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  • Oxford University Press (CrossRef)  (17)
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  • 1
    In: Age and Ageing, 2013, Vol. 42(5), pp.556-558
    Description: Medications for older people are increasingly dispensed in dose administration aids (DAAs). This includes automated or multidose drug dispensing (MDD)-machine-dispensed disposable sachets in which medications are packaged according to the intended time of administration. MDD is already common in Northern Europe, while blister packs, dosettes and other forms of DAAs are widely used elsewhere. Here, Bell et al comment on Kwint and colleagues' report that community-dwelling recipients of MDD in the Netherlands have better medication adherence but poorer medication knowledge compared with age- and sex-matched recipients of manual medication dispensing.
    Keywords: Netherlands ; Older People ; Drug Dosages ; Drug Policy ; Health Care Policy ; Clinical Trials;
    ISSN: 0002-0729
    E-ISSN: 1468-2834
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  • 2
    In: Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 2016, Vol. 71(6), pp.831-837
    Description: Background: Adverse drug events are a leading cause of hospitalization among older people. Up to half of all medication-related hospitalizations are potentially preventable. The objective of this study was to investigate and compare the association between medication regimen complexity and number of medications with unplanned hospitalizations over a 3-year period. Methods: Data were analyzed for 3,348 participants aged 60 years or older in Sweden. Regimen complexity was assessed using the 65item Medication Regimen Complexity Index (MRCI) and number of medications was assessed as a continuous variable. Cox proportional hazard models were used to compute unadjusted and adjusted hazard ratios with 95% confidence intervals (CIs) for associations between regimen complexity and number of medications with unplanned hospitalizations over a 3-year period. Receiver operating characteristics curves with corresponding areas under the curve were calculated for regimen complexity and number of medications in relation to unplanned hospitalizations. The population attributable fraction of unplanned hospitalizations was calculated for MRCI and number of medications. Results: In total, 1,125 participants (33.6%) had one or more unplanned hospitalizations. Regimen complexity (hazard ratio 1.22; 95% CI 1.14-1.34) and number of medications (hazard ratio 1.07; 95% CI 1.04-1.09) were both associated with unplanned hospitalizations and had similar sensitivity and specificity (area under the curve 0.641 for regimen complexity and area under the curve 0.644 for number of medications). The population attributable fraction was 14.08% (95% CI 9.62-18.33) for MRCI and 17.61% (95% CI 12.59- 22.35) for number of medications. Conclusions: There was no evidence that using a complex tool to assess regimen complexity was better at predicting unplanned hospitalization than number of medications. Keywords: Medication regimen complexity--Polypharmacy--Hospitalization--Aged--Inappropriate prescribing doi: 10.1093/gerona/glv219
    Keywords: Medication Regimen Complexity ; Polypharmacy ; Hospitalization ; Aged ; Inappropriate Prescribing
    ISSN: 1079-5006
    E-ISSN: 1758-535X
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  • 3
    In: Age and Ageing, 2013, Vol. 42(2), pp.173-180
    Description: Objective: to determine incidence and predictors of late-life depression. this is a 3-year observational cohort study of 3,214 non-demented patients aged 75 and over completing three waves of assessment. The patients were recruited in 138 primary care practices in six urban areas in Germany. Depressive symptoms were measured at baseline, and 18 months and 36 months later using the GDS-15 Geriatric Depression Scale with a cut-off 0–5/6–15. Cox proportional hazard regression models were applied to examine predictors of incident depression, adjusting for sex, age, education, living situation, activities of daily living - and instrumental activities of daily living impairment, somatic comorbidity, alcohol consumption, smoking, mild cognitive impairment and apoE4 status. the incidence of depression was 36.8 (95% CI: 29.6–45.3) per 1,000 person-years in men and 46.0 (95% CI: 39.9–52.8) in women (sex difference = 0.069). The incidence increased from 35.4 (95% CI: 29.7–41.9) per 1000 person-years between the ages of 75 and 79 to 75.2 (95% CI: 53.2–103.2) for subjects 85 years and older. After full adjustment for confounding variables, hazard ratios (HR) for incident depression were significantly higher for subjects 85 years and older (HR: 1.83, 95% CI: 1.24–2.70) and those with mobility impairment (HR: 2.53, 95% CI: 1.97–3.25), vision impairment (HR: 1.41, 95% CI: 1.04–1.91), mild cognitive impairment (HR: 1.52, 95% CI: 1.10–2.10), subjective memory impairment (HR: 1.33, 95% CI: 1.01–1.74) and current smoking (HR: 1.69, 95% CI: 1.13–2.53). the incidence of depression increased significantly with age. In designing prevention programmes, it is important to call more attention on functional impairment, cognitive impairment and smoking.
