@phdthesis{Herold2023,
  author    = {Herold, Fabian},
  title     = {Kraft und Kognition},
  doi       = {10.25932/publishup-61118},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-611181},
  school      = {Universit{\"a}t Potsdam},
  pages     = {187},
  year      = {2023},
  abstract  = {Die in den letzten Jahren aus Querschnittstudien gewonnenen empirischen Erkenntnisse deuten auf einen Zusammenhang zwischen muskul{\"a}rer Kraftleistungsf{\"a}higkeit und kognitiver Leistungsf{\"a}higkeit hin [10]. Diese Beobachtung wird von L{\"a}ngsschnittstudien gest{\"u}tzt, bei denen in Folge gezielter Krafttrainingsinterventionen, welche typischerweise zur Steigerung der muskul{\"a}ren Kraftleistungsf{\"a}higkeit f{\"u}hren, Verbesserungen der kognitiven Leistungsf{\"a}higkeit dokumentiert werden konnten [11]. Die zugrundeliegenden Mechanismen, die den Zusammenhang zwischen muskul{\"a}rer Kraftleistungsf{\"a}higkeit und kognitiver Leistungsf{\"a}higkeit begr{\"u}nden, sind jedoch noch nicht vollst{\"a}ndig bekannt und bed{\"u}rfen weiterer Forschung [10,12]. Vor diesem Hintergrund hatten die im Rahmen dieser Dissertation durchgef{\"u}hrten Forschungsarbeiten das {\"u}bergeordnete Ziel, die Mechanismen zu untersuchen, welche den Zusammenhang zwischen der muskul{\"a}ren Kraftleistungsf{\"a}higkeit und der kognitiven Leistungsf{\"a}higkeit erkl{\"a}ren k{\"o}nnen. In dieser Arbeit wurden dazu unterschiedliche Populationen (junge Menschen und {\"a}ltere Menschen ohne und mit leichten kognitiven St{\"o}rungen) unter Anwendung verschiedener untersuchungsmethodischer Ans{\"a}tze (systematische Literaturrecherche, Doppelaufgabenparadigma und funktionelle Nahinfrarotspektroskopie) untersucht. Aufgrund der im Rahmen dieser Dissertation durchgef{\"u}hrten Forschungsarbeiten, die konsekutiv aufeinander aufbauen, konnten folgende Haupterkenntnisse gewonnen werden: • Um einen umfassenden {\"U}berblick {\"u}ber die aktuelle Evidenzlage zum Thema Kraftleistungsf{\"a}higkeit und kognitiver Leistungsf{\"a}higkeit sowie den zugrundeliegenden neuronalen Korrelaten zu erlangen, wurde eine systematische Literaturrecherche zu diesem Forschungsthema durchgef{\"u}hrt. Die Ergebnisse dieser systematischen Literaturrecherche dokumentieren, dass ein gezieltes Krafttraining neben der Steigerung der kognitiven Leistungsf{\"a}higkeit zu funktionellen und strukturellen Ver{\"a}nderungen des Gehirns, insbesondere in frontalen Gehirnregionen, f{\"u}hren kann [13]. Ferner zeigen die Ergebnisse dieser systematischen Literaturrecherche, bei der eine begrenzte Anzahl verf{\"u}gbarer Studien (n = 18) identifiziert wurde, den Bedarf weiterer Forschungsarbeiten zu diesem Themenfeld an [13]. • Zur {\"U}berpr{\"u}fung der Hypothese, dass zur Ausf{\"u}hrung von Krafttrainings{\"u}bungen h{\"o}here kognitive Prozesse ben{\"o}tigt werden, wurde in einer experimentellen Studie bei j{\"u}ngeren gesunden Erwachsenen das Doppelaufgabenparadigma bei der Krafttrainings{\"u}bung Knie-beuge angewendet. Die in dieser Studie beobachteten Doppelaufgabenkosten bei der Ausf{\"u}hrung der Krafttrainings{\"u}bung Kniebeuge (im Vergleich zur Kontrollbedingung Stehen) deuten auf die Beteiligung h{\"o}herer kognitiver Prozesse zur L{\"o}sung dieser Bewegungsaufgabe hin und best{\"a}tigen die aufgestellte Hypothese [14]. • Um die Hypothese zu untersuchen, dass spezifische neuronale Korrelate (funktionelle Gehirnaktivit{\"a}t) den Zusammenhang zwischen muskul{\"a}rer Kraftleistungsf{\"a}higkeit und kognitiver Leistungsf{\"a}higkeit vermitteln, wurde bei jungen gesunden Erwachsenen der Zusammenhang zwischen der Auspr{\"a}gung der maximalen Handgriffkraft (normalisiert auf den Body-Mass-Index) und der kortikalen h{\"a}modynamischen Antwortreaktion untersucht, die bei der Durchf{\"u}hrung eines standardisierten kognitiven Tests mittels funktioneller Nahinfrarotspektroskopie in pr{\"a}frontalen Gehirnarealen gemessen wurde. Im Rahmen dieser Querschnittsstudie konnte die initiale Hypothese nicht vollst{\"a}ndig best{\"a}tigt werden, da zwar Zusammenh{\"a}nge zwischen maximaler Handgriffkraft