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How much is too much?
(2010)
Although dietary nutrient intake is often adequate, nutritional supplement use is common among elite athletes. However, high-dose supplements or the use of multiple supplements may exceed the recommended daily allowance (RDA) of particular nutrients or even result in a daily intake above tolerable upper limits (UL). The present case report presents nutritional intake data and supplement use of a highly trained male swimmer competing at international level. Habitual energy and micronutrient intake were analysed by 3 d dietary reports. Supplement use and dosage were assessed, and total amount of nutrient supply was calculated. Micronutrient intake was evaluated based on RDA and UL as presented by the European Scientific Committee on Food, and maximum permitted levels in supplements (MPL) are given. The athlete’s diet provided adequate micronutrient content well above RDA except for vitamin D. Simultaneous use of ten different supplements was reported, resulting in excess intake above tolerable UL for folate, vitamin E and Zn. Additionally, daily supplement dosage was considerably above MPL for nine micronutrients consumed as artificial products. Risks and possible side effects of exceeding UL by the athlete are discussed. Athletes with high energy intake may be at risk of exceeding UL of particular nutrients if multiple supplements are added. Therefore, dietary counselling of athletes should include assessment of habitual diet and nutritional supplement intake. Educating athletes to balance their diets instead of taking supplements might be prudent to prevent health risks
that may occur with long-term excess nutrient intake.
We asked whether invariant phonetic indices for syllable structure can be identified in a language where word-initial consonant clusters, regardless of their sonority profile, are claimed to be parsed heterosyllabically. Four speakers of Moroccan Arabic were recorded, using Electromagnetic Articulography. Pursuing previous work, we employed temporal diagnostics for syllable structure, consisting of static correspondences between any given phonological organisation and its presumed phonetic indices. We show that such correspondences offer only a partial understanding of the relation between syllabic organisation and continuous indices of that organisation. We analyse the failure of the diagnostics and put forth a new approach in which different phonological organisations prescribe different ways in which phonetic indices change as phonetic parameters are scaled. The main finding is that invariance is found in these patterns of change, rather than in static correspondences between phonological constructs and fixed values for their phonetic indices.
Restrictions on addition
(2012)
Children up to school age have been reported to perform poorly when interpreting sentences containing restrictive and additive focus particles by treating sentences with a focus particle in the same way as sentences without it. Careful comparisons between results of previous studies indicate that this phenomenon is less pronounced for restrictive than for additive particles. We argue that this asymmetry is an effect of the presuppositional status of the proposition triggered by the additive particle. We tested this in two experiments with German-learning three-and four-year-olds using a method that made the exploitation of the information provided by the particles highly relevant for completing the task. Three-year-olds already performed remarkably well with sentences both with auch 'also' and with nur 'only'. Thus, children can consider the presuppositional contribution of the additive particle in their sentence interpretation and can exploit the restrictive particle as a marker of exhaustivity.
Much previous experimental research on morphological processing has focused on surface and meaning-level properties of morphologically complex words, without paying much attention to the morphological differences between inflectional and derivational processes. Realization-based theories of morphology, for example, assume specific morpholexical representations for derived words that distinguish them from the products of inflectional or paradigmatic processes. The present study reports results from a series of masked priming experiments investigating the processing of inflectional and derivational phenomena in native (L1) and non-native (L2) speakers in a non-Indo-European language, Turkish. We specifically compared regular (Aorist) verb inflection with deadjectival nominalization, both of which are highly frequent, productive and transparent in Turkish. The experiments demonstrated different priming patterns for inflection and derivation, specifically within the L2 group. Implications of these findings are discussed both for accounts of L2 morphological processing and for the controversial linguistic distinction between inflection and derivation.
This study investigates phenomena that have been claimed to be indicative of Specific Language Impairment (SLI) in German, focusing on subject-verb agreement marking. Longitudinal data from fourteen German-speaking children with SLI, seven monolingual and seven Turkish-German successive bilingual children, were examined. We found similar patterns of impairment in the two participant groups. Both the monolingual and the bilingual children with SLI had correct (present vs. preterit) tense marking and produced syntactically complex sentences such as embedded clauses and wh-questions, but were limited in reliably producing correct agreement-marked verb forms. These contrasts indicate that agreement marking is impaired in German-speaking children with SLI, without any necessary concurrent deficits in either the CP-domain or in tense marking. Our results also show that it is possible to identify SLI from an early successive bilingual child's performance in one of her two languages.
