TY - GEN A1 - Baltes, Paul B. A1 - Kliegl, Reinhold T1 - Lernen und Gedächtnis im Alter : über Plastizität und deren Grenzen T1 - Learning and memory in old age N2 - Gedächtnishöchstleistungen sind auch im Alter möglich. Dies konnte am Beispiel der »Methode der Orte« experimentell bestätigt werden. Hierbei hat sich gezeigt, daß das Gehirn über große kognitive Kapazitätsreserven verfügt. In einer speziellen Testmethode (»testing the limits«) zeigt sich aber im Hochleistungsbereich, trotz der grundsätzlichen Plastizität, ein altersbezogenes Nachlassen der Gedächtnismechanik. Offenbar gibt es biologische Grenzen in der Schnelligkeit der menschlichen Vorstellungskraft. Vielleicht gelingt es auf der Grundlage dieser Erkentnnis, einen zuverlässigen Markierungsindikator für das hirnphysiologische Altern zu finden. Daraus könnten sich auch neue Methoden zur Früherkennung von Demenzen ableiten lassen. N2 - A very high level of performance in memory is also possible in old age. This could be confirmed, for example, by experiments using the »method of loci«. It was shown that the human brain has available a large cognitive developmental reserve capacity. Nevertheless, a special method of assessment (»testing the limits«) revealed a robust age related decrease of memory mechanics at the high performance level despite this basic plasticity. Obviously, there are biologic limits of the speed of human imagination. Perhaps it will be possible to find a reliable marker of brainphysiologic aging based on this knowledge. Furthermore, new methods in early detection of dementias might be derived from the approach described. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - paper 150 KW - Lernen KW - Gedächtnis KW - Alter KW - Plastizität KW - Methode der Orte KW - Testing the limits KW - Demenz KW - Learning KW - memory KW - old age KW - plasticity KW - method of places KW - testing the limits KW - dementia Y1 - 1988 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus-40277 ER - TY - GEN A1 - Booker, Anke A1 - Jacob, Louis E. C. A1 - Rapp, Michael Armin A1 - Bohlken, Jens A1 - Kostev, Karel T1 - Risk factors for dementia diagnosis in German primary care practices T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 449 KW - dementia KW - Alzheimer KW - risk factors KW - statins Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-413441 IS - 449 ER - TY - THES A1 - Deeken, Friederike T1 - Relevance of non-pharmacological interventions that modify environmental factors in order to prevent and treat mental disorders in older patients and their caregivers N2 - 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. N2 - Wir leben in einer alternden Gesellschaft. Die Veränderung von demografischen Strukturen bringt eine Reihe von Herausfordergungen mit sich, unter anderem die Zunahme von alters-assoziierten Erkrankungen. Den drei Erkrankungen Delir, Demenz und Depression wird für den Bereich mentale Gesundheit im Alter eine besondere Bedeutung zugesprochen. Eine gängige Theorie für gesundes Altern und mentale Gesundheit bildet die Annahme, dass die höchste Zufriedenheit und beste Leistung gezeigt werden kann, wenn eine Passung zwischen den Anforderungen aus der Umwelt und den Fähigkeiten der Person gegeben ist. Zur Umwelt der Person zählen hierbei sowohl die physikalische Umgebung als auch das soziale Umfeld. Auf dieser Annahme basierend, widmet sich diese Dissertation der Untersuchung nicht-pharmakologischer Interventionen zur Modifikation von Umweltfaktoren zur Prävention und Behandlung psychischer Erkrankungen bei älteren Patienten und ihren pflegenden Angehörigen. Der erste Teil der Dissertation besteht aus zwei Publikationen und beschäftigt sich mit der Prävention von postoperativem Delir bei älteren PatientInnen. Die PAWEL-Studie untersuchte eine multimodale, nicht-pharmakologische Intervention in der Regelversorgung von PatientInnen über 70 Jahren, bei denen eine Elektivoperation durchgeführt wurde. Die Intervention umfasste den Einsatz eines interdisziplinären Delirium-Präventionsteams, die tägliche Anwendung von sieben manualisierten "Best-Practice"-Verfahren, strukturierte Mitarbeiterschulungen zum Thema Delirium und die Anpassung der Krankenhausumgebung an die Bedürfnisse der PatientInnen. Im zweiten Teil der Dissertation wurde mit Hilfe einer Meta-Analyse untersucht, ob