und kognitiver Leistungsf{\"a}higkeit mit Parametern der h{\"a}modynamischen Antwortreaktion beobachtet wurden, aber die Auspr{\"a}gung der maximalen Handgriffkraft nicht im Zusammenhang mit der Kurzeitged{\"a}chtnisleistung stand [16]. • Zur Untersuchung der Annahme, dass eine vorliegende neurologische Erkrankung (im Speziellen eine leichte kognitive St{\"o}rung), die typischerweise mit Ver{\"a}nderungen von spezifischen neuronalen Korrelaten (z.B. des Hippokampus' [17-19] und des pr{\"a}frontalen Kortex' [20,21]) einhergeht, einen Einfluss auf die Assoziation zwischen muskul{\"a}rer Kraftleistungsf{\"a}higkeit und kognitiver Leistungsf{\"a}higkeit hat, wurde in einer Querschnittsstudie der Zusammenhang zwischen der Auspr{\"a}gung der maximalen Handgriffkraft (normalisiert auf den Body-Mass-Index) und der Auspr{\"a}gung der exekutiven Funktionen bei {\"a}lteren Erwachsenen mit amnestischem und nicht-amnestischem Subtyp der leichten kognitiven St{\"o}rung sowie gesunden {\"a}lteren Erwachsenen untersucht. In dieser Querschnittsstudie wurde nur bei {\"a}lteren Erwachsenen mit dem amnestischen Subtyp der leichten kognitiven St{\"o}rung ein Zusammenhang zwischen maximaler Handgriffkraft und exekutiven Funktionen beobachtet. Solch eine Korrelation existiert jedoch nicht bei {\"a}lteren Erwachsenen mit dem non-amnestischen Subtyp der leichten kognitiven St{\"o}rung oder bei gesunden {\"a}lteren Erwachsenen [24]. • In einem Perspektivenartikel wurde aufgezeigt, wie durch die theoriegeleitete Nutzung physiologischer Effekte, die bei einer speziellen Krafttrainingsmethode durch die Moderation des peripheren Blutflusses mittels Manschetten oder B{\"a}ndern auftreten, insbesondere Populationen mit niedriger mechanischer Belastbarkeit von den positiven Effekten des Krafttrainings auf die Gehirngesundheit profitieren k{\"o}nnten [25]. Insgesamt deuten die Ergebnisse der in dieser Dissertation zusammengef{\"u}hrten und aufeinander aufbauenden Forschungsarbeiten auf das Vorhandensein von gemeinsamen neuronalen Korrelaten (z.B. frontaler Kortex) hin, die sowohl f{\"u}r die muskul{\"a}re Kraftleistungsf{\"a}higkeit als auch f{\"u}r h{\"o}here kognitive Prozesse eine wichtige Rolle spielen [26]. Betrachtet man die in der vorliegenden Dissertation gewonnenen Erkenntnisse im Verbund mit den bereits in der Literatur existieren-den empirischen Belegen, unterst{\"u}tzen sie die Sichtweise, dass eine relativ hohe muskul{\"a}re Kraftleistungsf{\"a}higkeit und deren Erhalt durch gezielte Krafttrainingsinterventionen {\"u}ber die Lebenspanne positive Effekte auf die (Gehirn-)Gesundheit haben k{\"o}nnen [27].},
  language  = {de}
}
@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}
}
@phdthesis{Deeken2022,
  author    = {Deeken, Friederike},
  title     = {Relevance of non-pharmacological interventions that modify environmental factors in order to prevent and treat mental disorders in older patients and their caregivers},
  school      = {Universit{\"a}t Potsdam},
  year      = {2022},
  abstract  = {We live in an aging society. The change in demographic structures poses a number of challenges, including an increase in age-associated diseases. Delirium, dementia, and depression are considered to be of particular interest in the field of aging and mental health. A common theory regarding healthy aging and mental health is that the highest satisfaction and best performance is achieved when a person's abilities match the demands of their environment. In this context, the person's environment includes both the physical and the social environment. Based on this assumption, this dissertation focuses on the investigation of non-pharmacological interventions that modify environmental factors in order to facilitate the prevention and treatment of mental disorders in older patients and their caregivers. The first part of this dissertation consists of two publications and deals with the prevention of postoperative delirium in elderly patients. The PAWEL study investigated the use of a multimodal, non-pharmacological intervention in the routine