Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 343
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-32396611

RESUMO

We aimed to examine the relationship between APOE*4 carriage on cognitive decline, and whether these associations were moderated by sex, baseline age, ethnicity, and vascular risk factors. Participants were 19,225 individuals aged 54-103 years from 15 longitudinal cohort studies with a mean follow up duration ranging between 1.2 and 10.7 years. Two-step individual participant data (IPD) meta-analysis was used to pool results of study-wise analyses predicting memory and general cognitive decline from carriage of one or two APOE*4 alleles, and moderation of these associations by age, sex, vascular risk factors and ethnicity. Separate pooled estimates were calculated in both men and women who were younger (i.e., 62 years) and older (i.e., 80 years) at baseline. Results showed that APOE*4 carriage was related to faster general cognitive decline in women, and faster memory decline in men. A stronger dose-dependent effect was observed in older men, with faster general cognitive and memory decline in those carrying two versus one APOE*4 allele. Vascular risk factors were related to an increased effect of APOE*4 on memory decline in younger women, but a weaker effect of APOE*4 on general cognitive decline in older men. The relationship between APOE*4 carriage and memory decline was larger in older-aged Asians than Whites. In sum, APOE*4 is related to cognitive decline in men and women, although these effects are enhanced by age and carriage of two APOE*4 alleles in men, a higher numbers of vascular risk factors during the early stages of late adulthood in women, and Asian ethnicity.

2.
Int Psychogeriatr ; : 1-12, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32434623

RESUMO

OBJECTIVES: Research shows that mental demands at work affect later-life cognitive functioning and dementia risk, but systematic assessment of protective mental work demands (PMWDs) is still missing. The goal of this research was to develop a questionnaire to assess PMWDs. DESIGN: The instrument was developed in accordance with internationally recognized scientific standards comprising conceptualization, pretesting, and validation via confirmatory factor analysis (CFA), principal component analysis (PCA), and multiple regression analyses. PARTICIPANTS: We included 346 participants, 72.3% female, with an average age of 56.3 years. MEASUREMENT: Item pool, sociodemographic questions, and cognitive tests: Trail-Making Test A/B, Word List Recall, Verbal Fluency Test, Benton Visual Retention Test, Reading Minds in the Eyes Test. RESULTS: CFAs of eight existing PMWD-concepts revealed weaker fit indices than PCA of the item pool that resulted in five concepts. We computed multivariate regression analyses with all 13 PMWD-concepts as predictors of cognitive functioning. After removing PMWD-concepts that predicted less than two cognitive test scores and excluding others due to overlapping items, the final questionnaire contained four PMWD-concepts: Mental Workload (three items, Cronbach's α = .58), Verbal Demands (four, Cronbach's α = .74), Information Load (six, Cronbach's α = .83), and Extended Job Control (six, Cronbach's α = .83). CONCLUSIONS: The PMWD-Questionnaire intends to assess protective mental demands at the workplace. Information processing demands and job control make up the primary components emphasizing their relevance regarding cognitive health in old age. Long-term follow-up studies will need to validate construct validity with respect to dementia risk.

3.
Arch Gerontol Geriatr ; 89: 104069, 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32413689

RESUMO

PURPOSE: To determine the prevalence of overweight and obesity, and to identify factors associated with obesity, among the oldest old. METHODS: For this study, data from follow-up (FU) wave 7 and FU wave 8 of the "Study on Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)" (AgeQualiDe) were used. At FU wave 7, the mean age was 88.9 years (SD: 2.9; 85-100 years). Body-mass-index (BMI) categories were defined according to the World Health Organization (WHO) thresholds: underweight (BMI < 18.5 kg/m²), normal weight (18.5 kg/m² ≤ BMI < 25 kg/m²), overweight (25 kg/m² ≤ BMI < 30 kg/m²), and obesity (BMI ≥ 30 kg/m²). Longitudinal regression analysis was used to determine factors associated with obesity. RESULTS: At FU wave 7, 3.0 % were underweight, 48.9 % were normal weight, 37.9 % were overweight, and 10.2 % were obese. Regressions showed that the probability of obesity decreased with age (OR: 0.77 [95 % CI: .593-.999]) and less chronic conditions (OR: 1.32 [95 % CI: 1.11-1.57]). The probability of obesity was not associated with sex, educational level, marital status, social isolation, visual impairment, hearing impairment, depression, and dementia. CONCLUSION: Nearly half of the individuals in very late life had excess weight. Thus, excess weight remains a major challenge, even in very old age. Given the demographic ageing in upcoming decades, this is an issue which we should be aware of.

