-Heller, Steffi G, Mamone, Silke, Mallon, Tina, Wolfsgruber, Steffen, Weeg, Dagmar, Fuchs, Angela, Brettschneider, Christian, Scherer, Martin, Maier, Wolfgang, Weyerer, Siegfried, group, AgeCoDe study, Roehr, Susanne, van den Bussche, Hendrik, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Wiese, Birgitt, Köhler, Mirjam, Koppara, Alexander, Lubisch, Diana, Lühmann, Dagmar, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Prokein, Jana, Schumacher, Anna, Stein, Janine, van der Leeden, Carolin, Steinmann, Susanne, Tebarth, Franziska, Wagner, Michael, Weckbecker, Klaus, Zimmermann, Thomas, Heser, Kathrin, Bickel, Horst, Pentzek, Michael, König, Hans-Helmut, and Werle, Jochen
Subjects: Male, Pediatrics, medicine.medical_specialty, epidemiology [Germany], Kaplan-Meier Estimate, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Germany, Mean Survival Time, Medicine, Dementia, Humans, 030212 general & internal medicine, ddc:610, Prospective Studies, Prospective cohort study, Cognitive impairment, Aged, mortality [Cognition Disorders], Proportional hazards model, business.industry, Incidence, Cognition, medicine.disease, Increased risk, Ageing, Female, Geriatrics and Gerontology, Cognition Disorders, business, 030217 neurology & neurosurgery
Abstract: Objectives To investigate mortality risk and survival time in new-incident cases of cognitive impairment (CI) in old age. Design Prospective cohort study in six German cities. Setting German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). Participants Two thousand eighty-nine nondemented GP patients aged 75+. Measurements Every 18 months, trained psychologists and physicians conducted structured clinical interviews at the participants’ homes. Dates of death were obtained from relatives, general practitioner (GP), or the local registry offices. We used the Kaplan–Meier survival method to estimate survival times of individuals with and without incident CI and multivariable Cox proportional hazards regressions to assess the association between CI and mortality risk, controlled for covariates. Results Out of the 2,089 included patients at follow-up I, 859 (41.1%) died during the subsequent mean observation period of 8.0 years. Patients with incident CI at follow-up I showed a significantly higher case-fatality rate per 1,000 person-years (74.2, 95% CI = 64.2–84.2 vs 47.8, 95% CI = 44.6–51.0) and a significantly shorter mean survival time in the observation period than those without (7.8 vs 9.1 years; P < .001). The association between incident CI and mortality remained significant in the multivariable Cox analyses–incident CI was associated with a 42% increased, incident severe CI with a 75% increased mortality risk. Conclusion Our findings suggest an elevated mortality risk in newly acquired cognitive deficits in old age. Even though further studies are required to analyze potential underlying mechanisms, our findings support the notion that such cognitive deficits should be taken seriously in clinical practice not only for an increased risk of developing dementia but also for a broader range of possible adverse health outcomes.
Published: 2017
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9. Age of major depression onset, depressive symptoms, and risk for subsequent dementia: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe)