care of patients aged 70 years or older undergoing elective surgery. The intervention included an interdepartmental delirium prevention team, daily use of seven manualized "best practice" procedures, structured staff training on delirium, and the adaptation of the hospital environment to the patients' needs. The second part of the dissertation used a meta-analysis to investigate whether technology-based interventions are a suitable form of support for informal caregivers of people with dementia. Subgroup analyses were conducted to examine the effect of different types of technology on caregiver burden and depressive symptoms. The following main results were found: The PAWEL study showed that the use of a multimodal, non-pharmacological intervention resulted in a significantly lower incidence rate of postoperative delirium and reduced days with delirium in the intervention group compared to the control group. However, this difference could not be observed in the group of patients undergoing elective cardiac surgery. The results of the meta-analysis showed that technology-based interventions offer a promising alternative to traditional "face-to-face" services. Significant effect sizes could be found in relation to both the burden and the depressive symptoms of caregiving relatives. These results provide further important information on the significant impact of non-pharmacological interventions that modify environmental factors on mental health, and support the consideration of such interventions in the prevention and treatment of mental disorders in both older patients and their caregivers.},
  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{BohlkenJacobSchaumetal.2017,
  author    = {Bohlken, Jens and Jacob, Louis and Schaum, Peter and Rapp, Michael Armin and Kostev, Karel},
  title     = {Hip fracture risk in patients with dementia in German primary care practices},
  series = {Dementia},
  volume    = {16},
  journal   = {Dementia},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {1471-3012},
  doi       = {10.1177/1471301215621854},
  pages     = {853 -- 864},
  year      = {2017},
  abstract  = {The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3\% of patients and 0.7\% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2\% versus 4.3\%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.},
  language  = {en}
}
@article{SturmWildermuthStolzetal.2019,
  author    = {Sturm, Heidrun and Wildermuth, Ronja and Stolz, Regina and Bertram, L. and Eschweiler, G. W. and Thomas, C. and Rapp, Michael Armin and Joos, S.},
  title     = {Diverging awareness of postoperative delirium and cognitive dysfunction in German Health Care Providers},
  series = {Clinical interventions in agins},
  volume    = {14},
  journal   = {Clinical interventions in agins},
  publisher = {DOVE Medical Press},
  address   = {Albany},
  issn      = {1178-1998},
  doi       = {10.2147/CIA.S230800},
  pages     = {2125 -- 2135},
  year      = {2019},
  abstract  = {Purpose: Postoperative cognitive dysfunction (POCD) appears in up to 30\% of patients suffering from postoperative delirium (POD). Both are associated with higher mortality and postoperative complications, prolonged hospital stays, and increased costs. Multi-modal models with pre-admission risk reduction counselling, perioperative monitoring, and training of multidisciplinary patient care providers have been shown to decrease the prevalence of both. The aim of our study is to understand how far those measures are known and implemented in routine care and to detect potential gaps in the current practice regarding risk communication and information flow between involved caregivers for patients at risk for POD/POCD. Patients and Methods: As part of a multicenter study, seven semi-structured focus group (FG) discussions with nurses and physicians from tertiary care hospitals (surgery, anesthesiology, and orthopedics, n=31) and general practitioners (GPs) in private practice (n=7) were performed. Transcribed discussions were analyzed using qualitative content analysis. Results: POD is present above all in the daily work of nurses, whereas physicians do not perceive it as a relevant problem. Physicians report that no regular risk assessment or risk communication was performed prior to elective surgery. Information about POD often gets lost during hand-offs and is not regularly reported in discharge letters. Thus, persisting cognitive dysfunction is often missed. The importance of standardized documentation and continuous education concerning risks, screening, and treatment was emphasized. The often-suggested pre-OP medication adjustment was seen as less important; in contrast, avoiding withdrawal was regarded as far more important. Conclusion: Altogether, it seems that standards and available best practice concepts are rarely implemented. In contrast to physicians, nurses are highly aware of delirium and ask for standardized procedures and more responsibility. Therefore, raising awareness regarding risks, screening tools, and effective preventive measures for POD/POCD seems an urgent goal. Nurses should have a central role in coordination and care of POD to prevent the risk for POCD.},
  language  = {en}
}
@article{DeekenRezoHinzetal.2019,
  author    = {Deeken, Friederike and Rezo, Anna and Hinz, Matthias and Discher, Robert and Rapp, Michael Armin},
  title     = {Evaluation of technology-based interventions for informal caregivers of patients with dementia},
  series = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
  volume    = {27},
  journal   = {The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry},
  number    = {4},
  publisher = {Elsevier},
  address   = {New York},
  issn      = {1064-7481},
  doi       = {10.1016/j.jagp.2018.12.003},
  pages     = {426 -- 445},
  year      = {2019},
  abstract  = {Objective: The aim of this study was to estimate the efficacy of technology-based interventions for informal caregivers of people with dementia (PWD). Methods: PubMed, PsycINFO, and Cochrane Library databases were searched in August 2018, with no restrictions in language or publication date. Two independent reviewers identified 33 eligible randomized controlled trials (RCTs) conducting a technology-based intervention for informal carers of PWD. Meta-analyses for the outcome measures caregiver depression and caregiver burden were conducted with subgroup analyses according to mode of delivery (telephone, computer/web-based, combined interventions). To assess methodologic quality, the Cochrane risk-of-bias assessment was rated. Results: Meta-analyses revealed a small but significant postintervention effect of technology-based interventions for caregiver depression and caregiver burden. Combined interventions showed the strongest effects. Conclusion: Technology-based interventions have the potential to support informal caregivers of PWD. Because of advantages such as high flexibility and availability, technology-based interventions provide a promising alternative compared with "traditional services," e.g., those for people living in rural areas. More high-quality RCTs for specific caregiver groups are needed.},
  language  = {en}
}
@article{MeiberthRappJessen2019,
  author    = {Meiberth, Dix Urs and Rapp, Michael Armin and Jessen, Frank},
  title     = {Ged{\"a}chtnisambulanzstrukturen in Deutschland - Ergebnisse einer Klinikbefragung},
  series = {Psychiatrische Praxis},
  volume    = {46},
  journal   = {Psychiatrische Praxis},
  number    = {4},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0303-4259},
  doi       = {10.1055/a-0825-9049},
  pages     = {213 -- 216},
  year      = {2019},
  abstract  = {Ziel der Studie Erfassung der Strukturen zur Fr{\"u}hdiagnostik von Demenzen an Krankenh{\"a}usern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 \% von 1758 kontaktierten Einrichtungen antworteten. 52 \% berichteten {\"u}ber ein entsprechendes Angebot, zum großen Teil mit leitlinienorientierten Verfahren, wie Liquordiagnostik. Das Diagnosespektrum umfasste zu 46 \% Demenzen und zu 41 \% Diagnosen der leichten oder subjektiven kognitiven St{\"o}rung. Schlussfolgerung Leitlinienbasierte Diagnostik und Fr{\"u}herkennungskonzepte sind in Ged{\"a}chtnisambulanzen weitgehend etabliert.},
