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  • 1
    In: Neuroepidemiology, S. Karger AG, Vol. 31, No. 2 ( 2008), p. 100-108
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Information on the time until institutionalization and its predictors in demented subjects has so far been based on studies with selected samples or prevalent dementia cases. Thus, the aim of the study is to analyze the time until institutionalization and associated patient-related factors in incident dementia cases. 〈 i 〉 Methods: 〈 /i 〉 Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA 75+), a population-based study of individuals aged 75 years and older. Kaplan-Meier survival analysis was used to determine the time until institutionalization. Factors associated with time until institutionalization were analyzed using Cox proportional hazards models. 〈 i 〉 Results: 〈 /i 〉 One hundred and nine subjects with incident dementia who resided in a private home setting at the time of the dementia diagnosis were identified. Fifty-two (47.7%) of these subjects had become residents of a nursing home by the end of the study. The median time until institutionalization was 1,005 days (95% CI = 808–1,202). Being widowed/divorced (compared to being married) was associated with a significantly shorter time until institutionalization (univariate model: HR = 4.50, 95% CI = 1.09–18.57). 〈 i 〉 Conclusion: 〈 /i 〉 Being without a spouse seems to be an important factor for a shorter time until institutionalization in incident dementia cases. Tailored interventions for these subjects at risk are required.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1483032-2
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  • 2
    Online Resource
    Online Resource
    S. Karger AG ; 2006
    In:  Dementia and Geriatric Cognitive Disorders Vol. 22, No. 3 ( 2006), p. 185-193
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 22, No. 3 ( 2006), p. 185-193
    Abstract: Mortality caused by dementia has mainly been examined in population-based studies relying on prevalent cases. This study aims to investigate the impact of incident dementia on mortality as well as to identify factors influencing the course of dementia and those predicting early death in demented individuals. A representative community sample of 1,692 individuals aged 75 years and over was examined by neuropsychological testing in a four-wave study. Data were analyzed with the Cox proportional hazards model after making necessary adjustments for potential covariates. At the third follow-up 51% of the incident demented and 19% of the participants without dementia had died. The mean survival time was 3.1 years (95% CI = 2.8–3.4) for the demented subjects and 4.0 years (95% CI = 3.9–4.0) for those without dementia (p 〈 0.001). In the total sample, the relative risk of dying after developing dementia was estimated to be 2.4 (95% CI = 1.6–3.6) with age, sex, education, co-morbidity, and institutionalization being taken into consideration. Those persons with incident dementia who died had a more severe dementia. Population-based studies relying on incident cases are especially valuable in describing course and outcome of dementia. Studies relying on prevalent cases and clinical samples tend to overestimate mortality and propose course-modifying factors that are challenged by studies relying on incident cases.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2006
    detail.hit.zdb_id: 1482186-2
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  • 3
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    Online Resource
    S. Karger AG ; 2008
    In:  Dementia and Geriatric Cognitive Disorders Vol. 26, No. 1 ( 2008), p. 65-78
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 26, No. 1 ( 2008), p. 65-78
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 In the past decades, a substantial number of studies considered factors influencing institutionalisation of persons with dementia. This study reviews recent work on predictors of actual institutionalisation in dementia. 〈 i 〉 Method: 〈 /i 〉 Relevant articles were identified by a systematic search of the literature. Studies were considered which included persons aged 65 and over, and whose results were based on prospective design and on multivariate statistical analyses. 〈 i 〉 Results: 〈 /i 〉 Forty-two studies were identified. The rate of institutionalisation increased from 20% in the first year after diagnosis to 50% after 5 years. Median time to institutionalisation was estimated between 30 and 40 months. Predictors of institutionalisation were classified according to a provided conceptual framework in the categories sociodemographic and relationship characteristics of persons with dementia and caregivers, primary stressors, secondary stressors and resources. 〈 i 〉 Conclusion: 〈 /i 〉 The overview of research activities in this area showed a lack of methodological strength in a large part of identified studies. Nevertheless, a lot of well-examined and less highlighted predictors could be identified.
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1482186-2
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  • 4
    In: Obesity Facts, S. Karger AG, Vol. 10, No. 2 ( 2017), p. 139-151
    Abstract: 〈 b 〉 〈 i 〉 Aim: 〈 /i 〉 〈 /b 〉 Currently, health care professionals plead for stabilization of weight and improving health conditions rather than focusing on weight loss only. Individuals with obesity have been shown to report weight loss goals that are much higher than what has been suggested by guidelines. The aim was to determine whether weight discrimination and body dissatisfaction have an impact on how much weight an individual with obesity wants to lose. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this representative telephone survey, 878 participants with obesity were asked about their experiences with weight stigma, their body image concerns, and about the amount of weight they would like to weigh using random digital dialing and Kish selection grid to ensure random selection of participants. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Regression analysis reveals that being female, having a higher BMI, being younger, and trying to lose weight was related to a greater discrepancy between current weight and desired weight. The discrepancy between current weight and desired weight was greater when participants reported discrimination due to their weight as well as internalized stigma and body image concerns. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Independent on the weight loss method, treating obesity should include realistic weight loss goals without being affected by social pressure or weight stigma, especially since stigma can result in further weight gain and decline health issues related to obesity and overweight.
