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5. 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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7. 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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8. 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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