@article{BlockSchulzeDeekenetal.2021,
  author    = {Block, Andrea and Schulze, Susanne and Deeken, Friederike and H{\"a}usler, Andreas and Rezo, Anna and Rapp, Michael Armin and Wippert, Pia-Maria},
  title     = {Effects of inflammatory markers and biographical stress on treatment response in depression},
  series = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  volume    = {131},
  journal   = {Psychoneuroendocrinology : an international journal ; the official journal of the International Society of Psychoneuroendocrinology},
  number    = {Supplement},
  publisher = {Elsevier},
  address   = {Oxford},
  issn      = {0306-4530},
  doi       = {10.1016/j.psyneuen.2021.105535},
  pages     = {S24 -- S24},
  year      = {2021},
  abstract  = {Background Recent research emphasized the role of inflammatory processes in the pathophysiology of depression. Theories hypothesizes that life events (LE) can affect the immune system and trigger depressive symptoms. LE are also considered as one of the best predictors for the onset and course of depressive disorders. Methods Observational study across three treatment settings: n=208 depressive patients (75.5\%f, M 46.6 y) were examined on depression (BDI-II), life events (ILE) and inflammatory markers (IL-6, CRP, fibrinogen, ICAM-1, TNF-alpha, E-selectin) at baseline (t0), 5-week(t1) and 5-month(t2) follow-up. Effects and interactions were analyzed with regression models. Results LE were associated with depressive symptoms at t0 (beta=.209; p=.002) and both follow-ups. Except for CRP, which was linked to depression symptoms at t2 (betai=-.190; p=.032), there were no effects of inflammatory markers on depressive symptoms. At t1, an interaction between CRP and LE in total (beta=-.249; p=.041) was found as well as for LE in the past five years (beta=-.122; p=.027). Similar interactions were found between cumulative LE and ICAM-1 (beta=-.197; p=.003) and IL-6 (beta=-.425; p=.001). Conclusion The cumulative burden of LE effects symptoms and treatment outcome in depressive patients. There is some evidence that inflammatory marker may have long-term effects on treatment outcome as they seem to weaken the determining relation between LE and depression.},
  language  = {en}
}
@article{SchraplauBlockHaeusleretal.2021,
  author    = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael A. and V{\"o}ller, Heinz and Bonaventura, Klaus and Mayer, Frank},
  title     = {Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study},
  series = {Pilot and Feasibility Studies},
  volume    = {7},
  journal   = {Pilot and Feasibility Studies},
  publisher = {BioMed Central (Springer Nature)},
  address   = {London},
  issn      = {2055-5784},
  doi       = {10.1186/s40814-021-00898-w},
  pages     = {1 -- 11},
  year      = {2021},
  abstract  = {Background The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS. Methods In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis. Discussion The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the "Mobile Brandenburg Cohort" create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions. Trial registration German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.},
  language  = {en}
}
@misc{SchraplauBlockHaeusleretal.2021,
  author    = {Schraplau, Anne and Block, Andrea and H{\"a}usler, Andreas and Wippert, Pia-Maria and Rapp, Michael Armin and V{\"o}ller, Heinz and Bonaventura, Klaus and Mayer, Frank},
  title     = {Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort},
  series = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Zweitver{\"o}ffentlichungen der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  publisher = {Universit{\"a}tsverlag Potsdam},
  address   = {Potsdam},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-54950},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-549506},
  pages     = {1 -- 11},
  year      = {2021},
  abstract  = {Background The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a "Mobile Brandenburg Cohort" to reveal new causes and risk factors for MetS. Methods In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis. Discussion The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the "Mobile Brandenburg Cohort" create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions. Trial registration German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.},
  language  = {en}
}
@article{GellertHaeuslerGholamietal.2017,
  author    = {Gellert, Paul and H{\"a}usler, Andreas and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna},
  title     = {Own and partners' dyadic coping and depressive symptoms in individuals with early-stage dementia and their caregiving partners},
  series = {Aging \& Mental Health},
  volume    = {22},
  journal   = {Aging \& Mental Health},
  number    = {8},
  publisher = {Routledge, Taylor \& Francis Group},
  address   = {Abingdon},
  issn      = {1360-7863},
  doi       = {10.1080/13607863.2017.1334759},
  pages     = {1008 -- 1016},
  year      = {2017},