Author: Heser, K., Tebarth, F., Leicht, H., Bohnau, Harald, Pinsdorf, Ursula, Busch, Thomas, Keller, Gisela, Fuchs-Romer, Susanne, Beisel, Wolfgang, Richter-Polynice, Birgitt, Cupsa, Florinela, Unkelbach, Roland Matthias, Schiller, Gerhard, Pentzek, M., Damanakis, Barbara, Frenkel, Michael, Ebeling, Klaus-Wolfgang, Berger, Pauline, Gillhausen, Kurt, Hellmessen, Uwe, Hummerich, Helga, Heede, Hans-Christian, Kormann, Boguslaw-Marian, Peters, Josef, Fuchs, A., Schott, Ulrich, Matzies, Dirk, Schumacher, Andre, Oliver Flettner, Tim, Thraen, Winfried, Siegmund, Harald, Levacher, Claus, Blankenstein, Tim, Lamborelle, Eliane, Hollstein, Ralf, Riedel-Heller, S. G., Hoffmann, Edna, Ghane, Ingeborg, Claß, Regine, Meier, Stefan-Wolfgang, Moers, Leo W, Wundram, Udo, Schmitt, Klaus, Missghian, Rastin, Spallek, Karin, Schlosser, Christiane, Luppa, M., Groß, Kathrin, Bouche, Winfried, Linn, Ursula, Bormann, Gundula, Schulze, Gerhard, Stelter, Klaus, Gatermann, Heike, Fischer-Radizi, Doris, Witt, Peter, Kavka, Stefanie, Prokein, J., Klotzl, Gunther, Baumho, Michael, Oberlander, Maren, Schiewe, Cornelia, Hufnagel, Jorg, Kressel, Marei, Kebschull, Michael, Wagner, Christine, Burkhardt, Fridolin, Hase, Martina, Scherer, M., Houcken, Karl-Heinz, Zebidi, Christiane, Brohan, Johann, Russ, Christiane, Bethge, Frank, Rughase-Block, Gisela, Lorenzen, Margret, Elsen, Arne, Korte, Daniela, Jedicke, Ursula, Group, Age CoDe Study, Zoras, Constantin, Pfeil-Woltmann, Gabriele, Kaiser, Martin, Bruns, Johannes, Homann, Joachim, Gorgon, Georg, Middendorf, Niklas, Menschke, Kay, Bayer, Hans H, Maier, Wolfgang, Jesse, Nadine, Dahlke, Marcus, Lipp, Thomas, Amm, Martina, Bauer, Horst, Rauchmaul, Gabriele, Ebert, Hans Jochen, Gabriel-Mu, Angelika, Taut, Hans-Christian, Voß, Hella, Scherer, Martin, Schmidt, Holger, Hager, Eva, Tunze, Bettina, Paschke, Thomas, Assmann, Heinz-Michael, Rahnefeld, Uwe, Striegler, Petra, Gierth, Marga, Boehm, Margret, Harnisch, Dagmar, Wiese, B., van den Bussche, Hendrik, Kornisch-Koch, Simone, Hambsch, Frank, Herzig, Cornelia, Georgi, Astrid, Schwarzmann, Erhard, Schinagl, Gerd, Pehnke, Ulrike, Dayab, Mohammed, Brosig, Michael, Sperling, Volkmar, Abholz, Heinz-Harald, Lebuser, Frank, Hagert, Detlef, Arnold, Gerhard, Bauer, Viet-Harold, Becker, Hartwig, Becker, Hermine, Besier, Werner, Grella, Hartmut, Grimm, Hans Heinrich, Heck, Petra, Bachmann, Cadja, Hemler, Werner, Henn, Eric, Mayer, Manfred, Orlovius, Gerhard, Renz, Helmut, Scheer, Georg, Schilp, Michael, Schmid, Angela, Schneider, Matthias, Uhle, Christian, Bickel, Horst, Weinga, Brigitte, Wochele, Eberhard, Wolfram, Bernhard, Hofmann, Andreas, Allwein, Eugen, Ruile, Helmut, Koeppel, Andreas, Dick, Peter, Holtz, Friedrich, Schmidt, Gabriel, Blank, Wolfgang, Fischer, Lutz-Ingo, Thaller, Johann, Bloß, Guntram, Kreuzer, Franz, Holthausen, Gunther, Ludwig Maier, Karl, Krebs, Walter, Mohr, Christoph, Koschine, Heinz, Ellersdorfer, Richard, Speth, Michael, Kleinhans, Maria, Koutsouva-Sack, Panagiota, Staudinger, Gabriele, Eiber, Johann, Thiel, Stephan, Gold, Cornelia, Nalbach, Andrea, Reichert, Kai, Neef, Martin, Eifflaender-Gorfer, Sandra, Fleischmann, Viktor, Mayer, Natalija, Spiegl, Andreas, Renner, Fritz, Weishappel-Ketisch, Eva, Kochems, Thomas, Hunger, Hartmut, Hofbeck, Marianne, Neumeier, Alfred, Goldhofer, Elfriede, Eisele, Marion, Bommer, Thomas, Vollmuth, Reinhold, Lanzinger, Klaus, Pauli, Ramona, Lindner, Jutta, Brandt, Gerlinde, Hohentanner, Otto, Porz, Peter, Zimmerhackl, Bernd, Hallwachs, Alexander, Ernst, Annette, Haseke, Claudia, Ploch, Andreas, Swobodnik, Monika, Jost, Detlev, Narr, Renate, Nehmann, Gabriele, Eder, Christiane, Pillin, Helmut, Loth, Frank, Fritz, Nicola, Fuchs, Angela, Rafferzeder, Michael, Zirpel, Dietmar, Romberg, Heinz-Peter, Liese, Hanna, Burfent, Inge, von Aswege, Johann, Honig, Wolf-Dietrich, Schu, Heribert, Marx, Manfred, Straimer, Annemarie, Eisele, M., Heser, Kathrin, Uhlenbrock, Arndt, Werner, Michael, Gobel-Schlatholt, Maria, Prechtel, Eberhard, Kaschell, Hans-Jurgen, Weckbecker, Klaus, Alfen, Theodor, Eimers-Kleene, Jorg, Fischer, Klaus, Weisbach, Wolf-Rudiger, Jessen, Frank, Tschoke, Martin, Fliedner, Michael, Hodgson, Binjamin, Hamkens, Werner, Ackermann, Angela, Kaduszkiewicz, Hanna, Kirsch, Michael, Miasnikov, Vladimir, Kormann, Marian, Kaufeler, Teresa, Lu, Dieter, Wirtz, Clemens, Kohler, Mirjam, Krug, Bernd-Uwe, Hutter, Petra, Lau, Dietrich, Schroder-Hoch, Ursula, Herzog, Wolfgang, Weidner, Klaus, Witt, Otto-Peter, Konig, Hans-Helmut, Titova, Ljudmila, Moritz, Andrea, Lipp, Ina, Koppara, Alexander, Muhlmann, Ute, Bra, Barbara, Ziehbold, Sabine, Lange, Carolin, Schmalbruch, Ina, Ka, Gunter, Bo, Hanna, Ludwig, Ingrid, Noky, Adolf, Leicht, Hanna, Perleberg, Helmut, Rieder, Carsten, Rosen, Michael, Kunzendorf, Gerhard, Wachter, Jurgen, Weingartner, Brigitte, Luck, Tobias, Willhauck, Hans-Georg, Herbst, Helga, Friedrich, Peter, Kirchner, Hans-Georg, Kirchner, Elke, Knauer, Luitpold, Bickel, H., Luppa, Melanie, Holtz, Karl-Friedrich, Schmid, Elmar, Kahmann, Ulf, nther Holthausen, Gu, Mosch, Edelgard, Reich, Paul, Stahl, Eberhard, Lunow, Reinhold, Undritz, Klaus, Voss, Bernd, Spreer, Achim, Brenig, Oliver, Eich, Ralf, Vossel, Angelika, Leggewie, Dieter, Olbrich, Julia, Schmidt, Angelika, Aghdai-Heuser, Nahid, Witten, Lutz, Igel, Michael, Hodgson, Benjamin, Hoff, Bernhard, Pentzek, Michael, Luttringhaus, Dieter, Opitz, Rolf, Bausch, Jurgen, Mecking, Dirk, Ganßauge, Friederike, Peters, Elmar, Wester, Alfons, Petersen, Werner, Prokein, Jana, Daase, Martin, Rusing, Martin, von Sethe, Christoph, Borngra, Wilmhard, Colling-Pook, Brigitte, Weidner, Ullrich, Rieger, Peter, Witte, Lutz, Busch, Hans-Wilhelm, Unger, Jurgen, Schumacher, Anna, Preis, Angela, Mann, Michael, Haeberle, Ernst, Kohler, Horst, Sliwiok, Helmut, Deest, Harald, Ackermann-Korner, Margret, Reinstorff, Dieter, Schluter, Christamaria, Heinrichs, Henrik, Riedel-Heller, Steffi, Dankwarth, Ole, Bose, Michael, Ryll, Ulricke, Bauer, Reinhard, Schnakenbeck, Sven, Beckmann, Karin, Callsen, Annegret, Schiewe, Ewa, Gehm, Holger, Lambert, Volker, Stein, Janine, Hinkel-Reineke, Karin, Stolzenbach, Carl-Otto, Berdin, Peter, Windler, Friedhelm, Weidnitzer, Sabine, Rosenkranz, Erika, Letzien, Norbert, Klossek, Doris, Liebsch, Martin, Steinmann, Susanne, Zwicker, Andrea, Hantel, Ulrike, Pilz, Monika, Kirschner, Volker, Arnold, Rainer, Poser, Ulrich, Barthel, Wolfgang, Blechinger, Fritz, Fritz, Reiner Walter, Junemann, Susanne, Köhler, M., Tebarth, Franziska, Kirsch, Gabriele, Kulinna, Jurgen, Legner-Gorke, Andreas, Lehr, Christa, Meer, Wolfgang, Panzer, Christina, Raabe, Achim, Schmidt-Back, Helga, Wagner, Michael, Gunter Stieglitz, Hans, von der Heide, Marie-Luise, Kirchner, Georg, Kastner, Jorg, Janssen, Ulrike, Standl, Albert, Gottl, Clemens, Franze, Marianne, Moser, Gerhard, Blumm, Almut, Weber, Petra, Poetsch, Wolfgang, Puppe, Heinrich, Weeg, Dagmar, Specht, Gerd, Badmann, Leonard, Leveringhaus, May, Posern, Michael, Potkowski, Ralph, Schwandner, Michael, Weigert, Rudolf, Huber, Christoph, Werle, Jochen, Weyerer, Siegfried, Wiese, Birgitt, Wolfsgruber, Steffen, Zimmermann, Thomas, Adrian, Claudia, Mösch, E., Gulle, Peter, Schutzendorf, Heribert, Benz, Elisabeth, Werner, Klaus-Michael, Weyerer, S., Stahlschmidt, Markus, Dorn, Jurgen, Menke, Helmut, Werle, J., Sievert, Erik, Krockert, Ulrich, Salingre, Gabriele, Morchen, Christian, Raab, Peter, Baszenski, Angela, Loth, Clarli, Knaak, Christian, Hotte, Peter, Pieper, Jorg, König, H-H, Wassermann, Dirk, Leyendecker, Hans Josef, Gohde, Gerhard, Simons, Barbara, Brunger, Achim, Petersen, Uwe, Wahl, Heike, Tewes, Rainer, Junghans-Kullmann, Doris, and Grimm-Kraft, Angela
Subjects: Male, Risk, epidemiology [Cognition Disorders], Aging, medicine.medical_specialty, epidemiology [Alzheimer Disease], etiology [Alzheimer Disease], epidemiology [Depressive Disorder, Major], epidemiology [Germany], epidemiology [Dementia], Prodrome, Alzheimer Disease, Germany, medicine, History of depression, psychology [Aging], Humans, Dementia, ddc:610, Age of Onset, Risk factor, Psychiatry, Applied Psychology, Depression (differential diagnoses), Aged, Aged, 80 and over, epidemiology [Depression], Depressive Disorder, Major, Primary Health Care, Depression, business.industry, Hazard ratio, Cognition, Middle Aged, medicine.disease, Psychiatry and Mental health, Female, etiology [Dementia], Age of onset, Cognition Disorders, business, Follow-Up Studies
Abstract: BackgroundWhether late-onset depression is a risk factor for or a prodrome of dementia remains unclear. We investigated the impact of depressive symptoms and early- v. late-onset depression on subsequent dementia in a cohort of elderly general-practitioner patients (n = 2663, mean age = 81.2 years).MethodRisk for subsequent dementia was estimated over three follow-ups (each 18 months apart) depending on history of depression, particularly age of depression onset, and current depressive symptoms using proportional hazard models. We also examined the additive prediction of incident dementia by depression beyond cognitive impairment.ResultsAn increase of dementia risk for higher age cut-offs of late-onset depression was found. In analyses controlling for age, sex, education, and apolipoprotein E4 genotype, we found that very late-onset depression (aged ⩾70 years) and current depressive symptoms separately predicted all-cause dementia. Combined very late-onset depression with current depressive symptoms was specifically predictive for later Alzheimer's disease (AD; adjusted hazard ratio 5.48, 95% confidence interval 2.41–12.46, p ConclusionsDepression might be a prodrome of AD but not of dementia of other aetiology as very late-onset depression in combination with current depressive symptoms, possibly emerging as a consequence of subjectively perceived worrisome cognitive deterioration, was most predictive. As depression parameters and subjective memory impairment predicted AD independently of objective cognition, clinicians should take this into account.
Published: 2012
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10. Effect of Cardiovascular and Metabolic Disease on Cognitive Test Performance and Cognitive Change in Older Adults