Although all bilinguals encounter cross-language interference (CLI), some bilinguals are more susceptible to interference than others. Here, we report on language performance of late bilinguals (Russian/German) on two bilingual tasks (interview, verbal fluency), their language use and switching habits. The only between-group difference was CLI: one group consistently produced significantly more errors of CLI on both tasks than the other (thereby replicating our findings from a bilingual picture naming task). This striking group difference in language control ability can only be explained by differences in cognitive control, not in language proficiency or language mode.
Using the eye-movement monitoring technique in two reading comprehension experiments, this study investigated the timing of constraints on wh-dependencies (so-called island constraints) in first- and second-language (L1 and L2) sentence processing. The results show that both L1 and L2 speakers of English are sensitive to extraction islands during processing, suggesting that memory storage limitations affect L1 and L2 comprehenders in essentially the same way. Furthermore, these results show that the timing of island effects in L1 compared to L2 sentence comprehension is affected differently by the type of cue (semantic fit versus filled gaps) signaling whether dependency formation is possible at a potential gap site. Even though L1 English speakers showed immediate sensitivity to filled gaps but not to lack of semantic fit, proficient German-speaking learners of English as a L2 showed the opposite sensitivity pattern. This indicates that initial wh-dependency formation in L2 processing is based on semantic feature matching rather than being structurally mediated as in L1 comprehension.
This article investigates the nature of preposition copying and preposition pruning structures in present-day English. We begin by illustrating the two phenomena and consider how they might be accounted for in syntactic terms, and go on to explore the possibility that preposition copying and pruning arise for processing reasons. We then report on two acceptability judgement experiments examining the extent to which native speakers of English are sensitive to these types of 'error' in language comprehension. Our results indicate that preposition copying creates redundancy rather than ungrammaticality, whereas preposition pruning creates processing problems for comprehenders that may render it unacceptable in timed (but not necessarily in untimed) judgement tasks. Our findings furthermore illustrate the usefulness of combining corpus studies and experimentally elicited data for gaining a clearer picture of usage and acceptability, and the potential benefits of examining syntactic phenomena from both a theoretical and a processing perspective.
This study presents results from a cross-modal priming experiment investigating inflected verb forms of German. A group of late learners of German with Russian as their native language (L1) was compared to a control group of German L1 speakers. The experiment showed different priming patterns for the two participant groups. The L1 German data yielded a stem-priming effect for inflected forms involving regular affixation and a partial priming effect for irregular forms irrespective of stem allomorphy. By contrast, the data from the late bilinguals showed reduced priming effects for both regular and irregular forms. We argue that late learners rely more on lexically stored inflected word forms during word recognition and less on morphological parsing than native speakers.
Previous research has shown that high phonotactic frequencies
facilitate the production of regularly inflected verbs in English-learning
children with specific language impairment (SLI) but not with typical
development (TD). We asked whether this finding can be replicated
for German, a language with a much more complex inflectional
verb paradigm than English. Using an elicitation task, the production
of inflected nonce verb forms (3 rd person singular with -t suffix)
with either high- or low-frequency subsyllables was tested in
sixteen German-learning children with SLI (ages 4;1–5 ;1), sixteen
TD-children matched for chronological age (CA) and fourteen TD-
children matched for verbal age (VA) (ages 3;0–3 ;11). The findings
revealed that children with SLI, but not CA- or VA-children, showed
differential performance between the two types of verbs, producing
more inflectional errors when the verb forms resulted in low-frequency
subsyllables than when they resulted in high-frequency subsyllables,
replicating the results from English-learning children.
In Germany, active bat rabies surveillance was conducted between 1993 and 2012. A total of 4546 oropharyngeal swab samples from 18 bat species were screened for the presence of EBLV-1- , EBLV-2- and BBLV-specific RNA. Overall, 0 center dot 15% of oropharyngeal swab samples tested EBLV-1 positive, with the majority originating from Eptesicus serotinus. Interestingly, out of seven RT-PCR-positive oropharyngeal swabs subjected to virus isolation, viable virus was isolated from a single serotine bat (E. serotinus). Additionally, about 1226 blood samples were tested serologically, and varying virus neutralizing antibody titres were found in at least eight different bat species. The detection of viral RNA and seroconversion in repeatedly sampled serotine bats indicates long-term circulation of the virus in a particular bat colony. The limitations of random-based active bat rabies surveillance over passive bat rabies surveillance and its possible application of targeted approaches for future research activities on bat lyssavirus dynamics and maintenance are discussed.
