TY - JOUR A1 - Bohlken, Jens A1 - Weber, Simon A1 - Rapp, Michael A. A1 - Kostev, Karel T1 - Continuous treatment with antidementia drugs in Germany 2003-2013: a retrospective database analysis JF - International psychogeriatrics N2 - 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. KW - adherence KW - cholinesterase inhibitors KW - memantine Y1 - 2015 U6 - https://doi.org/10.1017/S1041610215000654 SN - 1041-6102 SN - 1741-203X VL - 27 IS - 8 SP - 1335 EP - 1342 PB - Cambridge Univ. Press CY - New York ER - TY - JOUR A1 - Heinzel, Stephan A1 - Lawrence, Jimmy B. A1 - Kallies, Gunnar A1 - Rapp, Michael A. A1 - Heissel, Andreas T1 - Using Exercise to Fight Depression in Older Adults BT - A Systematic Review and Meta-Analysis JF - GeroPsych : the journal of gerontopsychology and geriatric psychiatry N2 - Depression is the most prevalent psychiatric disorder in the general population. Despite a large demand for efficient treatment options, the majority of older depressed adults does not receive adequate treatment: Additional low-threshold treatments are needed for this age group. Over the past two decades, a growing number of randomized controlled trials (RCT) have been conducted, testing the efficacy of physical exercise in the alleviation of depression in older adults. This meta-analysis systematically reviews and evaluates these studies; some subanalyses testing specific effects of different types of exercise and settings are also performed. In order to be included, exercise programs of the RCTs had to fulfill the criteria of exercise according to the American College of Sports Medicine, including a sample mean age of 60 or above and an increased level of depressive symptoms. Eighteen trials with 1,063 participants fulfilled our inclusion criteria. A comparison of the posttreatment depression scores between the exercise and control groups revealed a moderate effect size in favor of the exercise groups (standardized mean difference (SMD) of –0.68, p < .001). The effect was comparable to the results achieved when only the eleven trials with low risk of bias were included (SMD = –0.63, p < .001). The subanalyses showed significant effects for all types of exercise and for supervised interventions. The results of this meta-analysis suggest that physical exercise may serve as a feasible, additional intervention to fight depression in older adults. However, because of small sample sizes of the majority of individual trials and high statistical heterogeneity, results must be interpreted carefully. KW - depression KW - exercise KW - older adults KW - meta-analysis KW - review Y1 - 2015 U6 - https://doi.org/10.1024/1662-9647/a000133 SN - 1662-9647 SN - 1662-971X VL - 28 SP - 149 EP - 162 PB - Hogrefe CY - Cambridge, Mass. ; Göttingen [u.a.] ER - TY - JOUR A1 - Kuschpel, Maxim S. A1 - Liu, Shuyan A1 - Schad, Daniel A1 - Heinzel, Stephan A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Differential effects of wakeful rest, music and video game playing on working memory performance in the n-back task JF - Frontiers in psychology N2 - The interruption of learning processes by breaks filled with diverse activities is common in everyday life. We investigated the effects of active computer gaming and passive relaxation (rest and music) breaks on working memory performance. Young adults were exposed to breaks involving (i) eyes-open resting, (ii) listening to music and (iii) playing the video game “Angry Birds” before performing the n-back working memory task. Based on linear mixed-effects modeling, we found that playing the “Angry Birds” video game during a short learning break led to a decline in task performance over the course of the task as compared to eyes-open resting and listening to music, although overall task performance was not impaired. This effect was associated with high levels of daily mind wandering and low self-reported ability to concentrate. These findings indicate that video games can negatively affect working memory performance over time when played in between learning tasks. We suggest further investigation of these effects because of their relevance to everyday activity. KW - break interventions KW - computer games KW - mozart effect KW - working memory KW - attention KW - cognitive resources KW - mind wandering Y1 - 2015 U6 - https://doi.org/10.3389/fpsyg.2015.01683 SN - 1664-1078 IS - 6 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Liu, Shuyan A1 - Kuschpel, Maxim S. A1 - Schad, Daniel A1 - Heinz, Andreas A1 - Rapp, Michael A. T1 - Differential Effects of Music and Video Gaming During Breaks on Auditory and Visual Learning JF - Cyberpsychology, behavior and social networking N2 - The interruption of learning processes by breaks filled with diverse activities is common in everyday life. This study investigated the effects of active computer gaming and passive relaxation (rest and music) breaks on auditory versus visual memory performance. Young adults were exposed to breaks involving (a) open eyes resting, (b) listening to music, and (c) playing a video game, immediately after memorizing auditory versus visual stimuli. To assess learning performance, words were recalled directly after the break (an 8:30 minute delay) and were recalled and recognized again after 7 days. Based on linear mixed-effects modeling, it was found that playing the Angry Birds video game during a short learning break impaired long-term retrieval in auditory learning but enhanced long-term retrieval in visual learning compared with the music and rest conditions. These differential effects of video games on visual versus auditory learning suggest specific interference of common break activities on learning. Y1 - 2015 U6 - https://doi.org/10.1089/cyber.2015.0140 SN - 2152-2715 SN - 2152-2723 VL - 18 IS - 11 SP - 647 EP - 653 PB - Liebert CY - New Rochelle ER -