Author: Köhler, Mirjam, Kliegel, Matthias, Pentzek, Michael, Leicht, Hanna, König, Hans-Helmut, Luppa, Melanie, Riedel-Heller, Steffi, Jessen, Frank, Maier, Wolfgang, Scherer, Martin, Wagner, Michael, Ageing, Cognition and Dementia in Primary Care Patients, Kaduszkiewicz, Hanna, Abholz, Heinz-Harald, Blank, Wolfgang, Daerr, Melanie, Eifflaender-Gorfer, Sandra, Eisele, Marion, Heser, Kathrin, Kaufeler, Teresa, Luck, Tobias, Mayer, Manfred, Olbrich, Julia, Bachmann, Cadja, Britta, Schürmann, Stein, Janine, Stock, Kristina, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Zimmermann, Thomas, Wiese, Birgitt, Bickel, Horst, Mösch, Edelgard, Weyerer, Siegfried, Werle, Jochen, and Fuchs, Angela
Subjects: Male, Gerontology, complications [Cardiovascular Diseases], physiopathology [Depression], Interviews as Topic, ddc:150, Germany, Diabetes mellitus, complications [Depression], Diabetes Mellitus, medicine, Humans, ddc:610, Longitudinal Studies, Prospective Studies, Cognitive decline, Prospective cohort study, Stroke, Depression (differential diagnoses), Disease burden, Aged, Aged, 80 and over, Psychiatric Status Rating Scales, Depression, business.industry, etiology [Cognition Disorders], physiopathology [Cardiovascular Diseases], Cognition, medicine.disease, Cognitive test, Cardiovascular Diseases, physiopathology [Cognition Disorders], Female, Geriatrics and Gerontology, Cognition Disorders, business, physiopathology [Diabetes Mellitus]
Abstract: Objectives: To examine the effect of cardiovascular and metabolic diseases on initial cognitive test performance and rate of change in three cognitive measures. Design: Prospective cohort study. Setting: General practices in six towns throughout Germany. Participants: Three thousand three hundred twenty-seven participants aged 75 and older (average 79.7 ± 3.6). Measurements: Data were collected during home visits every 18 months and included sociodemographic variables, depression, disease status, drug intake, and cognition. Results: Although the presence of transient ischemic attack (TIA) or stroke and diabetes mellitus was related to poor initial cognitive test performance, the presence of those and other far-reaching chronic diseases or a higher disease burden were not related to the rate of change in cognition over time. Conclusion: Diabetes mellitus, stroke and TIA affect cognitive test performance beyond well-known sociodemographic variables and depressive symptoms, although none of these diseases contributed to cognitive decline over time. In practical terms, prevention and diagnosis of cardiovascular and metabolic diseases may be essential to cognitively healthy aging.
Published: 2012
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11. Incident Subjective Cognitive Decline Does Not Predict Mortality in the Elderly--Results from the Longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe)

Author: Roehr, Susanne, Luck, Tobias, Pentzek, Michael, Lange, Carolin, Prokein, Jana, Weyerer, Siegfried, Mösch, Edelgard, König, Hans-Helmut, Maier, Wolfgang, Scherer, Martin, Jessen, Frank, Riedel-Heller, Steffi G, Heser, Kathrin, Group, AgeCoDe Study, Abholz, Heinz-Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Fuchs, Angela, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Leicht, Hanna, Luppa, Melanie, Mayer, Manfred, Olbrich, Julia, Posselt, Tina, Schumacher, Anna, Riedel-Heller, Steffi, Röhr, Susanne, Stein, Janine, Steinmann, Susanne, Wiese, Birgitt, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Wolfsgruber, Steffen, Zimmermann, Thomas, Brettschneider, Christian, and Koppara, Alexander
Subjects: Male, congenital, hereditary, and neonatal diseases and abnormalities, Aging, epidemiology [Cognitive Dysfunction], psychology [Dementia], lcsh:Medicine, Kaplan-Meier Estimate, epidemiology [Dementia], Cognition, hemic and lymphatic diseases, Prevalence, psychology [Aging], Humans, Cognitive Dysfunction, ddc:610, Longitudinal Studies, Prospective Studies, Mortality, lcsh:Science, Aged, Aged, 80 and over, lcsh:R, Age Factors, Socioeconomic Factors, lcsh:Q, Dementia, Female, psychology [Cognitive Dysfunction], etiology [Dementia], Research Article
Abstract: OBJECTIVE:Subjective cognitive decline (SCD) might represent the first symptomatic representation of Alzheimer's disease (AD), which is associated with increased mortality. Only few studies, however, have analyzed the association of SCD and mortality, and if so, based on prevalent cases. Thus, we investigated incident SCD in memory and mortality. METHODS:Data were derived from the German AgeCoDe study, a prospective longitudinal study on the epidemiology of mild cognitive impairment (MCI) and dementia in primary care patients over 75 years covering an observation period of 7.5 years. We used univariate and multivariate Cox regression analyses to examine the relationship of SCD and mortality. Further, we estimated survival times by the Kaplan Meier method and case-fatality rates with regard to SCD. RESULTS:Among 971 individuals without objective cognitive impairment, 233 (24.0%) incidentally expressed SCD at follow-up I. Incident SCD was not significantly associated with increased mortality in the univariate (HR = 1.0, 95% confidence interval = 0.8-1.3, p = .90) as well as in the multivariate analysis (HR = 0.9, 95% confidence interval = 0.7-1.2, p = .40). The same applied for SCD in relation to concerns. Mean survival time with SCD was 8.0 years (SD = 0.1) after onset. CONCLUSION:Incident SCD in memory in individuals with unimpaired cognitive performance does not predict mortality. The main reason might be that SCD does not ultimately lead into future cognitive decline in any case. However, as prevalence studies suggest, subjectively perceived decline in non-memory cognitive domains might be associated with increased mortality. Future studies may address mortality in such other cognitive domains of SCD in incident cases.
Published: 2015
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12. Prevalence and determinants of overweight and obesity in old age in Germany

