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Language: English

In: Health and Quality of Life Outcomes, 01 July 2017, Vol.15(1), pp.1-8

Description: 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....

Keywords: Depressive Symptoms ; Eq-Vas ; Geriatric Depression Scale ; Health-Related Quality of Life ; Old Age ; Public Health

E-ISSN: 1477-7525

DOI: 10.1186/s12955-017-0715-8

URL: View full text in DOAJ

In: Journal of the American Geriatrics Society, November 2015, Vol.63(11), pp.2408-2410

Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13802/abstract Byline: Claudia Luck-Sikorski, Melanie Luppa, Kathrin Heser, Markus Bleckwenn, Tina Posselt, Annette Ernst, Jochen Werle, Dagmar Weeg, Edelgard Mosch, Birgitt Wiese, Susanne Steinmann, Angela Fuchs, Michael Pentzek, Hans-Helmut Konig, Christian Brettschneider, Martin Scherer, Wolfgang Maier, Siegfried Weyerer, Steffi G. Riedel-Heller ***** No abstract is available for this article. ***** Article Note: Shared last authorship

Keywords: Heart Failure – Prognosis ; Heart Failure – Psychological Aspects ; Heart Failure – Health Aspects ; Elderly – Psychological Aspects ; Elderly – Health Aspects ; Mortality – Psychological Aspects ; Depression (Mood Disorder) – Prognosis ; Depression (Mood Disorder) – Psychological Aspects ; Depression (Mood Disorder) – Health Aspects;

ISSN: 0002-8614

E-ISSN: 1532-5415

DOI: 10.1111/jgs.13802

Language: English

In: Journal of Affective Disorders, 15 July 2016, Vol.199, pp.139-147

Description: The study aimed at determining excess costs of late-life depression from a societal perspective. Moreover, the impact of recognition of depression by GPs on costs was investigated. Cross-sectional data were obtained from a large multicenter observational cohort study (AgeMooDe). Participants (n=1197) aged 75 years or older and were recruited via their GPs in Leipzig, Bonn, Hamburg, and Mannheim in Germany from May 2012 until December 2013. In the base case analysis, depression was assessed using the Geriatric Depression Scale (GDS; cutoff GDS≥6). Data on health care utilization and costs were based on participants' self-reports for inpatient treatment, outpatient treatment, pharmaceuticals, and formal and informal nursing care. Unadjusted mean costs in a six-month period for depressed individuals (€5031) exceeded those of non-depressed (€2700) by the factor 1.86 and were higher in all health care sectors considered. Statistically significant positive excess costs persisted in all formal health care sectors after adjusting for comorbidity and socio-demographics. Recognition of depression by the GP did not moderate the relationship of depression and health care costs. Analyses were restricted to a cross-sectional design, not permitting any conclusions on causal interference of the variables considered. The findings stress the enormous burden of depression in old age for all sectors of the health care system. The fact that GPs' recognition of depression does not moderate the relationship between depression and costs adds further insights into the economics of this frequent psychiatric disorder.

Keywords: Late-Life Depression ; Older Adults ; Health Care Use ; Costs ; Germany, Health Services Research

ISSN: 0165-0327

E-ISSN: 1573-2517

DOI: 10.1016/j.jad.2016.04.008

URL: View record in ScienceDirect (Access to full text may be restricted)

Language: English

In: Journal of Affective Disorders, 2013, Vol.150(1), pp.63-69

Keywords: Cerebrovascular Accident ; Depression ; Epidemiology ; Prevention ; Risk Factors ; Mortality

ISSN: 0165-0327

ISSN: 1573-2517

Source: NARCIS (National Academic Research and Collaborations Information System)

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Language: English

In: Journal of Affective Disorders, 15 August 2013, Vol.150(1), pp.63-69

Description: Depression is a risk factor for stroke and mortality but whether this also holds into old age is uncertain. We therefore studied the association of depression with the risk for non-fatal stroke and all-cause mortality in very old age. A representative sample of 3085 primary care patients aged ≥75 years were serially assessed during a 6-year follow-up. The relation between depression (Geriatric Depression Scale 〉6, =261) and relevant covariates including vascular risk factors and disease, functional and mild cognitive impairment and ApoE genotype on primary care givers information of incident stroke ( =209) and mortality ( =647) were assessed by Cox regression and by competing risk regressions. Depression was not independently associated with incident stroke in fully adjusted models that treated death as the competing event (subdistribution hazard ratio=0.80, 95% confidence interval=0.47 to 1.36). The risk associated with depression was similar for men and women, and for age groups 75–79, 80–84 and ≥85 years. In contrast, depression increased all-cause mortality rates, even after adjusting for a range of confounders (hazard ratio=1.31, 95% confidence interval=1.03 to 1.67). We have no information on past depressive episodes and cause of death. In contrast to reports in younger populations, depression does not appear to increase stroke risk among the old and very old, but continuous to be a risk factor for all-cause mortality.