    Keywords: Incident Depression ; Predictors ; Prospective Longitudinal Study ; Older People
    ISSN: 0002-0729
    E-ISSN: 1468-2834
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  • 4
    In: Age and Ageing, 2011, Vol. 40(4), pp.456-463
    Description: Objective: to investigate prospectively the relationship between current alcohol consumption (quantity and type of alcohol) and incident overall dementia and Alzheimer dementia. the study is based on individuals (75+) attending general practitioners in Germany: 3,202 subjects free of dementia were studied at baseline, 1.5 years and 3 years later by means of structured clinical interviews including detailed assessment of current alcohol consumption and DSM-IV dementia diagnoses. Associations between alcohol consumption (in grams of ethanol), type of alcohol (wine, beer, mixed alcohol beverages) and incident dementia were examined using Cox proportional hazard models, controlling for several confounders. incident overall dementia occurred in 217 of 3,202 participants over a mean follow-up period of 3 years. Significant relationships were found between alcohol consumption (prevalence at baseline: 50.0%) and incident overall dementia (adjusted hazard ratio (HR) 0.71, 95% CI 0.53–0.96), respectively, incident Alzheimer dementia (adjusted HR 0.58, 95% CI 0.38–0.89). With regard to quantity of alcohol and type of alcohol, all hazard ratios were found to be lower than 1. in agreement with meta-analyses that include younger age groups, our study suggests that light-to-moderate alcohol consumption is inversely related to incident dementia, also among individuals aged 75 years and older.
    Keywords: Incident Dementia ; Alcohol Consumption ; Prospective Longitudinal Study ; Elderly
    ISSN: 0002-0729
    E-ISSN: 1468-2834
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  • 5
    In: Journal of Experimental Botany, 2010, 2010, Vol. 61(6), pp.1751-1759
    Description: Diel (24 h) leaf growth patterns were differently affected by temperature variations and the circadian clock in several plant species. In the monocotyledon Zea mays , leaf elongation rate closely followed changes in temperature. In the dicotyledons Nicotiana tabacum , Ricinus communis , and Flaveria bidentis , the effect of temperature regimes was less obvious and leaf growth exhibited a clear circadian oscillation.These differences were related neither to primary metabolism nor to altered carbohydrate availability for growth. The effect of endogenous rhythms on leaf growth was analysed under continuous light in Arabidopsis thaliana , Ricinus communis, Zea mays , and Oryza sativa . No rythmic growth was observed under continuous light in the two monocotyledons, while growth rhythmicity persisted in the two dicotyledons. Based on model simulations it is concluded that diel leaf growth patterns in mono- and dicotyledons result from the additive effects of both circadian-clock-controlled processes and responses to environmental changes such as temperature and evaporative demand. Apparently very distinct diel leaf growth behaviour of monocotyledons and dicotyledons can thus be explained by the different degrees to which diel temperature variations affect leaf growth in the two groups of species which, in turn, depends on the extent of the leaf growth control by internal clocks.