  abstract  = {Objectives: In patients with early-stage dementia and their caregiving partners, reciprocal dyadic coping (DC) is crucial for preventing or reducing depressive symptoms in both partners. This study examines the relationships between 'own DC' and 'perceived partner DC' with depressive symptoms in couples coping with dementia on individual (actor effects) and cross-person (partner effects) levels. Method: 164 individuals (82 patients with early-stage dementia and their 82 caregiving partners; ND = 82 dyads) participated in this prospective study with measures (DC, depressive symptoms, and dementia severity) taken at baseline and at six months. Each partner evaluated their own and the perceived partner DC. Actor-partner interdependence models were applied to the resulting four independent evaluations. Results: Results differed substantially between patients and caregivers. DC was significantly related to patients' but not to caregivers' depressive symptoms, when adjustments were made for individual coping. Perceived partner DC showed a negative association with depressive symptoms in patients, whereas own DC was adversely related for actor as well as for partner effects across individuals. Conclusion: The adverse association between the own DC of the caregiver and the patient on depressive symptoms of the patient might be due to inappropriate efforts or to the loss of autonomy as a care-receiver. DC is important in both patients and caregivers, as shown by the negative association between perceived partner DC and depressive symptoms in the patients, which might inform interventions that target the couple as a whole.},
  language  = {en}
}
@article{NiemannMirmehdiHaeuslerGellertetal.2019,
  author    = {Niemann-Mirmehdi, Mechthild and H{\"a}usler, Andreas and Gellert, Paul and Nordheim, Johanna},
  title     = {Perceived Overprotection and Its Association With Quality of Life in Dementia},
  series = {Geropsych - The Journal of gerontopsychology and geriatric psychiatry},
  volume    = {32},
  journal   = {Geropsych - The Journal of gerontopsychology and geriatric psychiatry},
  number    = {3},
  publisher = {Hogrefe},
  address   = {G{\"o}ttingen},
  issn      = {1662-9647},
  doi       = {10.1024/1662-9647/a000207},
  pages     = {125 -- 134},
  year      = {2019},
  abstract  = {To date, few studies have focused on perceived overprotection from the perspective of people with dementia (PwD). In the present examination, the association of perceived overprotection in PwD is examined as an autonomy-restricting factor and thus negative for their mental well-being. Cross-sectional data from the prospective DYADEM study of 82 patient/partner dyads (mean age = 74.26) were used to investigate the association between overprotection, perceived stress, depression, and quality of life (QoL). The analyses show that an overprotective contact style with PwD has a significant positive association with stress and depression, and has a negative association with QoL. The results emphasize the importance of avoiding an overprotective care style and supporting patient autonomy.},
  language  = {en}
}
@misc{HaeuslerSanchezGellertetal.2016,
  author    = {H{\"a}usler, Andreas and S{\´a}nchez, Alba and Gellert, Paul and Deeken, Friederike and Nordheim, Johanna and Rapp, Michael Armin},
  title     = {Perceived stress and quality of life in dementia patients and their caregiving spouses},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {448},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-413464},
  pages     = {10},
  year      = {2016},
  abstract  = {Background: Given the well-established association between perceived stress and quality of life (QoL) in dementia patients and their partners, our goal was to identify whether relationship quality and dyadic coping would operate as mediators between perceived stress and QoL. Methods: 82 dyads of dementia patients and their spousal caregivers were included in a cross-sectional assessment from a prospective study. QoL was assessed with the Quality of Life in Alzheimer's Disease scale (QoL-AD) for dementia patients and the WHO Quality of Life-BREF for spousal caregivers. Perceived stress was measured with the Perceived Stress Scale (PSS-14). Both partners were assessed with the Dyadic Coping Inventory (DCI). Analyses of correlation as well as regression models including mediator analyses were performed. Results: We found negative correlations between stress and QoL in both partners (QoL-AD: r = -0.62; p < 0.001; WHO-QOL Overall: r = -0.27; p = 0.02). Spousal caregivers had a significantly lower DCI total score than dementia patients (p < 0.001). Dyadic coping was a significant mediator of the relationship between stress and QoL in spousal caregivers (z = 0.28; p = 0.02), but not in dementia patients. Likewise, relationship quality significantly mediated the relationship between stress and QoL in caregivers only (z = -2.41; p = 0.02). Conclusions: This study identified dyadic coping as a mediator on the relationship between stress and QoL in (caregiving) partners of dementia patients. In patients, however, we found a direct negative effect of stress on QoL. The findings suggest the importance of stress reducing and dyadic interventions for dementia patients and their partners, respectively.},
  language  = {en}
}
@article{HaeuslerSanchezGellertetal.2016,
  author    = {H{\"a}usler, Andreas and S{\´a}nchez, Alba and Gellert, Paul and Deeken, Friederike and Rapp, Michael Armin and Nordheim, Johanna},
  title     = {Perceived stress and quality of life in dementia patients and their caregiving spouses: does dyadic coping matter?},
  series = {International psychogeriatrics},
  volume    = {28},
  journal   = {International psychogeriatrics},
  publisher = {Cambridge Univ. Press},
  address   = {New York},
  issn      = {1041-6102},
  doi       = {10.1017/S1041610216001046},
  pages     = {1857 -- 1866},
  year      = {2016},
