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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.
forum:logopädie 30.2016, 2
(2016)
Although the climate development over the Holocene in the Northern Hemisphere is well known, palaeolimnological climate reconstructions reveal spatiotemporal variability in northern Eurasia. Here we present a multi-proxy study from north-eastern Siberia combining sediment geochemistry, and diatom and pollen data from lake-sediment cores covering the last 38,000 cal. years. Our results show major changes in pyrite content and fragilarioid diatom species distributions, indicating prolonged seasonal lake-ice cover between similar to 13,500 and similar to 8900 cal. years BP and possibly during the 8200 cal. years BP cold event. A pollen-based climate reconstruction generated a mean July temperature of 17.8 degrees C during the Holocene Thermal Maximum (HTM) between similar to 8900 and similar to 4500 cal. years BP. Naviculoid diatoms appear in the late Holocene indicating a shortening of the seasonal ice cover that continues today. Our results reveal a strong correlation between the applied terrestrial and aquatic indicators and natural seasonal climate dynamics in the Holocene. Planktonic diatoms show a strong response to changes in the lake ecosystem due to recent climate warming in the Anthropocene. We assess other palaeolimnological studies to infer the spatiotemporal pattern of the HTM and affirm that the timing of its onset, a difference of up to 3000 years from north to south, can be well explained by climatic teleconnections. The westerlies brought cold air to this part of Siberia until the Laurentide ice sheet vanished 7000 years ago. The apparent delayed ending of the HTM in the central Siberian record can be ascribed to the exceedance of ecological thresholds trailing behind increases in winter temperatures and decreases in contrast in insolation between seasons during the mid to late Holocene as well as lacking differentiation between summer and winter trends in paleolimnological reconstructions. (C) 2015 Elsevier Ltd. All rights reserved.
My thesis focused on the predictions of the activation-based model of Lewis and Vasishth (2005) to investigate the evidence for the use of the memory system in the formation of non-local dependencies in sentence comprehension.
The activation-based model, which follows the Adaptive Control of Thought-Rational framework (ACT-R; Anderson et al., 2004), has been used to explain locality effects and similarity-based interference by assuming that dependencies are resolved by a cue-based retrieval mechanism, and that the retrieval mechanism is affected by decay and interference.
Both locality effects and (inhibitory) similarity-based interference cause increased difficulty (e.g., longer reading times) at the site of the dependency completion where a retrieval is assumed: (I) Locality effects are attributed to the increased difficulty in the retrieval of a dependent when the distance from its retrieval site is increased. (II) Similarity-based interference is attributed to the retrieval being affected by the presence of items which have similar features as the dependent that needs to be retrieved.
In this dissertation, I investigated some findings problematic to the activation-based model, namely, facilitation where locality effects are expected (e.g., Levy, 2008), and the lack of similarity-based interference from the number feature in grammatical sentences (e.g., Wagers et al., 2009). In addition, I used individual differences in working memory capacity and reading fluency as a way to validate the theories investigated (Underwood, 1975), and computational modeling to achieve a more precise account of the phenomena.
Regarding locality effects, by using self-paced reading and eye-tracking-while reading methods with Spanish and German data, this dissertation yielded two main findings: (I) Locality effects seem to be modulated by working memory capacity, with high-capacity participants showing expectation-driven facilitation. (II) Once expectations and other potential confounds are controlled using baselines, with increased distance, high-capacity readers can show a slow-down (i.e., locality effects) and low-capacity readers can show a speedup. While the locality effects are compatible with the activation-based model, simulations show that the speedup of low-capacity readers can only be accounted for by changing some of the assumptions of the activation-based model.
Regarding similarity-based interference, two relatively high-powered self-paced reading experiments in German using grammatical sentences yielded a slowdown at the verb as predicted by the activation-based model. This provides evidence in favor of dependency creation via cue-based retrieval, and in contrast with the view that cue-based retrieval is a reanalysis mechanism (Wagers et al., 2009).
Finally, the same experimental results that showed inhibitory interference from the number feature are used for a finer grain evaluation of the retrieval process. Besides Lewis and Vasishth’s (2005) activation-based model, also McElree’s (2000) direct-access model can account for inhibitory interference. These two models assume a cue-based retrieval mechanism to build dependencies, but they are based on different assumptions. I present a computational evaluation of the predictions of these two theories of retrieval. The models were compared by implementing them in a Bayesian hierarchical framework. The evaluation of the models reveals that some aspects of the data fit better under the direct access model than under the activation-based model. However, a simple extension of the activation-based model provides a comparable fit to the direct access model. This serves as a proof of concept showing potential ways to improve the original activation-based model.