This study investigates whether number dissimilarities on subject and object DPs facilitate the comprehension of subject-and object-extracted centre-embedded relative clauses in children with Grammatical Specific Language Impairment (G-SLI). We compared the performance of a group of English-speaking children with G-SLI (mean age: 12; 11) with that of two groups of younger typically developing (TD) children, matched on grammar and receptive vocabulary, respectively. All groups were more accurate on subject-extracted relative clauses than object-extracted ones and, crucially, they all showed greater accuracy for sentences with dissimilar number features (i.e., one singular, one plural) on the head noun and the embedded DP. These findings are interpreted in the light of current psycholinguistic models of sentence comprehension in TD children and provide further insight into the linguistic nature of G-SLI.
Two experiments tested how faithfully German children aged 4; 5 to 5; 6 reproduce ditransitive sentences that are unmarked or marked with respect to word order and focus (Exp1) or definiteness (Exp2). Adopting an optimality theory (OT) approach, it is assumed that in the German adult grammar word order is ranked lower than focus and definiteness. Faithfulness of children's reproductions decreased as markedness of inputs increased; unmarked structures were reproduced most faithfully and unfaithful outputs had most often an unmarked form. Consistent with the OT proposal, children were more tolerant against inputs marked for word order than for focus; in conflict with the proposal, children were less tolerant against inputs marked for word order than for definiteness. Our results suggest that the linearization of objects in German double object constructions is affected by focus and definiteness, but that prosodic principles may have an impact on the position of a focused constituent.
Regular and irregular inflection in children's production has been examined in many previous studies. Yet, little is known about the processes involved in children's recognition of inflected words. To gain insight into how children process inflected words, the current study examines regular -t and irregular -n participles of German using the cross-modal priming technique testing 108 monolingual German-speaking children in two age groups (group I, mean age: 8;4, group II, mean age: 9;9) and a control group of.. adults. Although both age groups of children had the same full priming effect as adults for -t forms, only children of age group II showed an adult-like (partial) priming effect for -n participles. We argue that children (within the age range tested) employ the same mechanisms for regular inflection as adults but that the lexical retrieval processes required for irregular forms become more efficient when children get older.
Object and action naming in Russian- and German- speaking monolingual and bilingual children*
(2014)
The present study investigates the influence of word category on naming performance in two populations: bilingual and monolingual children. The question is whether and, if so, to what extent monolingual and bilingual children differ with respect to noun and verb naming and whether a noun bias exists in the lexical abilities of bilingual children. Picture naming of objects and actions by Russian-German bilingual children (aged 4-7 years) was compared to age-matched monolingual children. The results clearly demonstrate a naming deficit of bilingual children in comparison to monolingual children that increases with age. Noun learning is more fragile in bilingual contexts than is verb learning. In bilingual language acquisition, nouns do not predominate over verbs as much as is seen in monolingual German and Russian children. The results are discussed with respect to semantic-conceptual aspects and language-specific features of nouns and verbs, and the impact of input on the acquisition of these word categories.
Ultraschall Berlin
(2014)
Masked priming research with late (non-native) bilinguals has reported facilitation effects following morphologically derived prime words (scanner - scan). However, unlike for native speakers, there are suggestions that purely orthographic prime-target overlap (scandal - scan) also produces priming in non-native visual word recognition. Our study directly compares orthographically related and derived prime-target pairs. While native readers showed morphological but not formal overlap priming, the two prime types yielded the same magnitudes of facilitation for non-natives. We argue that early word recognition processes in a non-native language are more influenced by surface-form properties than in one's native language.
This paper examines phonological phrasing in the Kwa language Akan. Regressive [+ATR] vowel harmony between words (RVH) serves as a hitherto unreported diagnostic of phonological phrasing. In this paper I discuss VP-internal and NP-internal structures, as well as SVO(O) and serial verb constructions. RVH is a general process in Akan grammar, although it is blocked in certain contexts. The analysis of phonological phrasing relies on universal syntax-phonology mapping constraints whereby lexically headed syntactic phrases are mapped onto phonological phrases. Blocking contexts call for a domain-sensitive analysis of RVH assuming recursive prosodic structure which makes reference to maximal and non-maximal phonological phrases. It is proposed (i) that phonological phrase structure is isomorphic to syntactic structure in Akan, and (ii) that the process of RVH is blocked at the edge of a maximal phonological phrase; this is formulated in terms of a domain-sensitive CrispEdge constraint.