4.
Eur Addict Res ; : 1-7, 2020 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-32454482

RESUMO

INTRODUCTION: Shiftwork can be a risk factor for a number of different somatic and psychological health conditions, especially sleep disorders. Shiftworkers sleep less than dayworkers, and 20-40% of them suffer from difficulties initiating and maintaining sleep, which result in reduced capacity for work and social life. A common coping strategy might be the use of alcohol, which presents a health and safety hazard as it further impairs sleep quality and exacerbates sleepiness in the workplace. This review aimed to assess the extent of such possible connections. METHODS: We performed a systematic search of the scientific literature on shiftwork and alcohol consumption in PubMed, PsycInfo, and Cochrane Library. Only original studies comparing shiftworkers with non-shiftworkers were included. The recommendations of the Preferred Reporting Items of Systematic Reviews and Meta-Analyses were followed. RESULTS: Fourteen articles are included in this review. Six studies report some kind of connection between shift- or nightwork and alcohol consumption, especially as a sleep aid. Conflicting or negative results are reported by 3 studies. DISCUSSION: Shiftwork, especially working at night and in rotation shifts, is associated with binge drinking disorder in different professions. The reasons for pathological consumption of alcohol can be self-medication of sleep problems or coping with stress and psychosocial problems typical for shiftwork. Nurses aged over 50 years represent one important risk group. These results can be important for preventive programs against sleep disorders, including measures other than drinking alcohol as a sleep aid in the workplace of shiftworkers.

5.
Curr Opin Psychiatry ; 33(4): 414-421, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32427593

RESUMO

PURPOSE OF REVIEW: To provide an overview of the update of the evidence-based and consensus-based German S3 guideline on psychosocial therapies for severe mental illnesses (SMI), with particular attention to current developments and future research tasks. RECENT FINDINGS: There has been a significant increase in studies on the effectiveness of psychosocial interventions in treatment of people with SMI. In the guideline a distinction is made between system-level interventions (e.g. multidisciplinary team-based psychiatric community care) and single-handed (nonteam-based) interventions (e.g. psychoeducation). Furthermore, principles of treatment (e.g. recovery-orientation) and self-help interventions (e.g. peer support) are addressed. The update of the guideline includes 33 recommendations and 12 statements. Compared with the first edition, there were upgrades in the recommendation of Supported Employment (A) and Supported Housing (A). Interventions such as peer support (B) and lifestyle interventions (A) were included for the first time. Developments are discussed in the context of most recent literature. Areas for further research are highlighted and fields for next updates such as antistigma interventions and supported parenting were identified. SUMMARY: The present guideline offers an important opportunity to further improve health services for people with SMI. However, guideline implementation is challenging.

6.
Artigo em Alemão | MEDLINE | ID: mdl-32460967

RESUMO

INTRODUCTION: The loss of a significant other is a stressful life event, especially for older people. The aim of this study is to investigate user acceptance of an internet-based self-help program for mourners aged 60 years and above. Potential access paths as well as barriers of use will be identified from both users' and experts' perspectives. METHODS: This study is following a qualitative design. Two focus groups were formed consisting of elderly people (60+) with loss experience (N=12) and of experts from the medical care system (N=8). The focus groups were conducted using a discussion guide related to the model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Focus group data were recorded by audio tape and fully transcribed. Qualitative content analysis according to Mayring (2015) was applied using MAXQDA. RESULTS: The mean age of elderly participants with loss experience was 64.5 years, 50 % were women. From the user's perspective, an internet-based self-help program should comprise information regarding grieving, suggestions and motivation for behavioral activation, strengthening self-esteem, and suggestions for dealing with other feelings related to grief (such as guilt). Directions for relatives of mourners as well as faith and spirituality were important topics for users. Elderly participants felt confident to be able to use an internet-based self-help program. Processing time and topic selection should be flexible for the user. Potential access paths included general practitioners and specialists, mourning cafés, or local media. A potential barrier was seen for people who prefer a personal relationship. The average age of participants in the expert focus group was 40.1 years, 87.5 % were female. There was a high user acceptance from the perspective of health care experts with regard to the target group of elderly people (60+). Access paths were seen across all specialist groups working with elderly people (e.g., physicians, occupational therapists, nursing facilities). Lack of guidance was discussed as a potential barrier. DISCUSSION: A key aspect and prerequisite for the use and effectiveness of an internet-based self-help intervention for mourners is user acceptance. Judgments from potential users and experts showed a high user acceptance, but also the need to address age group-specific topics for coping with grief. CONCLUSION: Internet-based self-help interventions can be a promising add-on treatment option for elderly bereaved people. The implementation of such programs should take the access paths mentioned into account in order to inform users and experts about the intervention.