  abstract  = {Background: Given the well-established association between perceived stress and quality of life (QoL) in dementia patients and their partners, our goal was to identify whether relationship quality and dyadic coping would operate as mediators between perceived stress and QoL. Results: We found negative correlations between stress and QoL in both partners (QoL-AD: r = -0.62; p < 0.001; WHO-QOL Overall: r = -0.27; p = 0.02). Spousal caregivers had a significantly lower DCI total score than dementia patients (p < 0.001). Dyadic coping was a significant mediator of the relationship between stress and QoL in spousal caregivers (z = 0.28; p = 0.02), but not in dementia patients. Likewise, relationship quality significantly mediated the relationship between stress and QoL in caregivers only (z = -2.41; p = 0.02). Conclusions: This study identified dyadic coping as a mediator on the relationship between stress and QoL in (caregiving) partners of dementia patients. In patients, however, we found a direct negative effect of stress on QoL. The findings suggest the importance of stress reducing and dyadic interventions for dementia patients and their partners, respectively.},
  language  = {en}
}
@article{DeekenHaeuslerNordheimetal.2017,
  author    = {Deeken, Friederike and H{\"a}usler, Andreas and Nordheim, Johanna and Rapp, Michael Armin and Knoll, Nina and Rieckmann, Nina},
  title     = {Psychometric properties of the Perceived Stress Scale in a sample of German dementia patients and their caregivers},
  series = {International psychogeriatrics},
  volume    = {30},
  journal   = {International psychogeriatrics},
  number    = {1},
  publisher = {Cambridge Univ. Press},
  address   = {New York},
  issn      = {1041-6102},
  doi       = {10.1017/S1041610217001387},
  pages     = {39 -- 47},
  year      = {2017},
  abstract  = {Background: The aim of the present study was to investigate the psychometric characteristics of the Perceived Stress Scale (PSS) in a sample of dementia patients and their spousal caregivers. Methods: We investigated the reliability and validity of the 14-item PSS in a sample of 80 couples, each including one spouse who had been diagnosed with mild to moderate dementia (mean age 75.55, SD = 5.85, 38.7\% female) and one spousal caregiver (mean age 73.06, SD = 6.75, 61.3\% female). We also examined the factor structure and sensitivity of the scale with regard to gender differences. Results: Exploratory factor analysis of the PSS revealed a two-factor solution for the scale; the first factor reflected general stress while the second factor consisted of items reflecting the perceived ability to cope with stressors. A confirmatory factor analysis verified that the data were a better fit for the two-factor model than a one-factor model. The two factors of the PSS showed good reliability for patients as well as for caregivers ranging between alpha = 0.73 and alpha = 0.82. Perceived stress was significantly positively correlated with depressive symptomatology in both caregivers and patients. Mean PSS scores did not significantly differ between male and female patients nor did they differ between male and female caregivers. Conclusion: The present data indicate that the PSS provides a reliable and valid measure of perceived stress in dementia patients and their caregivers.},
  language  = {en}
}
@misc{GellertHaeuslerSuhretal.2018,
  author    = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna},
  title     = {Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {657},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-44627},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-446270},
  pages     = {16},
  year      = {2018},
  abstract  = {Purpose To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.},
  language  = {en}
}
@article{GellertHaeuslerSuhretal.2018,
  author    = {Gellert, Paul and H{\"a}usler, Andreas and Suhr, Ralf and Gholami, Maryam and Rapp, Michael Armin and Kuhlmey, Adelheid and Nordheim, Johanna},
  title     = {Testing the stress-buffering hypothesis of social support in couples coping with early-stage dementia},
  series = {PLoS one},
  volume    = {13},
  journal   = {PLoS one},
  number    = {1},
  publisher = {PLoS},
  address   = {San Fransisco},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0189849},
  pages     = {14},
  year      = {2018},
  abstract  = {Purpose: To test whether the negative relationship between perceived stress and quality of life (Hypothesis 1) can be buffered by perceived social support in patients with dementia as well as in caregivers individually (Hypothesis 2: actor effects) and across partners (Hypothesis 3: partner effects and actor-partner effects). Method: A total of 108 couples (N = 216 individuals) comprised of one individual with early-stage dementia and one caregiving partner were assessed at baseline and one month apart. Moderation effects were investigated by applying linear mixed models and actor-partner interdependence models. Results: Although the stress-quality of life association was more pronounced in caregivers (beta = -.63, p<.001) compared to patients (beta= -.31, p<.001), this association was equally moderated by social support in patients (beta = .14, p<.05) and in the caregivers (beta =.13, p<.05). From one partner to his or her counterpart, the partner buffering and actor-partner-buffering effect were not present. Conclusion: The stress-buffering effect has been replicated in individuals with dementia and caregivers but not across partners. Interventions to improve quality of life through perceived social support should not only focus on caregivers, but should incorporate both partners.},
  language  = {en}
}