Extract: Topics in psycholinguistics and the neurocognition of language rarely attract the attention of journalists or the general public. One topic that has done so, however, is the potential benefits of bilingualism for general cognitive functioning and development, and as a precaution against cognitive decline in old age. Sensational claims have been made in the public domain, mostly by journalists and politicians. Recently (September 4, 2014) The Guardian reported that “learning a foreign language can increase the size of your brain”, and Michael Gove, the UK's previous Education Secretary, noted in an interview with The Guardian (September 30, 2011) that “learning languages makes you smarter”. The present issue of BLC addresses these topics by providing a state-of-the-art overview of theoretical and experimental research on the role of bilingualism for cognition in children and adults.
Although morphosyntax has been identified as a major source of difficulty for adult (nonnative) language learners, most previous studies have examined a limited set of largely affix-based phenomena. Little is known about word-based morphosyntax in late bilinguals and of how morphosyntax is represented and processed in a nonnative speaker's lexicon. To address these questions, we report results from two behavioral experiments investigating stem variants of strong verbs in German (which encode features such as tense, person, and number) in groups of advanced adult learners as well as native speakers of German. Although the late bilinguals were highly proficient in German, the results of a lexical priming experiment revealed clear native-nonnative differences. We argue that lexical representation and processing relies less on morphosyntactic information in a nonnative than in a native language.
Although morphosyntax has been identified as a major source of difficulty for adult (nonnative) language learners, most previous studies have examined a limited set of largely affix-based phenomena. Little is known about word-based morphosyntax in late bilinguals and of how morphosyntax is represented and processed in a nonnative speaker's lexicon. To address these questions, we report results from two behavioral experiments investigating stem variants of strong verbs in German (which encode features such as tense, person, and number) in groups of advanced adult learners as well as native speakers of German. Although the late bilinguals were highly proficient in German, the results of a lexical priming experiment revealed clear native-nonnative differences. We argue that lexical representation and processing relies less on morphosyntactic information in a nonnative than in a native language.
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.
The semantics of focus particles like only requires a set of alternatives (Rooth, 1992). In two experiments, we investigated the impact of such particles on the retrieval of alternatives that are mentioned in the prior context or unmentioned. The first experiment used a probe recognition task and showed that focus particles interfere with the recognition of mentioned alternatives and the rejection of unmentioned alternatives relative to a condition without a particle. A second lexical decision experiment demonstrated priming effects for mentioned and unmentioned alternatives (compared with an unrelated condition) while focus particles caused additional interference effects. Overall, our results indicate that focus particles trigger an active search for alternatives and lead to a competition between mentioned alternatives, unmentioned alternatives, and the focused element.
Rhythm perception is assumed to be guided by a domain-general auditory principle, the Iambic/Trochaic Law, stating that sounds varying in intensity are grouped as strong-weak, and sounds varying in duration are grouped as weak-strong. Recently, Bhatara et al. (2013) showed that rhythmic grouping is influenced by native language experience, French listeners having weaker grouping preferences than German listeners. This study explores whether L2 knowledge and musical experience also affect rhythmic grouping. In a grouping task, French late learners of German listened to sequences of coarticulated syllables varying in either intensity or duration. Data on their language and musical experience were obtained by a questionnaire. Mixed-effect model comparisons showed influences of musical experience as well as L2 input quality and quantity on grouping preferences. These results imply that adult French listeners' sensitivity to rhythm can be enhanced through L2 and musical experience.