  language  = {de}
}
@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}
}
@article{BookerJacobRappetal.2016,
  author    = {Booker, Anke and Jacob, Louis E. C. and Rapp, Michael Armin and Bohlken, Jens and Kostev, Karel},
  title     = {Risk factors for dementia diagnosis in German primary care practices},
  series = {International psychogeriatrics},
  volume    = {28},
  journal   = {International psychogeriatrics},
  publisher = {Cambridge Univ. Press},
  address   = {New York},
  issn      = {1041-6102},
  doi       = {10.1017/S1041610215002082},
  pages     = {1059 -- 1065},
  year      = {2016},
  abstract  = {Background: Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. Methods: The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. Conclusions: Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.},
  language  = {en}
}
@article{BookersJacobBohlkenetal.2016,
  author    = {Bookers, Anke and Jacob, Louis and Bohlken, Jens and Rapp, Michael Armin and Kostev, Karel},
  title     = {Persistence with antipsychotics in dementia patients in Germany},
  series = {International journal of clinical pharmacology and therapeutics},
  volume    = {54},
  journal   = {International journal of clinical pharmacology and therapeutics},
  publisher = {Dustri-Verlag Dr. Karl Feistle},
  address   = {Deisenhofen-M{\~A}¼nchen},
  issn      = {0946-1965},
  doi       = {10.5414/CP202631},
  pages     = {835 -- 840},
  year      = {2016},
  abstract  = {Background/Aims: To analyze the duration of treatment with antipsychotics in German dementia patients. Methods: This study included patients aged 60 years and over with dementia who received a first-time antipsychotic prescription by psychiatrists between 2009 and 2013. The main outcome measure was the treatment rate for more than 6 months following the index date. Results: A total of 12,979 patients with dementia (mean age 82 years, 52.1\% living in nursing homes) were included. After 2 years of follow-up, 54.8\%, 57.2\%, 61.1\%, and 65.4\% of patients aged 60 - 69, 70 - 79, 80 - 89, and 90 - 99 years, respectively, received antipsychotic prescriptions. 63.9\% of subjects living in nursing homes and 55.0\% of subjects living at home also continued their treatment (p-value < 0.001). Conclusion: The percentage of dementia patients treated with anti psychotics is very high.},
  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}
}
@misc{BohlkenWeberRappetal.2015,
  author    = {Bohlken, Jens and Weber, Simon and Rapp, Michael Armin and Kostev, Karel},
  title     = {Continuous treatment with antidementia drugs in Germany 2003-2013},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {522},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-41471},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-414718},
  pages     = {8},
  year      = {2015},
  abstract  = {Background: Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics. Methods: Data from 12,910 outpatients with dementia (mean age 79.2 years; SD = 7.6 years) treated between January 2003 and December 2013 in Germany were included. Continuous treatment was analysed using Kaplan-Meier curves and log-rank tests. In addition, multivariate Cox regression models were fitted with continuous treatment as dependent variable and the predictors antidementia agent, age, gender, medical comorbidities, physician specialty, and health insurance status. Results: After one year of follow-up, nearly 60\% of patients continued drug treatment. Donezepil (HR: 0.88; 95\% CI: 0.82-0.95) and memantine (HR: 0.85; 0.79-0.91) patients were less likely to be discontinued treatment as compared to rivastigmine users. Patients were less likely to be discontinued if they were treated by specialist physicians as compared to general practitioners (HR: 0.44; 0.41-0.48). Younger male patients and patients who had private health insurance had a lower discontinuation risk. Regarding comorbidity, patients were more likely to be continuously treated with the index substance if a diagnosis of heart failure or hypertension had been diagnosed at baseline. Conclusions: Our results imply that besides type of antidementia agent, involvement of a specialist in the complex process of prescribing antidementia drugs can provide meaningful benefits to patients, in terms of more disease-specific and continuous treatment.},