Author: Hajek, André, Lehnert, Thomas, Luck, Tobias, Bickel, Horst, Mösch, Edelgard, Heser, Kathrin, Wagner, Michael, Maier, Wolfgang, Scherer, Martin, Riedel-Heller, Steffi G, König, Hans-Helmut, Group, AgeCoDe Study, Ernst, Annette, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Fuchs, Angela, Lange, Carolin, Jessen, Frank, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Koppara, Alexander, Leicht, Hanna, Wiese, Birgitt, Luppa, Melanie, Mayer, Manfred, Olbrich, Julia, Pentzek, Michael, Prokein, Jana, Schumacher, Anna, Riedel-Heller, Steffi, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, Wolfsgruber, Steffen, and Zimmermann, Thomas
Subjects: Male, Pediatrics, Younger age, Cross-sectional study, Overweight, Severity of Illness Index, Body Mass Index, Elderly, Cognition, Germany, Prevalence, Longitudinal Studies, Aged, 80 and over, Confounding, Confounding Factors, Epidemiologic, psychology [Obesity], ddc, Causality, physiopathology [Cognition Disorders], Female, medicine.symptom, Research Article, epidemiology [Cognition Disorders], medicine.medical_specialty, Confounding Factors (Epidemiology), epidemiology [Germany], Motor Activity, Severity of illness, medicine, Humans, ddc:610, Obesity, Mobility Limitation, physiopathology [Obesity], Aged, epidemiology [Obesity], business.industry, Physical Activity, diagnosis [Obesity], medicine.disease, Cross-Sectional Studies, Socioeconomic Factors, Longitudinal, Geriatrics and Gerontology, Cognition Disorders, business, Body mass index, Demography
Abstract: Background Mean body weight gradually increases with age. Yet, little data exists on the prevalence of excess weight in populations aged 80 years or older. Moreover, little is known about predictors of overweight and obesity in old age. Thus, the purpose of this study was: To present data on the prevalence of excess weight in old age in Germany, to investigate predictors of excess weight in a cross-sectional approach and to examine factors affecting excess weight in a longitudinal approach. Methods Subjects consisted of 1,882 individuals aged 79 years or older. The course of excess weight was observed over 3 years. Excess weight was defined as follows: Overweight (25 kg/m2 ≤ BMI
Published: 2015
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13. Longitudinal Predictors of Institutionalization in Old Age

Author: Hajek, André, Brettschneider, Christian, Stein, Janine, Luck, Tobias, Bickel, Horst, Mösch, Edelgard, Wagner, Michael, Jessen, Frank, Maier, Wolfgang, Scherer, Martin, Riedel-Heller, Steffi G, König, Hans-Helmut, Lange, Carolin, Group, AgeCoDe Study, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Posselt, Tina, Fuchs, Angela, Heser, Kathrin, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, Koppara, Alexander, Leicht, Hanna, Wiese, Birgitt, Luppa, Melanie, Mayer, Manfred, Olbrich, Julia, Pentzek, Michael, Prokein, Jana, Schumacher, Anna, Riedel-Heller, Steffi, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, Wolfsgruber, Steffen, and Zimmermann, Thomas
Subjects: Male, Gerontology, Activities of daily living, physiopathology [Depression], lcsh:Medicine, statistics & numerical data [Homes for the Aged], Personality Assessment, Logistic regression, Germany, Activities of Daily Living, Homes for the Aged, Longitudinal Studies, diagnosis [Hearing Loss], lcsh:Science, Depression (differential diagnoses), Aged, 80 and over, education.field_of_study, Multidisciplinary, Depression, Institutionalization, physiopathology [Dementia], physiopathology [Hearing Loss], statistics & numerical data [Nursing Homes], ddc, Spouse, Marital status, Female, Personality Assessment Inventory, statistics & numerical data [Marital Status], Psychology, Research Article, Population, diagnosis [Depression], medicine, Humans, Dementia, statistics & numerical data [Institutionalization], ddc:610, Mobility Limitation, Hearing Loss, education, Aged, Probability, Marital Status, lcsh:R, medicine.disease, Nursing Homes, diagnosis [Dementia], Logistic Models, lcsh:Q
Abstract: Objective To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. Methods In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits. Results The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization. Conclusion Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges.
Published: 2015
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14. Mortality in incident dementia - results from the German Study on Aging, Cognition, and Dementia in Primary Care Patients

Author: Roehr, S., Luck, T., Pentzek, M., Steinmann, S., Weyerer, S., Werle, J., Wiese, B., Scherer, M., Maier, W., Riedel-Heller, S. G., Group, AgeCoDe Study, Scherer, Martin, Bickel, H., Abholz, Heinz-Harald, Bachmann, Cadja, Bickel, Horst, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Fuchs, Angela, Heser, Kathrin, Brettschneider, C., Kaduszkiewicz, Hanna, Kaufeler, Teresa, Köhler, Mirjam, König, Hans-Helmut, Koppara, Alexander, Lange, Carolin, Leicht, Hanna, Luck, Tobias, Luppa, Melanie, Mayer, Manfred, Ernst, A., Mösch, Edelgard, Olbrich, Julia, Pentzek, Michael, Prokein, Jana, Schumacher, Anna, Riedel-Heller, Steffi, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Fuchs, A., Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, Wiese, Birgitt, Wolfsgruber, Steffen, Zimmermann, Thomas, König, H-H, Jessen, F., Lange, C., and Mösch, E.
Subjects: Gerontology, Male, psychology [Dementia], epidemiology [Germany], Primary care, Subjective memory, German, Cognition, German population, Risk Factors, Germany, medicine, Dementia, Humans, ddc:610, Longitudinal Studies, Prospective Studies, Aged, Demography, Proportional Hazards Models, Aged, 80 and over, Proportional hazards model, Age Factors, physiology [Cognition], mortality [Dementia], medicine.disease, Prognosis, language.human_language, Sociological Factors, diagnosis [Dementia], Psychiatry and Mental health, Life expectancy, language, Female, Psychology, Follow-Up Studies
Abstract: Objective Dementia is known to increase mortality, but the relative loss of life years and contributing factors are not well established. Thus, we aimed to investigate mortality in incident dementia from disease onset. Method Data were derived from the prospective longitudinal German AgeCoDe study. We used proportional hazards models to assess the impact of sociodemographic and health characteristics on mortality after dementia onset, Kaplan–Meier method for median survival times. Results Of 3214 subjects at risk, 523 (16.3%) developed incident dementia during a 9-year follow-up period. Median survival time after onset was 3.2 years (95% CI = 2.8–3.7) at a mean age of 85.0 (SD = 4.0) years (≥2.6 life years lost compared with the general German population). Survival was shorter in older age, males other dementias than Alzheimer's, and in the absence of subjective memory complaints (SMC). Conclusion Our findings emphasize that dementia substantially shortens life expectancy. Future studies should further investigate the potential impact of SMC on mortality in dementia.
Published: 2015
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15. Elevated HbA1c is associated with increased risk of incident dementia in primary care patients