Keywords: Cerebrovascular Accident ; Depression ; Epidemiology ; Prevention ; Risk Factors ; Mortality

ISSN: 0165-0327

E-ISSN: 1573-2517

DOI: 10.1016/j.jad.2013.02.020

URL: View record in ScienceDirect (Access to full text may be restricted)

URL: View full text in ScienceDirect

Language: English

In: Journal of Affective Disorders, 15 January 2018, Vol.226, pp.28-35

Description: Potentially inappropriate medication (PIM) is associated with an increased risk for detrimental health outcomes in elderly patients. Some antidepressant drugs are considered as PIM, but previous research on the association between antidepressants and subsequent dementia has been inconclusive. Therefore, we investigated whether the intake of antidepressants, particularly of those considered as PIM according to the Priscus list, would predict incident dementia. We used data of a prospective cohort study of non-demented primary care patients (n = 3239, mean age = 79.62) to compute Cox proportional hazards models. The risk for subsequent dementia was estimated over eight follow-ups up to 12 years depending on antidepressant intake and covariates. The intake of antidepressants was associated with an increased risk for subsequent dementia (HR = 1.53, 95% CI: 1.16–2.02, = .003; age-, sex-, education-adjusted). PIM antidepressants (HR = 1.49, 95% CI: 1.06–2.10, = .021), but not other antidepressants (HR = 1.04, 95% CI: 0.66–1.66, = .863), were associated with an increased risk for subsequent dementia (in age-, sex-, education-, and depressive symptoms adjusted models). Significant associations disappeared after global cognition at baseline was controlled for. Methodological limitations such as selection biases and self-reported drug assessments might have influenced the results. Only antidepressants considered as PIM were associated with an increased subsequent dementia risk. Anticholinergic effects might explain this relationship. The association disappeared after the statistical control for global cognition at baseline. Nonetheless, physicians should avoid the prescription of PIM antidepressants in elderly patients whenever possible.

Keywords: Late-Life Depression ; Antidepressant Drugs ; Antidepressants ; Potentially Inappropriate Medication ; Dementia ; Oldest-Old

ISSN: 0165-0327

E-ISSN: 1573-2517

DOI: 10.1016/j.jad.2017.09.016

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In: Journal of the American Geriatrics Society, November 2016, Vol.64(11), pp.2311-2316

Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jgs.14458/abstract Byline: Andre Hajek, Christian Brettschneider, Dagmar Luhmann, Marion Eisele, Silke Mamone, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Michael Pentzek, Angela Fuchs, Steffi G. Riedel-Heller, Tobias Luck, Horst Bickel, Dagmar Weeg, Alexander Koppara, Michael Wagner, Martin Scherer, Wolfgang Maier, Hans-Helmut Konig,, Heinz-Harald Abholz, Cadja Bachmann, Wolfgang Blank, Hendrik den Bussche, Sandra Eifflaender-Gorfer, Annette Ernst, Kathrin Heser, Frank Jessen, Hanna Kaduszkiewicz, Teresa Kaufeler, Mirjam Kohler, Carolin Lange, Diana Lubisch, Melanie Luppa, Manfred Mayer, Edelgard Mosch, Julia Olbrich, Tina Posselt, Jana Prokein, Susanne Rohr, Anna Schumacher, Janine Stein, Susanne Steinmann, Franziska Tebarth, Klaus Weckbecker, Steffen Wolfsgruber, Thomas Zimmermann Keywords: visual impairment; physical function; cognitive function; older people; longitudinal study Objectives To examine how visual impairment affects physical and cognitive function in old age. Design A longitudinal population-based prospective cohort study. Setting General practitioner offices at six study centers in Germany. They were observed every 1.5 years over four waves. Participants Individuals aged 77-101 at follow-up Wave 2 (N = 2,394). Measurements Physical 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). Results Adjusting 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 ([beta] = -0.15, P = .01) and in women ([beta] = -.15, P = .03). Moreover, the onset of severe visual impairment was associated with decline in cognitive function score in the total sample ([beta] = -0.38, P 〈 .001) and in women ([beta] = -0.38, P 〈 .001) and men ([beta] = -0.37, P = .001). Conclusion Visual impairment affects physical and cognitive function in old age. Interventional strategies to postpone visual impairment may contribute to maintaining physical and cognitive function. Article Note: These authors contributed equally to this work. See Appendix 1. CAPTION(S): Table S1. Mean level of changes in visual impairment, physical and cognitive function (all treated as continuous variables) from FU Wave 2 to FU Wave 5. Table S2. Pairwise correlations in differences (from FU Wave 2 to FU Wave 5). Table S3. Predictors of physical function. Results of fixed effects regressions for individuals with complete data (FU Waves 2-5). Table S4. Predictors of cognitive function. Results of fixed effects regressions for individuals with complete data (FU Waves 2-5).

