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Hannah Wehrmann,1 Bernhard Michalowsky,1 Simon Lepper,1 Wiebke Mohr,1 Anika Raedke,1 Wolfgang Hoffmann1,2 1Translational Health Care Research, German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany; 2Epidemiology of Health Care and Community Health, Institute for Community Medicine & University Medicine Greifswald (UMG), Greifswald, GermanyCorrespondence: Bernhard Michalowsky Tel +49 3834 86 75 07Email bernhard.michalowsky@dzne.deBackground: Knowledge about the priorities and preferences of people living with dementia (PwD) might help to individualize treatment, care, and support, which could improve patient-related outcomes. This study aimed to summarize preferences of PwD or people with mild cognitive impairment (MCI), considering all relevant aspects of health care and everyday life.Methods: We conducted a systematic literature review and included studies about patient preferences published in English between January 1, 1990 and October 28, 2019. The inclusion criteria were that preferences were elicited directly by PwD or patients with MCI. We used the International Consortium for Health Outcomes Management value set for dementia to categorize the preferences into the following topics: a) clinical status, b) symptoms, functioning, and quality of life, and c) sustainability of care.Results: Of 578 initially identified studies, 45 met the inclusion criteria. Patients preferred to be informed about the diagnosis as early as possible, especially for anticipatory care planning. They ranked caregiver quality of life as their highest priority. They preferred not to be a burden to others more than their caregivers’ mood, their own functional status, or their own distressing behaviors. Furthermore, PwD are eager to participate in medical decisions, especially in those about creating an everyday life routine. PwD preferred their own quality of life, self-efficacy, and emotional well-being. Institutionalized PwD preferred individualized and person-centered care. According to the sustainability of care, PwD preferred to maintain close bonds with their family at the end of their life and wanted to be treated with empathy.Conclusion: This systematic review provides essential insights into cognitively impaired patients’ preferences, which are rarely considered in treatment, care, and support services. Further studies should evaluate whether considering preferences in treatment and care or daily living can improve patient-reported outcomes.Keywords: dementia, patient preference, patient outcome assessment, decision-making

Jochen René Thyrian,1,* Tilly Eichler,1,* Andrea Pooch,1 Kerstin Albuerne,1 Adina Dreier,2 Bernhard Michalowsky,1 Diana Wucherer,1 Wolfgang Hoffmann1,2 1German Center for Neurodegenerative Diseases (DZNE), Site Greifswald, WG Interventional Health Care Research, Greifswald, 2Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University of Greifswald, Greifswald, Germany. *These authors contributed equally to this work Background: There is evidence about the benefits of early detection of dementia and subsequent provision of adequate treatment and care. However, there is a lack of knowledge about the acceptance of detection and intervention procedures. These analyses describe the attitudes of general physicians [GPs] toward 1) dementia in general, 2) systematic detection of people with dementia, and 3) an intervention approach after they have experienced both. Comparisons are made based on experience with systematic screening and dementia-specific intervention. Methods: Postal, cross-sectional survey to all n=1,252 GPs in the Mecklenburg-Western Pomerania, Germany. A subsample was drawn based on participation in the randomized, controlled, prospective intervention DelpHi-MV trial (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania). In this trial, systematic screening is implemented and an intervention group receives support through dementia care management (DCM). GPs were categorized into either GPs with DCM and systematic screening (DCM-GP), GPs with systematic screening only (DelpHi-GP), or GPs not participating in the trial. Data from n=257 GPs were available. Attitudes toward dementia were assessed using a validated questionnaire. Results: There was strong agreement toward the helpfulness of implementing a brief cognitive screening test (89.9% agreed). Approximately two-thirds of the respondents indicated that they had identified at least some patients as being cognitively impaired for the first time. The majority of the respondents indicated agreement toward DCM. It was described as supportive and helpful. The qualified nurses were perceived as competent in dementia care and 79.3% would like to be supported with DCM. Attitudes toward dementia are positive and do not differ between groups. Conclusion: The results indicate that early recognition and DCM is highly appreciated by GPs and is considered feasible or wanted to be implemented in routine care. Keywords: dementia care management, screening, general physician, primary care, implementation

Markus Wübbeler,1 Jochen René Thyrian,1 Bernhard Michalowsky,2 Johannes Hertel,2 Franziska Laporte Uribe,3 Karin Wolf-Ostermann,4 Susanne Schäfer-Walkmann,6 Wolfgang Hoffmann2,5 1Interventional Health Care Research Group, German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, 2German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Greifswald, Germany; 3Implementation and Dissemination Research Group, German Center for Neurodegenerative Diseases (DZNE), Witten, Germany; 4Department of Human and Health Science, University of Bremen, Bremen, Germany; 5Epidemiology of Health Care and Community Health, Institute for Community Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany; 6Institute for Applied Social Sciences, Stuttgart, Germany Background: Nonpharmacological therapies and the provision of aids are described to be supportive in the treatment of persons with dementia (PWDs). These aim to maintain individuals' participation in daily activities as long as possible, to slow the progression of their disease, and to support their independent living at home. However, there is a lack of knowledge about the utilization of therapies and aids among community-dwelling PWDs.Objective: The aims of the study were a) to describe the utilization of nonpharmacological therapies and aids among community-dwelling PWDs and b) to analyze the factors associated with utilization.Method: As part of a cross-sectional study of n=560 caregivers of PWDs in dementia networks throughout Germany, we assessed sociodemographics, clinical variables, and the utilization of nonpharmacological therapies (physiotherapy [PT], occupational therapy [OT]), and aids (sensory, mobility, and others), using face-to-face interviews and questionnaires.Results: Approximately every fourth PWD received PT and every seventh PWD received OT. Sensory aids were utilized by 91.1%, personal hygiene aids by 77.2%, mobility aids by 58.6%, and medical aids by 57.7% of the sample. Regression analysis revealed that the utilization of PT and medical aids was associated with comorbidities (odds ratio [OR] 1.17 and OR 1.27, respectively) and that the utilization of OT and sensory aids was associated with age (OR 1.06 and OR 0.95, respectively).Conclusion: The utilization of nonpharmacological therapies and aids among community-dwelling people served by dementia networks is more frequent than that reported for people in other settings. This result indicates that PWDs in integrated care models such as dementia networks receive better health care. Keywords: aid, integrated care, collaborative care

The term "potentially inadequate medication" (PIM) describes medications or active substances that should not be prescribed to older persons because of their adverse effects profile. Such relative contraindications should always be considered in the overall context and in view of comorbidities and further medications. The PRISCUS 2.0 list was published recently--a revised version of a PIM list for the German pharmaceutical market (1). When considering the number of older patients in the healthcare system for whom these medications may pose risks, this topic is more topical than ever. Thus far only few published data exist on the prevalence of PIMs and their development as well as on the PIM substances most commonly prescribed in primary care in Germany. [ABSTRACT FROM AUTHOR]