    Keywords: Circadian Clock ; Elongation ; Expansion ; Image Analysis ; Photosynthesis ; Starch ; Sucrose
    ISBN: 0002767353000
    ISSN: 0022-0957
    E-ISSN: 1460-2431
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  • 6
    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
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  • 7
    Language: English
    In: The Gerontologist, 16 July 2019, Vol.59(4), pp.738-748
    Description: We examined the validity of 5 successful aging (SA) operationalizations that assessed different facets of the SA construct (cognitive and physical health and disability; well-being; social engagement). A total of 2,478 participants (mean age = 82.5 years, standard deviation [SD] = 3.47) were studied. We used confirmatory factor analysis to investigate the relationships between facets and to determine the convergent validity as well as short-term (1.5 years) and long-term (4.5 years) predictive validity of the 5 SA operationalizations for measures of quality of life (QoL) and objective health outcomes. A general SA operationalization that included all SA facets but also allowed differences between them showed the best model fit and construct validity. A biomedical operationalization of SA that excluded either the well-being or the social engagement facet showed lower convergent and predictive validity for subjective measures (e.g., QoL) but higher associations with objective measures (e.g., health). A purely psychosocial SA operationalization that excluded the physiological facet did not allow good prediction of objective health outcomes. Our results suggest that a well-balanced SA operationalization should include measures assessing health, disability, well-being, and social engagement.
    Keywords: Confirmatory Factor Analysis ; Healthy Aging ; Operationalization ; Validity
    ISSN: 00169013
    E-ISSN: 1758-5341
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  • 8
    Language: English
    In: The journals of gerontology. Series B, Psychological sciences and social sciences, 06 July 2018
    Description: This study examines the relationship between late-life depressive symptoms, cognitive and functional impairment in a cohort of very old community-based participants. A sample of 1226 primary care patients was assessed at baseline (Mage = 80.6 years). Statistical analyses were conducted using baseline and 12 month follow-up data. At baseline, depressed participants showed minor cognitive deficits compared to non-depressed participants, whereas functional deficits were pronounced. Depressive symptoms and global cognition were not associated longitudinally. In contrast, follow-up functional impairment was predicted by baseline level and increase of depressive symptoms between baseline and follow-up. Reversely, follow-up depressive symptoms were predicted by functional decline between baseline and follow-up, whereas baseline functional status was not predictive. Depressive symptoms and global cognitive function were not associated longitudinally, but level and increase of depressive symptoms over time predicted functional impairment after one year. Interventions to reduce depressive symptoms, or to encourage coping strategies might be promising to reduce functional impairment. Elevated follow-up depressive symptoms were only predicted by functional decline, supposedly emphasizing that incident functional impairment might be associated with an acute increase of depressive symptoms. Psychological adjustment processes were not examined, but might be targeted in future.
    ISSN: 10795014
    E-ISSN: 1758-5368
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  • 9
    In: Brain, 2010, Vol. 133(8), pp.2248-2263
    Description: Brain-derived neurotrophic factor plays a key role in neuronal and axonal survival. Brain-derived neurotrophic factor is expressed in the immune cells in lesions of experimental autoimmune encephalomyelitis and multiple sclerosis, thus potentially mediating neuroprotective effects. We investigated the functional role of brain-derived neurotrophic factor in myelin oligodendrocyte glycoprotein-induced experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Mice deficient for brain-derived neurotrophic factor in immune cells displayed an attenuated immune response in the acute phase of experimental autoimmune encephalomyelitis, but progressive disability with enhanced axonal loss in the chronic phase of the disease. In mice deficient for central nervous system-derived brain-derived neurotrophic factor via glial fibrillary acidic protein-crescentin-mediated deletion, a more severe course of experimental autoimmune encephalomyelitis and an overall increased axonal loss was observed. In a lentiviral approach, injection of brain-derived neurotrophic factor-overexpressing T cells led to a less severe course of experimental autoimmune encephalomyelitis and direct axonal protection. Our data imply a functional role of brain-derived neurotrophic factor in autoimmune demyelination by mediating axon protection.
    Keywords: Axonal Damage ; Experimental Autoimmune Encephalomyelitis ; Neurotrophin
    ISSN: 0006-8950
    E-ISSN: 1460-2156
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  • 10
    In: Open Forum Infectious Diseases, 2015, Vol. 2(suppl1), pp.S364-S364
    Keywords: Medicine;
    E-ISSN: 2328-8957
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