technologie-basierte Interventionen geeignet sind, um pflegende Angehörige von Menschen mit Demenz zu unterstützen. In Subgruppen-Analysen wurde geprüft, wie unterschiedliche Technologiearten die Belastung und depressive Symptomatik der Angehörigen beeinflussen. Folgende Hauptergebnisse wurden gefunden: Die PAWEL-Studie zeigte, dass der Einsatz einer multimodalen, nicht-pharmakologischen Intervention zu einer signifikant niedrigeren Inzidenzrate von postoperativen Delirien sowie insgesamt weniger Delirtagen in der Interventionsgruppe im Vergleich zur Kontrollgruppe führte. Dieser Unterschied konnte jedoch nicht in der Gruppe der PatientInnen gezeigt werden, bei denen eine Herz- oder Gefäßoperation durchgeführt wurde. Die Ergebnisse der Meta-Analyse belegen, dass technologie-basierte Interventionen eine vielversprechende Alternative zu traditionellen „face-to-face“-Angeboten bieten. Es zeigten sich signifikante Effekte sowohl in Bezug auf die Belastung als auch auf die depressive Symptomatik der pflegenden Angehörigen. Die Ergebnisse dieser Dissertation belegen die Relevanz von nicht-pharmakologischen Interventionen zur Modifikation von Umweltfaktoren bei der Prävention und Behandlung von psychischen Erkankungen sowohl bei älteren PatientInnen als auch deren pflegenden Angehörigen. KW - delirium KW - prevention KW - old age KW - caregiver KW - dementia Y1 - 2022 ER - TY - GEN A1 - Häusler, Andreas A1 - Sánchez, Alba A1 - Gellert, Paul A1 - Deeken, Friederike A1 - Nordheim, Johanna A1 - Rapp, Michael Armin T1 - Perceived stress and quality of life in dementia patients and their caregiving spouses BT - does dyadic coping matter? T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 448 KW - dementia KW - dyadic coping KW - perceived stress KW - quality of life Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-413464 IS - 448 ER - TY - JOUR A1 - Meiberth, Dix Urs A1 - Rapp, Michael Armin A1 - Jessen, Frank T1 - Gedächtnisambulanzstrukturen in Deutschland – Ergebnisse einer Klinikbefragung JF - Psychiatrische Praxis N2 - Ziel der Studie Erfassung der Strukturen zur Frühdiagnostik von Demenzen an Krankenhäusern in Deutschland. Methodik Fragebogenerhebung. Ergebnisse 14 % von 1758 kontaktierten Einrichtungen antworteten. 52 % berichteten über 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 Störung. Schlussfolgerung Leitlinienbasierte Diagnostik und Früherkennungskonzepte sind in Gedächtnisambulanzen weitgehend etabliert. N2 - Objective To assess the structures for early and differential diagnosis of dementia in hospitals in Germany. Methods Written questionnaire to all German hospitals. Results 14 % of 1.758 hospitals responded. Of those, 52 % reported to offer a special service for early dementia diagnosis, mostly on an outpatient basis. The applied methods were in agreement with the national guideline for diagnosis and treatment of dementias, including technical diagnostics, such as neuroimaging and cerebrospinal fluid examinations. 46 % of the diagnostic spectrum were dementia. 41 % were either diagnosed as mild cognitive impairment (MCI) or as subjective cognitive decline (SCD). Conclusion Despite mostly insufficient reimbursement, a large proportion of the responding hospitals offer a specialized service, which largely adheres to guideline-based diagnostic procedures. The concepts of at-risk and prodromal stages of dementia seem to be largely established. T2 - Memory Clinics in Germany - Results of a Hospital Survey KW - dementia KW - Alzheimer KW - memory clinic KW - early diagnosis KW - Demenz KW - Alzheimer KW - Gedächtnisambulanz KW - Frühdiagnose Y1 - 2019 U6 - https://doi.org/10.1055/a-0825-9049 SN - 0303-4259 SN - 1439-0876 VL - 46 IS - 4 SP - 213 EP - 216 PB - Thieme CY - Stuttgart ER - TY - JOUR A1 - Niemann-Mirmehdi, Mechthild A1 - Häusler, Andreas A1 - Gellert, Paul A1 - Nordheim, Johanna T1 - Perceived Overprotection and Its Association With Quality of Life in Dementia JF - Geropsych - The Journal of gerontopsychology and geriatric psychiatry N2 - 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. KW - dementia KW - perceived overprotection KW - perceived stress KW - depression KW - quality of life Y1 - 2019 U6 - https://doi.org/10.1024/1662-9647/a000207 SN - 1662-9647 SN - 1662-971X VL - 32 IS - 3 SP - 125 EP - 134 PB - Hogrefe CY - Göttingen ER -