Author: Ramirez, Alfredo, Wolfsgruber, Steffen, Mösch, Edelgard, Bickel, Horst, Wiese, Birgitt, Prokein, Jana, König, Hans-Helmut, Brettschneider, Christian, Breteler, Monique M, Maier, Wolfgang, Jessen, Frank, Scherer, Martin, Lange, Carolin, Group, AgeCoDe Study, Abholz, Heinz-Harald, Bachmann, Cadja, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Heser, Kathrin, Kaufeler, Teresa, Köhler, Mirjam, Kaduszkiewicz, Hanna, Koppara, Alexander, Luppa, Melanie, Mayer, Manfred, Schumacher, Anna, Stein, Janine, Tebarth, Franziska, Wagner, Michael, Weckbecker, Klaus, Weeg, Dagmar, Zimmermann, Thomas, Weyerer, Siegfried, Werle, Jochen, Pentzek, Michael, Fuchs, Angela, Riedel-Heller, Steffi G, and Luck, Tobias
Subjects: Male, medicine.medical_specialty, Glycated Hemoglobin A, endocrine system diseases, metabolism [Glycated Hemoglobin A], blood [Diabetes Mellitus, Type 2], Comorbidity, epidemiology [Dementia], Internal medicine, Epidemiology, metabolism [Glycated Hemoglobin], medicine, Dementia, Humans, ddc:610, Risk factor, Psychiatry, Aged, Retrospective Studies, Aged, 80 and over, Glycated Hemoglobin, Primary Health Care, business.industry, General Neuroscience, Incidence (epidemiology), epidemiology [Diabetes Mellitus, Type 2], Incidence, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, Retrospective cohort study, General Medicine, medicine.disease, blood [Dementia], Psychiatry and Mental health, Clinical Psychology, Diabetes Mellitus, Type 2, Cohort, statistics & numerical data [Primary Health Care], Female, hemoglobin A1c protein, human, Geriatrics and Gerontology, business, Mental Status Schedule
Abstract: Type 2 diabetes mellitus (T2DM) is a risk factor of dementia. The effect of T2DM treatment quality on dementia risk, however, is unclear. 1,342 elderly individuals recruited via general practitioner registries (AgeCoDe cohort) were analyzed. This study analyzed the association between HbA1c level and the incidence of all-cause dementia (ACD) and of Alzheimer's disease dementia (referred to here as AD). HbA1c levels ≥6.5% were associated with 2.8-fold increased risk of incident ACD (p = 0.027) and for AD (p = 0.047). HbA1c levels ≥7% were associated with a five-fold increased risk of incident ACD (p = 0.001) and 4.7-fold increased risk of incident AD (p = 0.004). The T2DM diagnosis per se did not increase the risk of either ACD or AD. Higher levels of HbA1c are associated with increased risk of ACD and AD in an elderly population. T2DM diagnosis was not associated with increased risk if HbA1c levels were below 7%.
Published: 2014
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16. The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care?