In conclusion, this thesis adds to the body of evidence that argues for the use of the general memory system in dependency resolution, and in particular for a cue-based retrieval mechanism. However, it also shows that some of the default assumptions inherited from ACT-R in the activation-based model need to be revised.
We tested the independent influences of two content-based factors on dual-task costs, and on the parallel processing ability: The pairing of S-R modalities and the pairing of relevant features between stimuli and responses of two tasks. The two pairing factors were realized across four dual-task groups. Within each group the two tasks comprised two different stimulus modalities (visual and auditory), two different relevant stimulus features (spatial and verbal) and two response modalities (manual and vocal). Pairings of S-R modalities (standard: visual-manual and auditory-vocal, non-standard: visual-vocal and auditory manual) and feature pairings (standard: spatial-manual and verbal-vocal, non-standard: spatial-vocal and verbal-manual) varied across groups. All participants practiced their respective dual-task combination in a paradigm with simultaneous stimulus onset before being transferred to a psychological refractory period paradigm varying stimulus-onset asynchrony. A comparison at the end of practice revealed similar dual-task costs and similar pairing effects in both paradigms. Dual-task costs depended on modality and feature pairings. Groups training with non-standard feature pairings (i.e., verbal stimulus features mapped to spatially separated response keys, or spatial stimulus features mapped to verbal responses) and non-standard modality pairings (i.e., auditory stimulus mapped to manual response, or visual stimulus mapped to vocal responses) had higher dual-task costs than respective standard pairings. In contrast, irrespective of modality pairing dual-task costs virtually disappeared with standard feature pairings after practice in both paradigms. The results can be explained by crosstalk between feature-binding processes for the two tasks. Crosstalk was present for non-standard but absent for standard feature pairings. Therefore, standard feature pairings enabled parallel processing at the end of practice. (C) 2016 Elsevier B.V. All rights reserved.
Saccades to single targets in peripheral vision are typically characterized by an undershoot bias. Putting this bias to a test, Kapoula [1] used a paradigm in which observers were presented with two different sets of target eccentricities that partially overlapped each other. Her data were suggestive of a saccadic range effect (SRE): There was a tendency for saccades to overshoot close targets and undershoot far targets in a block, suggesting that there was a response bias towards the center of eccentricities in a given block. Our Experiment 1 was a close replication of the original study by Kapoula [1]. In addition, we tested whether the SRE is sensitive to top-down requirements associated with the task, and we also varied the target presentation duration. In Experiments 1 and 2, we expected to replicate the SRE for a visual discrimination task. The simple visual saccade-targeting task in Experiment 3, entailing minimal top-down influence, was expected to elicit a weaker SRE. Voluntary saccades to remembered target locations in Experiment 3 were expected to elicit the strongest SRE. Contrary to these predictions, we did not observe a SRE in any of the tasks. Our findings complement the results reported by Gillen et al. [2] who failed to find the effect in a saccade-targeting task with a very brief target presentation. Together, these results suggest that unlike arm movements, saccadic eye movements are not biased towards making saccades of a constant, optimal amplitude for the task.
As a contribution to a theoretical debate about the degree of high-level influences on saccade targeting during sentence reading, we investigated eye movements during the reading of structurally ambiguous Chinese character strings and examined whether parafoveal word segmentation could influence saccade-target selection. As expected, ambiguous strings took longer to process. More critically there were theoretically relevant interactions between ambiguity and launch site when first-fixation location and saccade amplitude served as dependent variables: Ambiguous strings in the parafovea triggered longer saccades and more rightward fixations for close launch sites than unambiguous ones; the reverse result was obtained for far launch sites. These crossover interactions indicate that parafoveal word segmentation influences saccade generation in Chinese and provide support of the hypothesis that high-level information can be involved in the decision about where to fixate next.
Saccadic eye movements are frequently followed by smaller secondary saccades which are generally assumed to correct for the error in primary saccade landing position. However, secondary saccades can also occur after accurate primary saccades and they are often as small as microsaccades, therefore raising the need to further scrutinize the processes involved in secondary saccade generation. Following up a previous study, we analyzed secondary saccades using rate analysis which allows us to quantify experimental effects as shifts in distributions, therefore going beyond comparisons of mean differences. We use Aalen’s additive hazards model to delineate the time course of key influences on the secondary saccade rate. In addition to the established effect of primary saccade error, we observed a time-varying influence of under- vs. overshooting – with a higher risk of generating secondary saccades following undershoots. Moreover, increasing target eccentricity influenced the programming of secondary saccades, therefore demonstrating that error-unrelated variables co-determine secondary saccade programs. Our results provide new insights into the generative mechanisms of small saccades during postsaccadic fixation that need to be accounted for by secondary saccade models.