  language  = {en}
}
@misc{BookerJacobRappetal.2016,
  author    = {Booker, Anke and Jacob, Louis E. C. and Rapp, Michael Armin and Bohlken, Jens and Kostev, Karel},
  title     = {Risk factors for dementia diagnosis in German primary care practices},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {449},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-413441},
  pages     = {7},
  year      = {2016},
  abstract  = {Background: Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients. Methods: The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician. Practice visit records were used to verify that there had been 10 years of continuous follow-up prior to the index date. Multivariate logistic regression models were fitted with dementia as a dependent variable and the potential predictors. Results: The mean age for the 11,956 cases and the 11,956 controls was 80.4 (SD: 5.3) years. 39.0\% of them were male and 1.9\% had private health insurance. In the multivariate regression model, the following variables were linked to a significant extent with an increased risk of dementia: diabetes (OR: 1.17; 95\% CI: 1.10-1.24), lipid metabolism (1.07; 1.00-1.14), stroke incl. TIA (1.68; 1.57-1.80), Parkinson's disease (PD) (1.89; 1.64-2.19), intracranial injury (1.30; 1.00-1.70), coronary heart disease (1.06; 1.00-1.13), mild cognitive impairment (MCI) (2.12; 1.82-2.48), mental and behavioral disorders due to alcohol use (1.96; 1.50-2.57). The use of statins (OR: 0.94; 0.90-0.99), proton-pump inhibitors (PPI) (0.93; 0.90-0.97), and antihypertensive drugs (0.96, 0.94-0.99) were associated with a decreased risk of developing dementia. Conclusions: Risk factors for dementia found in this study are consistent with the literature. Nevertheless, the associations between statin, PPI and antihypertensive drug use, and decreased risk of dementia need further investigations.},
  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}
}
@misc{BohlkenJacobSchaumetal.2017,
  author    = {Bohlken, Jens and Jacob, Louis and Schaum, Peter and Rapp, Michael Armin and Kostev, Karel},
  title     = {Hip fracture risk in patients with dementia in German primary care practices},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {395},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-404526},
  pages     = {12},
  year      = {2017},
  abstract  = {The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3\% of patients and 0.7\% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2\% versus 4.3\%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.},
  language  = {en}
}
@misc{BaltesKliegl1988,
  author    = {Baltes, Paul B. and Kliegl, Reinhold},
  title     = {Lernen und Ged{\"a}chtnis im Alter : {\"u}ber Plastizit{\"a}t und deren Grenzen},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus-40277},
  year      = {1988},
  abstract  = {Ged{\"a}chtnish{\"o}chstleistungen sind auch im Alter m{\"o}glich. Dies konnte am Beispiel der »Methode der Orte« experimentell best{\"a}tigt werden. Hierbei hat sich gezeigt, daß das Gehirn {\"u}ber große kognitive Kapazit{\"a}tsreserven verf{\"u}gt. In einer speziellen Testmethode (»testing the limits«) zeigt sich aber im Hochleistungsbereich, trotz der grunds{\"a}tzlichen Plastizit{\"a}t, ein altersbezogenes Nachlassen der Ged{\"a}chtnismechanik. Offenbar gibt es biologische Grenzen in der Schnelligkeit der menschlichen Vorstellungskraft. Vielleicht gelingt es auf der Grundlage dieser Erkentnnis, einen zuverl{\"a}ssigen Markierungsindikator f{\"u}r das hirnphysiologische Altern zu finden. Daraus k{\"o}nnten sich auch neue Methoden zur Fr{\"u}herkennung von Demenzen ableiten lassen.},
  language  = {de}
}