Author: König, Hans-Helmut, Leicht, Hanna, Pentzek, Michael, Bouché, Winfried, Linn, Ursula, Bormann, Gundula, Schulze, Gerhard, Stelter, Klaus, Gatermann, Heike, Fischer-Radizi, Doris, Witt, Otto-Peter, Kavka, Stefanie, Klötzl, Günther, Werle, Jochen, Münter, Karl-Christian, Baumhöfener, Michael, Oberländer, Maren, Schiewe, Cornelia, Hufnagel, Jörg, Kressel, Anne-Marei, Kebschull, Michael, Wagner, Christine, Burkhardt, Fridolin, Hase, Martina, Weyerer, Siegfried, Büttner, Matthias, Houcken, Karl-Heinz, Zebidi, Christiane, Bröhan, Johann, Russ, Christiane, Bethge, Frank, Rughase-Block, Gisela, Lorenzen, Margret, Elsen, Arne, Stiller, Lerke, Wiese, Birgitt, Giovanopoulos, Angelika, Korte, Daniela, Jedicke, Ursula, Müller-Mette, Rosemarie, Richter, Andrea, Rauhala-Parrey, Sanna, Zoras, Constantin, Pfeil-Woltmann, Gabriele, Knöppel-Frenz, Annett, Kaiser, Martin, Scherer, Martin, Bruns, Johannes, Homann, Joachim, Gorgon, Georg, Middendorf, Niklas, Menschke, Kay, Stöver, Hans Heiner, Bayer, Hans H, Quandt, Rüdiger, Köllner, Hans-Michael, Maier, Wolfgang, Strohbehn, Enno, Haller, Thomas, Jesse, Nadine, Domsch, Martin, Dahlke, Marcus, Lipp, Thomas, Lipp, Ina, Amm, Martina, Bauer, Horst, Rauchmaul, Gabriele, Riedel-Heller, Steffi G, Ebert, Hans Jochen, Gabriel-Müller, Angelika, Taut, Hans-Christian, Voß, Hella, Mühlmann, Ute, Schmidt, Holger, Müller, Gabi, Hager, Eva, Tunze, Bettina, Bräutigam, Barbara, Group, AgeCoDe Study, Paschke, Thomas, Assmann, Heinz-Michael, Schmalbruch, Ina, Kässner, Gunter, Pförtzsch, Iris, Ernst-Brennecke, Brigitte, Rahnefeld, Uwe, Striegler, Petra, Gierth, Marga, Krügel, Anselm, Adrian, Claudia, Boehm, Margret, Harnisch, Dagmar, Kornisch-Koch, Simone, Höne, Birgit, Schönherr, Lutz, Hambsch, Frank, Meitsch, Katrin, Krägelin-Nobahar, Britta, Herzig, Cornelia, Georgi, Astrid, Liese, Hanna, Schwarzmann, Erhard, Schinagl, Gerd, Pehnke, Ulrike, Dayab, Mohammed, Müller, Sabine, Onnasch, Jörg-Friedrich, Brosig, Michael, Frydetzki, Dorothea, Abschke, Uwe, Sperling, Volkmar, Brettschneider, Christian, Bürfent, Inge, Gläser, Ulrich, Lebuser, Frank, Hagert, Detlef, Arnold, Gerhard, Bauer, Viet-Harold, Becker, Hartwig, Becker, Hermine, Besier, Werner, Böttcher-Schmidt, Hanna, Füllgraf-Horst, Susanne, von Aswege, Johann, Göry, Enikö, Grella, Hartmut, Grimm, Hans Heinrich, Heck, Petra, Hemler, Werner, Henn, Eric, Löb, Violetta, Maaßen-Kalweit, Grid, Mayer, Manfred, Mühlig, Hubertus, Honig, Wolf-Dietrich, Müller, Arndt, Orlovius, Gerhard, Perleberg, Helmut, Radon, Brigitte, Renz, Helmut, Rieder, Carsten, Rosen, Michael, Scheer, Georg, Schilp, Michael, Schmid, Angela, Gülle, Peter, Schneider, Matthias, Schneider, Christian, Stahl, Rüdiger, Uhle, Christian, Wachter, Jürgen, Weihs, Necla, Weingärtner, Brigitte, Werner, Monika, Willhauck, Hans-Georg, Wochele, Eberhard, Schützendorf, Heribert, Wolfram, Bernhard, Hofmann, Andreas, Allwein, Eugen, Ruile, Helmut, Koeppel, Andreas, Dick, Peter, Holtz, Karl-Friedrich, Schmidt, Gabriel, Fischer, Lutz-Ingo, Thaller, Johann, Benz, Elisabeth, Bloß, Guntram, Kreuzer, Franz, Holthausen, Günther, Maier, Karl Ludwig, Krebs, Walter, Mohr, Christoph, Koschine, Heinz, Ellersdorfer, Richard, Speth, Michael, Kleinhans, Maria, Straimer, Annemarie, Koutsouva-Sack, Panagiota, Staudinger, Gabriele, Eiber, Johann, Thiel, Stephan, Gold, Cornelia, Nalbach, Andrea, Reichert, Kai, Rückgauer, Markus, Neef, Martin, Fleischmann, Viktor, Uhlenbrock, Arndt, Mayer, Natalija, Spiegl, Andreas, Renner, Fritz, Weishappel-Ketisch, Eva, Kochems, Thomas, Hunger, Hartmut, Hofbeck, Marianne, Neumeier, Alfred, Goldhofer, Elfriede, Bommer, Thomas, Werner, Klaus-Michael, Vollmuth, Reinhold, Lanzinger, Klaus, Bustami-Löber, Simone, Pauli, Ramona, Lindner, Jutta, Brandt, Gerlinde, Hohentanner, Otto, Urban-Hüttner, Rosita, Porz, Peter, Zimmerhackl, Bernd, Göbel-Schlatholt, Maria, Naumann, Barbara, Vach, Margarete, Hallwachs, Alexander, Haseke, Claudia, Ploch, Andreas, Bürkle-Grasse, Paula, Swobodnik, Monika, Tröger, Corina, Jost, Detlev, Steinhuber, Roman, Bachmann, Cadja, Kaschell, Hans-Jürgen, Narr, Renate, Nehmann-Hörwick, Gabriele, Eder, Christiane, Pillin, Helmut, Loth, Frank, Rücker, Beate, Fritz, Nicola, Rafferzeder, Michael, Zirpel, Dietmar, Romberg, Heinz-Peter, Weckbecker, Klaus, Marx, Manfred, Alfen, Theodor, Prechtel, Eberhard, Eimers-Kleene, Jörg, Fischer, Klaus, Weisbach, Wolf-Rüdiger, Tschoke, Martin, Richter-Polynice, Birgitt, Stahlschmidt, Markus, Fliedner, Michael, Hodgson, Binjamin, Cupsa, Florinela, Hamkens, Werner, Unkelbach, Roland Matthias, Schiller, Gerhard, Damanakis, Barbara, Ackermann, Angela, Frenkel, Michael, Ebeling, Klaus-Wolfgang, Hoff, Bernhard, Kirsch, Michael, Miasnikov, Vladimir, Berger, Pauline, Gillhausen, Kurt, Hellmessen, Uwe, Hümmerich, Helga, Heede, Hans-Christian, Kormann, Boguslaw-Marian, Lüttringhaus, Dieter, Peters, Wolfgang Josef, Schott, Ulrich, Matzies, Dirk, Schumacher, Andre, Flettner, Tim Oliver, Thraen, Winfried, Wirtz, Clemens, Siegmund, Harald, Groß, Kathrin, Krug, Bernd-Uwe, Hütter, Petra, Lau, Dietrich, Schröder-Höch, Ursula, Herzog, Wolfgang, Weidner, Klaus, Dorn, Jürgen, Titova, Ljudmila, Moritz, Andrea, Menke, Helmut, Ziehbold, Sabine, Sievert, Erik, Ludwig, Ingrid, Noky, Adolf, Bickel, Horst, Kröckert, Ulrich, Kunzendorf, Gerhard, Willhauck, Georg, Herbst, Helga, Salingré, Gabriele, Friedrich, Peter, Kirchner, Hans-Georg, Kirchner, Elke, Knauer, Luitpold, Mörchen, Christian, Schmid, Elmar, Kahmann, Ulf, Raab, Peter, Reich, Paul, Stahl, Eberhard, Baszenski, Angela, Lunow, Reinhold, Undritz, Klaus, Voss, Bernd, Spreer, Achim, Brenig, Oliver, Müller, Bernhard G, Eich, Ralf, Vossel, Angelika, Leggewie, Dieter, Schmidt, Angelika, Loth, Clärli, Aghdai-Heuser, Nahid, Witten, Lutz, Igel, Michael, Hodgson, Benjamin, Knaak, Christian, Opitz, Rolf, Bausch, Jürgen, Mecking, Dirk, Ganßauge, Friederike, Peters, Elmar, Wester, Alfons, Petersen, Werner, Daase, Martin, Hötte, Peter, Rüsing, Martin, von Sethe, Christoph, Borngräber, Wilmhard, Colling-Pook, Brigitte, Weidner, Ullrich, Rieger, Peter, Witte, Lutz, Busch, Hans-Wilhelm, Unger, Jürgen, Preis, Angela, Pieper, Jörg, Mann, Michael, Haeberle, Ernst, Köhler, Horst, Schäfer, Ruth, Sliwiok, Helmut, Brühl, Volker L, Stöver, Hans-Heiner, Deest, Harald, Ackermann-Körner, Margret, Reinstorff, Dieter, Wassermann, Dirk, Schlüter, Christamaria, Heinrichs, Henrik, Dankwarth, Ole, Böse, Michael, Ryll, Ulricke, Bauer, Reinhard, Möltgen, Dieter, Schnakenbeck, Sven, Beckmann, Karin, Callsen, Annegret, Fuchs, Angela, Leyendecker, Hans Josef, Schiewe, Ewa, Gehm, Holger, Lambert, Volker, Hinkel-Reineke, Karin, Stolzenbach, Carl-Otto, Berdin, Peter, Windler, Friedhelm, Weidnitzer, Sabine, Rosenkranz, Erika, Gohde, Gerhard, Letzien, Norbert, Klossek, Doris, Liebsch, Martin, Zwicker, Andrea, Hantel, Ulrike, Pilz, Monika, Kirschner, Volker, Arnold, Rainer, Poser, Ulrich, Barthel, Wolfgang, Simons, Barbara, Blechinger, Fritz, Fähnle, Marcus, Fritz, Reiner Walter, Jünemann, Susanne, Kirsch, Gabriele, Kulinna, Jürgen, Legner-Görke, Andreas, Lehr, Christa, Meer, Wolfgang, Brünger, Achim, Panzer, Christina, Raabe, Achim, Schmidt-Back, Helga, Schürmann, Ralf, Stieglitz, Hans-Günter, von der Heide, Marie-Luise, Petersen, Uwe, Kastner, Jörg, Janssen, Ulrike, Standl, Albert, Göttl, Clemens, Franze, Marianne, Moser, Gerhard, Wahl, Heike, Blümm, Almut, Weber, Petra, Poetsch, Wolfgang, Puppe, Heinrich, Specht, Gerd, Badmann, Leonard, Leveringhaus, May, Posern, Michael, Tewes, Rainer, Potkowski, Ralph, Schwandner, Michael, Weigert, Rudolf, Huber, Christoph, Junghans-Kullmann, Doris, Grimm-Kraft, Angela, Bohnau, Harald, Jessen, Frank, Pinsdorf, Ursula, Busch, Thomas, Keller, Gisela, Fuchs-Römer, Susanne, Beisel, Wolfgang, Köhler, Mirjam, Kormann, Marian, Luppa, Melanie, Levacher, Claus, Blankenstein, Tim, Lamborelle, Eliane, Hollstein, Ralf, Hoffmann, Edna, Mösch, Edelgard, Ghane, Ingeborg, Claß, Regine, Meier, Stefan-Wolfgang, Moers, Leo W, Wundram, Udo, Schmitt, Klaus, Missghian, Rastin, Spallek und Chriatiane, Karin, and Schlösser, Christiane
Subjects: Male, medicine.medical_specialty, Activities of daily living, economics [Caregivers], Total cost, economics [Home Care Services], epidemiology [Germany], epidemiology [Dementia], economics [Nursing Homes], statistics & numerical data [Ambulatory Care], Severity of Illness Index, Nursing care, Disability Evaluation, Germany, Intervention (counseling), Activities of Daily Living, Ambulatory Care, medicine, Dementia, Humans, ddc:610, General Nursing, Primary nursing, Aged, statistics & numerical data [Hospitalization], Aged, 80 and over, business.industry, Health Policy, General Medicine, medicine.disease, Home Care Services, Comorbidity, Nursing Homes, economics [Hospitalization], Hospitalization, statistics & numerical data [Home Care Services], Long-term care, Cross-Sectional Studies, Caregivers, Family medicine, economics [Dementia], Regression Analysis, Female, Geriatrics and Gerontology, business, economics [Ambulatory Care]
Abstract: Objective To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective. Design Cross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort. Setting Community and nursing homes. Participants One hundred twenty-eight community-dwelling dementia patients and 48 dementia patients living in nursing homes. Intervention None. Measurements Utilization and costs of medical care and long term care, including formal and informal social and nursing care based on proxy interviews. Informal care was valued using the replacement cost method. Results Unadjusted mean annual total costs including informal care were €29,930 ($43,997) for community-dwelling patients and €33,482 ($49,218) for patients living in nursing homes. However, multiple regression analysis controlling for age, sex, deficits in basic and instrumental activities of daily living and comorbidity showed that living in the community significantly increased total costs by €11,344 ($16,676; P P Conclusion From the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for.
Published: 2014
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17. The CERAD neuropsychological assessment battery total score detects and predicts Alzheimer disease dementia with high diagnostic accuracy