    Type of Medium: Online Resource
    ISSN: 1662-4025 , 1662-4033
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 2455819-9
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  • 5
    In: Obesity Facts, S. Karger AG, Vol. 11, No. 6 ( 2018), p. 514-523
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 Identifying the underlying pathways between obesity and depression and which individuals with obesity are at risk for developing depressive symptoms is important for improving prevention and treatment efforts. The current study investigated appearance evaluation as a potential mediator of the relationship between obesity and depression. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 1,000 participants with a self-reported BMI greater than 30 kg/m 〈 sup 〉 2 〈 /sup 〉 were interviewed about their experiences with an elevated body weight and completed measures on appearance evaluation and depression. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 A negative relationship between satisfaction with appearance and BMI and a negative association between satisfaction with appearance and depression was found in men and women. Men reported less depressive symptoms and higher satisfaction with appearance compared to women. While no mediation effect could be determined in women, satisfaction with appearance mediated the obesity-depression relationship in men. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Efforts to reduce adverse effects of either obesity or depression need to take the reciprocal relationship between the two conditions into account. The current findings underscore the importance of appearance evaluation for treatment efforts in individuals with obesity. Interventions addressing body image might improve both, psychological distress and weight management efforts in general.
    Type of Medium: Online Resource
    ISSN: 1662-4025 , 1662-4033
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
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  • 6
    In: Gerontology, S. Karger AG, Vol. 67, No. 5 ( 2021), p. 591-598
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 There is a lack of studies examining the link between perceived autonomy and frailty among the oldest old. Therefore, our objective was to fill this gap. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Data were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe; follow-up [FU] wave 9; 〈 i 〉 n 〈 /i 〉 = 510 observations in the analytical sample). The average age was 90.3 years (SD: 2.7 years). The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used to assess frailty. Socioeconomic and health-related covariates were included in our regression model. The autonomy scale developed by Schwarzer was used to assess perceived autonomy in old age. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Adjusting for various confounders, multiple linear regressions showed that lower perceived autonomy was associated with increased levels of frailty (total sample: β = −0.13, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; women: β = −0.14, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001; and men: β = −0.12, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). Furthermore, lower perceived autonomy was associated with more depressive symptoms, higher cognitive impairment, and being institutionalized (except for men) in the total sample and in both sexes, but it was not significantly associated with age, sex, marital status, educational level, and social support. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Findings indicate that frailty is associated with lower autonomy among the oldest old. More generally, while health-related factors were consistently associated with autonomy, sociodemographic factors (except for being institutionalized) were not associated with autonomy among the oldest old. We should be aware of the strong association between autonomy and physical as well as mental health in very old age.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482689-6
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  • 7
    In: Gerontology, S. Karger AG, Vol. 68, No. 8 ( 2022), p. 894-902
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the 〈 i 〉 oldest old 〈 /i 〉 longitudinally. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Longitudinal data (follow-up [FU] wave 7–9) were gathered from 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). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482689-6
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  • 8
    In: Neuroepidemiology, S. Karger AG, Vol. 54, No. 2 ( 2020), p. 157-170
    Abstract: In recent years, a rapidly increasing collection of investigative methods in addition to changes in diagnostic criteria for dementia have followed “high-tech” trends in medicine, with the aim to better define the dementia syndrome and its biological substrates, mainly in order to predict risk prior to clinical expression. These approaches are not without challenge. A set of guidelines have been developed by a group of European experts in population-based cohort research through a series of workshops, funded by the Joint Program for Neurodegenerative Disorders (JPND). The aims of the guidelines are to assist policy makers and researchers to understand (1) What population studies for ageing populations should encompass and (2) How to interpret the findings from population studies. Such studies are essential to provide evidence relevant to the understanding of healthy and frail brain ageing, including the dementia syndrome for contemporary and future societies by drawing on the past.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1483032-2
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  • 9
    Online Resource
    Online Resource
    S. Karger AG ; 2021
    In:  European Addiction Research Vol. 27, No. 1 ( 2021), p. 9-15
    In: European Addiction Research, S. Karger AG, Vol. 27, No. 1 ( 2021), p. 9-15
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Shiftwork can be a risk factor for a number of different somatic and psychological health conditions, especially sleep disorders. Shiftworkers sleep less than dayworkers, and 20–40% of them suffer from difficulties initiating and maintaining sleep, which result in reduced capacity for work and social life. A common coping strategy might be the use of alcohol, which presents a health and safety hazard as it further impairs sleep quality and exacerbates sleepiness in the workplace. This review aimed to assess the extent of such possible connections. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We performed a systematic search of the scientific literature on shiftwork and alcohol consumption in PubMed, PsycInfo, and Cochrane Library. Only original studies comparing shiftworkers with non-shiftworkers were included. The recommendations of the 〈 i 〉 Preferred Reporting Items of Systematic Reviews and Meta-Analyses 〈 /i 〉 were followed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Fourteen articles are included in this review. Six studies report some kind of connection between shift- or nightwork and alcohol consumption, especially as a sleep aid. Conflicting or negative results are reported by 3 studies. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 Shiftwork, especially working at night and in rotation shifts, is associated with binge drinking disorder in different professions. The reasons for pathological consumption of alcohol can be self-medication of sleep problems or coping with stress and psychosocial problems typical for shiftwork. Nurses aged over 50 years represent one important risk group. These results can be important for preventive programs against sleep disorders, including measures other than drinking alcohol as a sleep aid in the workplace of shiftworkers.
    Type of Medium: Online Resource
    ISSN: 1022-6877 , 1421-9891
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482231-3
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  • 10
    In: Dementia and Geriatric Cognitive Disorders, S. Karger AG, Vol. 33, No. 4 ( 2012), p. 282-288
    Type of Medium: Online Resource
    ISSN: 1420-8008 , 1421-9824
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482186-2
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