Keywords: Visual Impairment ; Physical Function ; Cognitive Function ; Older People ; Longitudinal Study

ISSN: 0002-8614

E-ISSN: 1532-5415

DOI: 10.1111/jgs.14458

In: International Journal of Geriatric Psychiatry, October 2018, Vol.33(10), pp.1383-1388

Description: Byline: Andre Hajek,Christian Brettschneider, Hendrik Bussche, Dagmar Luhmann, Anke Oey, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Angela Fuchs, Michael Pentzek, Janine Stein,Tobias Luck, Horst Bickel, Edelgard Mosch, Kathrin Heser, Michael Wagner, Martin Scherer, Wolfgang Maier, Steffi G. Riedel-Heller, Hans-Helmut Konig, Keywords: depression; falls; longitudinal study; oldest old Objective The purpose of this study was to examine the impact of falls on depressive symptoms among the oldest old in Germany longitudinally. Methods Data were used from 2 waves of 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). This study covers primary care patients a[yen]85 years (at baseline: n = 547, average age of 88.9 [+ or -] 3.0 years; ranging from 85 to 100 years). General practitioner-diagnosed falls were used as explanatory variable. The Geriatric Depression Scale was used as outcome measure. Results Linear fixed effects regressions showed that the occurrence of falls is associated with an increase in depressive symptoms ([beta] = .60, P = .02), whereas changes in marital status, ageing, social support, functional decline (instrumental activity of daily living), cognitive impairment, and an increase in chronic diseases did not affect depressive symptoms. In sensitivity analysis, an increase in depressive symptoms was associated with functional impairment (basic activities of daily living; Barthel index; [beta] = -.04, P = .005). Conclusions Based on a large, population-based longitudinal study, this study underlined the impact of falls on depressive symptoms and consequently extended previous knowledge about an association between falls and depressive symptoms in the oldest old. Developing strategies to prevent falls might also help to prevent depressive symptoms. Article Note: The authors Steffi G. Riedel-Heller and Hans-Helmut Konig equally contributed in this work.

Keywords: Depression ; Falls ; Longitudinal Study ; Oldest Old

ISSN: 0885-6230

E-ISSN: 1099-1166

DOI: 10.1002/gps.4949

In: Age and Ageing, 2017, Vol. 46(5), pp.813-820

Description: Objective: to investigate how social support affects functional impairment (FI) in late life in a longitudinal approach.Methods: in a multicenter prospective cohort study, subjects in old age (≥75 years at baseline) were interviewed every 1.5 years. Social support was quantified in the follow-up (FU) Waves 2 and 4 (FU Wave 2: n = 2,349; FU Wave 4: n = 1,484). FI was assessed by using the Lawton and Brody Instrumental Activities of Daily Living scale.Results: fixed effects regressions showed that a decrease in social support is associated with FI in the total sample and in both sexes. The effect on FI was most pronounced with the dimension social integration, whereas changes in practical support only affected FI in the total sample and changes in emotional support only affected FI in men.Conclusions: our findings emphasise the importance of social support for functional status in late life. Thus, strengthening social support in old age might be effective in maintaining functional abilities.

Keywords: Social Support ; Functional Impairment ; Iadl ; Longitudinal Study ; Older People

ISSN: 0002-0729

E-ISSN: 1468-2834

DOI: 10.1093/ageing/afx012

Language: English

In: Psychological Assessment, 2015, Vol.27(3), pp.895-904

Description: The aim of the study was to investigate the psychometric properties of a Short Form of the Mini-Mental State Examination (SMMSE) for the screening of dementia in older primary care patients. Data were obtained from a large longitudinal cohort study of initially nondemented individuals recruited via primary care chart registries and followed at 18-month intervals. Item and scale parameters for MMSE and SMMSE scores were analyzed and cross-validated for 2 follow-up assessments ( n 1 = 2,657 and n 2 = 2,274). Binary logistic regression and receiver-operating-characteristic (ROC) curve analyses were conducted in order to assess diagnostic accuracy parameters for MMSE and SMMSE scores. Cross-sectional differentiation between dementia-free and dementia patients yielded moderate to good results for MMSE and SMMSE scores. With regard to most diagnostic accuracy parameters, SMMSE scores did not outperform the MMSE scores. The current study provides first evidence regarding the psychometric properties of the SMMSE score in a sample of older primary care patients. However, our findings do not confirm previous findings that the SMMSE is a more accurate screening instrument for dementia than the original MMSE. Further studies are needed in order to assess and to develop short, reliable and valid instruments for routine cognitive screening in clinical practice and primary care settings.

Keywords: Mini-Mental State Examination ; Short Form Of The Mini-Mental State Examination ; Screening ; Psychometric Properties ; Dementia

ISSN: 1040-3590

E-ISSN: 1939-134X

DOI: 10.1037/pas0000076

URL: View this record in PsycARTICLES