Author: Wolfsgruber, Steffen, Jessen, Frank, Köhler, Mirjam, Bachmann, Cadja, Riedel-Heller, Steffi G, Scherer, Martin, Maier, Wolfgang, Wagner, Michael, Group, AgeCoDe Study, Abholz, Heinz-Harald, Wiese, Birgitt, Bickel, Horst, Blank, Wolfgang, van den Bussche, Hendrik, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Fuchs, Angela, Kaduszkiewicz, Hanna, Kaufeler, Teresa, Stein, Janine, König, Hans-Helmut, Lange, Carolin, Leicht, Hanna, Luck, Tobias, Luppa, Melanie, Mayer, Manfred, Mösch, Edelgard, Olbrich, Julia, Pentzek, Michael, Prokein, Jana, Schumacher, Anna, Riedel-Heller, Steffi, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Werle, Jochen, Weyerer, Siegfried, and Zimmermann, Thomas
Subjects: Male, medicine.medical_specialty, Diagnostic accuracy, Neuropsychological Tests, Logistic regression, Alzheimer Disease, Predictive Value of Tests, Germany, mental disorders, medicine, Dementia, Humans, Neuropsychological assessment, ddc:610, Longitudinal Studies, Psychiatry, Aged, Aged, 80 and over, medicine.diagnostic_test, Medical record, Area under the curve, diagnosis [Alzheimer Disease], Cognition, standards [Neuropsychological Tests], medicine.disease, Psychiatry and Mental health, Cross-Sectional Studies, ROC Curve, Physical therapy, Regression Analysis, Female, Geriatrics and Gerontology, Alzheimer's disease, Psychology
Abstract: Objectives To establish the diagnostic accuracy of the Total Score of the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological assessment battery (CERAD-NP) both for cross-sectional discrimination of Alzheimer disease (AD) dementia and short-term prediction of incident AD dementia. Design Longitudinal cohort study with two assessments at a 1.5-year interval. Setting Primary care sample randomly recruited via medical record registries. Participants As part of the German Study on Ageing, Cognition, and Dementia (AgeCoDe), a sample of elderly individuals (N = 1,606; mean age: 84 years) was assessed. Measurements Subjects were assessed with the CERAD-NP and followed up for 18 months (97.6% follow-up rate). Logistic regression and receiver-operating-characteristic (ROC) curve analysis were used to compare the diagnostic accuracy of the CERAD-NP Total Score (CTS) with that of single CERAD-NP scores and the Mini-Mental-State-Examination (MMSE) score. Results ROC curve analysis resulted in excellent (area under the curve [AUC]: 0.97) cross-sectional discrimination between non-AD and AD dementia subjects. Prediction of incident AD dementia with the CTS was also very good (AUC: 0.89), and was significantly better than prediction based on the MMSE. Conclusions The cross-sectional results confirm that the CTS is a highly accurate diagnostic tool for detecting AD dementia in elderly primary care patients. In addition, we provide evidence that the CTS is also accurate for the prediction of incident AD dementia. These findings further support the validity of the CTS as an index of overall cognitive functioning for detection and prediction of AD dementia.
Published: 2014
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18. Relative Impact of Multimorbid Chronic Conditions on Health-Related Quality of Life – Results from the MultiCare Cohort Study