Changes in free symptom attributions in hypochondriasis after cognitive therapy and exposure therapy
(2016)
Background: Cognitive-behavioural therapy can change dysfunctional symptom attributions in patients with hypochondriasis. Past research has used forced-choice answer formats, such as questionnaires, to assess these misattributions; however, with this approach, idiosyncratic attributions cannot be assessed. Free associations are an important complement to existing approaches that assess symptom attributions. Aims: With this study, we contribute to the current literature by using an open-response instrument to investigate changes in freely associated attributions after exposure therapy (ET) and cognitive therapy (CT) compared with a wait list (WL). Method: The current study is a re-examination of a formerly published randomized controlled trial (Weck, Neng, Richtberg, Jakob and Stangier, 2015) that investigated the effectiveness of CT and ET. Seventy-three patients with hypochondriasis were randomly assigned to CT, ET or a WL, and completed a 12-week treatment (or waiting period). Before and after the treatment or waiting period, patients completed an Attribution task in which they had to spontaneously attribute nine common bodily sensations to possible causes in an open-response format. Results: Compared with the WL, both CT and ET reduced the frequency of somatic attributions regarding severe diseases (CT: Hedges's g = 1.12; ET: Hedges's g = 1.03) and increased the frequency of normalizing attributions (CT: Hedges's g = 1.17; ET: Hedges's g = 1.24). Only CT changed the attributions regarding moderate diseases (Hedges's g = 0.69). Changes in somatic attributions regarding mild diseases and psychological attributions were not observed. Conclusions: Both CT and ET are effective for treating freely associated misattributions in patients with hypochondriasis. This study supplements research that used a forced-choice assessment.
Much research on language control in bilinguals has relied on the interpretation of the costs of switching between two languages. Of the two types of costs that are linked to language control, switching costs are assumed to be transient in nature and modulated by trial-specific manipulations (e.g., by preparation time), while mixing costs are supposed to be more stable and less affected by trial-specific manipulations. The present study investigated the effect of preparation time on switching and mixing costs, revealing that both types of costs can be influenced by trial-specific manipulations.
The Gradient Symbolic Computation (GSC) model presented in the keynote article (Goldrick, Putnam & Schwarz) constitutes a significant theoretical development, not only as a model of bilingual code-mixing, but also as a general framework that brings together symbolic grammars and graded representations. The authors are to be commended for successfully integrating a theory of grammatical knowledge with the voluminous research on lexical co-activation in bilinguals. It is, however, unfortunate that a certain conception of bilingualism was inherited from this latter research tradition, one in which the contrast between native and non-native language takes a back seat.
Processes involved in late bilinguals' production of morphologically complex words were studied using an event-related brain potentials (ERP) paradigm in which EEGs were recorded during participants' silent productions of English past- and present-tense forms. Twenty-three advanced second language speakers of English (first language [L1] German) were compared to a control group of 19 L1 English speakers from an earlier study. We found a frontocentral negativity for regular relative to irregular past-tense forms (e.g., asked vs. held) during (silent) production, and no difference for the present-tense condition (e.g., asks vs. holds), replicating the ERP effect obtained for the L1 group. This ERP effect suggests that combinatorial processing is involved in producing regular past-tense forms, in both late bilinguals and L1 speakers. We also suggest that this paradigm is a useful tool for future studies of online language production.
Processes involved in late bilinguals' production of morphologically complex words were studied using an event-related brain potentials (ERP) paradigm in which EEGs were recorded during participants' silent productions of English past- and present-tense forms. Twenty-three advanced second language speakers of English (first language [L1] German) were compared to a control group of 19 L1 English speakers from an earlier study. We found a frontocentral negativity for regular relative to irregular past-tense forms (e.g., asked vs. held) during (silent) production, and no difference for the present-tense condition (e.g., asks vs. holds), replicating the ERP effect obtained for the L1 group. This ERP effect suggests that combinatorial processing is involved in producing regular past-tense forms, in both late bilinguals and L1 speakers. We also suggest that this paradigm is a useful tool for future studies of online language production.
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.
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.
Background: The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.
Methods: This study was a retrospective database analysis in Germany utilizing the Disease Analyzer (R) Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices. The observation period was between 2004 and 2013. Follow-up lasted up to five years and ended in April 2015. A total of 66,497 HF patients were selected after applying exclusion criteria. The same number of 66,497 controls were chosen and were matched (1:1) to HF patients on the basis of age, sex, health insurance, depression diagnosis in the past, and follow-up duration after index date.
Results: HF was a strong risk factor for diagnosed depression (p < 0.0001). A total of 10.5% of HF patients and 6.3% of matched controls developed depression after one year of follow-up (p < 0.001). Depression was documented in 28.9% of the HF group and 18.2% of the control group after the five-year follow-up (p < 0.001). Cancer, dementia, osteoporosis, stroke, and osteoarthritis were associated with a higher risk of developing depression. Male gender and private health insurance were associated with lower risk of depression.
Conclusions: The risk of diagnosed depression is significantly increased in patients with HF compared to patients without HF in primary care practices in Germany.