@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{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{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}
}
@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{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}
}