Author: Brettschneider, Christian, Leicht, Hanna, Bickel, Horst, Dahlhaus, Anne, Fuchs, Angela, Gensichen, Jochen, Maier, Wolfgang, Riedel-Heller, Steffi, Schäfer, Ingmar, Schön, Gerhard, Weyerer, Siegfried, Wiese, Birgitt, van den Bussche, Hendrik, Scherer, Martin, König, Hans-Helmut, Altiner, Attila, Blank, Wolfgang, Bullinger, Monika, Ehreke, Lena, Freitag, Michael, Gerlach, Ferdinand, Hansen, Heike, Heinrich, Sven, Höfels, Susanne, von dem Knesebeck, Olaf, Krause, Norbert, Luppa, Melanie, Mayer, Manfred, Mellert, Christine, Nützel, Anna, Paschke, Thomas, Petersen, Juliana, Prokein, Jana, Romberg, Heinz-Peter, Steinmann, Susanne, Schulz, Sven, Wegscheider, Karl, Weckbecker, Klaus, Werle, Jochen, and Zieger, Margrit
Subjects: Male, medicine.medical_specialty, Non-Clinical Medicine, Epidemiology, Clinical Research Design, lcsh:Medicine, Disease, Logistic regression, Global Health, Cohort Studies, Quality of life, Medicine, Humans, Obesity, Prospective Studies, Prospective cohort study, lcsh:Science, Biology, Depression (differential diagnoses), Primary Care, Nutrition, Aged, Psychiatry, Aged, 80 and over, Multidisciplinary, Survey Research, Health Care Policy, Population Biology, business.industry, Mood Disorders, Depression, lcsh:R, Epidemiology of Aging, Parkinson Disease, medicine.disease, Mental Health, Neurology, Geriatrics, Physical therapy, Quality of Life, Anxiety, lcsh:Q, Female, medicine.symptom, business, Rheumatism, Cohort study, Research Article
Abstract: BACKGROUND: Multimorbidity has a negative impact on health-related quality of life (HRQL). Previous studies included only a limited number of conditions. In this study, we analyse the impact of a large number of conditions on HRQL in multimorbid patients without preselecting particular diseases. We also explore the effects of these conditions on the specific dimensions of HRQL. MATERIALS AND METHODS: This analysis is based on a multicenter, prospective cohort study of 3189 multimorbid primary care patients aged 65 to 85. The impact of 45 conditions on HRQL was analysed. The severity of the conditions was rated. The EQ-5D, consisting of 5 dimensions and a visual-analogue-scale (EQ VAS), was employed. Data were analysed using multiple ordinary least squares and multiple logistic regressions. Multimorbidity measured by a weighted count score was significantly associated with lower overall HRQL (EQ VAS), b = -1.02 (SE: 0.06). Parkinson's disease had the most pronounced negative effect on overall HRQL (EQ VAS), b = -12.29 (SE: 2.18), followed by rheumatism, depression, and obesity. With regard to the individual EQ-5D dimensions, depression (OR = 1.39 to 3.3) and obesity (OR = 1.44 to 1.95) affected all five dimensions of the EQ-5D negatively except for the dimension anxiety/depression. Obesity had a positive effect on this dimension, OR = 0.78 (SE: 0.07). The dimensions "self-care", OR = 4.52 (SE: 1.37) and "usual activities", OR = 3.59 (SE: 1.0), were most strongly affected by Parkinson's disease. As a limitation our sample may only represent patients with at most moderate disease severity. CONCLUSIONS: The overall HRQL of multimorbid patients decreases with an increasing count and severity of conditions. Parkinson's disease, depression and obesity have the strongest impact on HRQL. Further studies should address the impact of disease combinations which require very large sample sizes as well as advanced statistical methods.
Published: 2013

19. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment

Author: Jessen, Frank, Wolfsgruber, Steffen, Weyerer, Siegfried, Werle, Jochen, van den Bussche, Hendrik, Scherer, Martin, Maier, Wolfgang, Wagner, Michael, German Study on Aging, Cognition and Dementia in Primary Care Patients, Abholz, Heinz-Harald, Bachmann, Cadja, Blank, Wolfgang, Wiese, Birgitt, Eifflaender-Gorfer, Sandra, Eisele, Marion, Ernst, Annette, Heser, Kathrin, Kaufeler, Teresa, Köhler, Mirjam, König, Hans-Helmut, Koppara, Alexander, Lange, Carolin, Leicht, Hanna, Bickel, Horst, Luppa, Melanie, Mayer, Manfred, Olbrich, Julia, Prokein, Jana, Schumacher, Anna, Stein, Janine, Steinmann, Susanne, Tebarth, Franziska, Weckbecker, Klaus, Weeg, Dagmar, Mösch, Edelgard, Zimmermann, Thomas, Kaduszkiewicz, Hanna, Pentzek, Michael, Riedel-Heller, Steffi G, Luck, Tobias, and Fuchs, Angela
Subjects: Male, Risk, medicine.medical_specialty, psychology [Alzheimer Disease], epidemiology [Cognitive Dysfunction], Epidemiology, epidemiology [Alzheimer Disease], Apolipoprotein E4, Disease, Subjective memory, Primary care, Neuropsychological Tests, Cohort Studies, Cellular and Molecular Neuroscience, Developmental Neuroscience, Alzheimer Disease, mental disorders, medicine, Memory impairment, Dementia, Humans, Cognitive Dysfunction, ddc:610, Psychiatry, Prospective cohort study, epidemiology [Memory Disorders], genetics [Apolipoprotein E4], Aged, Aged, 80 and over, Psychiatric Status Rating Scales, Memory Disorders, Health Policy, diagnosis [Alzheimer Disease], Cognition, medicine.disease, Survival Analysis, Psychiatry and Mental health, diagnosis [Cognitive Dysfunction], mortality [Alzheimer Disease], Test performance, Female, Neurology (clinical), Geriatrics and Gerontology, diagnosis [Memory Disorders], Psychology, mortality [Cognitive Dysfunction]
Abstract: Objective To compare the risk of developing Alzheimer's disease (AD) dementia in late mild cognitive impairment (LMCI), early MCI (EMCI), and subjective memory impairment (SMI) with normal test performance. Methods The baseline sample (n = 2892) of the prospective cohort study in nondemented individuals (German Study on Aging, Cognition and Dementia in Primary Care Patients) was divided into LMCI, EMCI, SMI, and control subjects by delayed recall performance. These groups were subdivided by the presence of self-reported concerns associated with experienced memory impairment. AD dementia risk was assessed over 6 years. Results Across all groups, risk of AD dementia was greatest in LMCI. In those with self-reported concerns regarding their memory impairment, SMI and EMCI were associated with a similarly increased risk of AD dementia. In those subgroups without concerns, SMI was not associated with increased risk of AD dementia, but EMCI remained an at-risk condition. Conclusions SMI and EMCI with self-reported concerns were associated with the same risk of AD dementia, suggesting that pre-LMCI risk conditions should be extended to SMI with concerns.
Published: 2012
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20. 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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21. 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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21 results on '"Weckbecker, Klaus"'

1. The value of the GP’s clinical judgement in predicting dementia: a multicentre prospective cohort study among patients in general practice

2. Correlates of hospitalization among the oldest old: results of the AgeCoDe–AgeQualiDe prospective cohort study

3. Does transpersonal trust moderate the association between chronic conditions and general practitioner visits in the oldest old? Results of the AgeCoDe and AgeQualiDe study

4. Effect of Visual Impairment on Physical and Cognitive Function in Old Age: Findings of a Population-Based Prospective Cohort Study in Germany

5. Prevalence of pain and its associated factors among the oldest-olds in different care settings – results of the AgeQualiDe study

6. Advance directives and power of attorney for health care in the oldest-old – results of the AgeQualiDe study

7. The impact of social engagement on health-related quality of life and depressive symptoms in old age - evidence from a multicenter prospective cohort study in Germany

8. Mortality in Incident Cognitive Impairment: Results of the Prospective AgeCoDe Study

9. Age of major depression onset, depressive symptoms, and risk for subsequent dementia: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe)

10. Effect of Cardiovascular and Metabolic Disease on Cognitive Test Performance and Cognitive Change in Older Adults

11. Incident Subjective Cognitive Decline Does Not Predict Mortality in the Elderly--Results from the Longitudinal German Study on Ageing, Cognition, and Dementia (AgeCoDe)

12. Prevalence and determinants of overweight and obesity in old age in Germany

13. Longitudinal Predictors of Institutionalization in Old Age

14. Mortality in incident dementia - results from the German Study on Aging, Cognition, and Dementia in Primary Care Patients

15. Elevated HbA1c is associated with increased risk of incident dementia in primary care patients

16. The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care?

17. The CERAD neuropsychological assessment battery total score detects and predicts Alzheimer disease dementia with high diagnostic accuracy

18. Relative Impact of Multimorbid Chronic Conditions on Health-Related Quality of Life – Results from the MultiCare Cohort Study

19. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment

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

21. Prediction of Dementia in Primary Care Patients

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21 results on '"Weckbecker, Klaus"'

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