7.
Nutrients ; 12(5)2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32443920

RESUMO

Restricting animal-based products from diet may exert beneficial effects on weight status; however, less is known about such a diet and emotional health. Moreover, personality traits, for example high neuroticism, may contribute to restrictive eating habits and potentially confound diet-health associations. We aim to systematically assess if restrictive dietary intake of animal-based products relates to lower weight and higher depressive symptoms, and if differences in personality traits play a significant role. Cross-sectional data from the baseline LIFE-Adult study were collected from 2011-2014 in Leipzig, Germany (n = 8943). Main outcomes of interest were dietary frequency of animal-derived products in the last year measured using a Food Frequency Questionnaire (FFQ), body-mass-index (BMI) (kg/m2), and the Center of Epidemiological Studies Depression Scale (CES-D). Personality traits were assessed in a subsample of n = 7906 using the Five Factor Inventory (NEO-FFI). Higher restriction of animal-based product intake was associated with a lower BMI, but not with depression scores. Personality, i.e., lower extraversion, was related to higher frequency of animal product intake. Moreover, personality traits were significantly associated with depressive symptoms, i.e., higher neuroticism, lower extraversion, lower agreeableness, lower conscientiousness, and with higher BMI. These findings encourage future longitudinal studies to test the efficacy of restricting animal-based products as a preventive and therapeutic strategy for overweight and obesity.

8.
Psychiatr Prax ; 47(4): 179-189, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32340047

RESUMO

OBJECTIVE: Review of the evidence on the psychosocial impact of quarantine measures during serious coronavirus outbreaks before COVID-19. Such information is highly relevant in regard to the COVID-19 pandemic. METHODS: Search of the MEDLINE database for relevant studies related to SARS-CoV and MERS-CoV outbreaks. RESULTS: Across 13 identified studies, quarantine measures were consistently associated with negative psychosocial outcomes, including depressive symptoms, anxiety, anger, stress, posttraumatic stress, social isolation, loneliness and stigmatization. Determinants comprised duration of quarantine measures and income losses. Health care workers constituted a particularly vulnerable group. CONCLUSION: Quarantine measures during serious coronavirus outbreaks have extensive negative consequences for mental health. Prevention and intervention approaches to attenuate the psychosocial impact should be an integral component of crisis response during pandemic conditions.


Assuntos
Infecções por Coronavirus/psicologia , Coronavirus , Pessoal de Saúde/psicologia , Pneumonia Viral/psicologia , Quarentena/psicologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Emoções , Alemanha , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Isolamento Social , Transtornos de Estresse Pós-Traumáticos , Estresse Psicológico
9.
Psychiatr Prax ; 47(4): 190-197, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32340048

RESUMO

AIM: Review of studies on the psychological stress of healthcare workers caused by the COVID-19 pandemic. METHODS: A literature search of PubMed was performed using the terms "COVID-19", "stress", "mental health", "healthcare worker", "staff", "psychiatry". Quantitative studies (including letters to the editor) published from January to March 2020 were included. RESULTS: 14 studies on healthcare workers in departments of infectiology, internal medicine, and fever wards including intensive care wards as well as surgery and psychiatry, were included. The Patient Health Questionnaire 9 (PHQ9), Self-rating-Anxiety Scale (SAS) and Impact of Event Scale (IES-R) were the most often used test instruments. The sample size ranged between 37 and 1257 participants consisting of mostly nursing and medical personnel. The fraction of COVID-19-associated activities varied from 7.5 % to 100 %. An extensive strain was reported due to stress experience as well as depression and anxiety symptoms. Severe degrees of those symptoms were found in 2.2 % to 14.5 % of all participants. The severity of mental symptoms was influenced by age, gender, occupation, specialization, type of activities performed and proximity to COVID-19 patients. As mediator variables selection of personnel, preventive interventions, resilience, and social support were reported. CONCLUSION: Considering the frequency of mental symptoms occurring in healthcare workers, accompanying mental health informed interventions to facilitate coping are necessary. Further research in this field is needed.


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pandemias , Pneumonia Viral/psicologia , Estresse Psicológico , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Alemanha , Humanos , Saúde Mental , Pneumonia Viral/epidemiologia
10.
Psychiatr Prax ; 47(4): 214-217, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32340050

RESUMO

AIM: To date, to our knowledge there are no studies regarding attitudes and experiences of outpatient medical personnel during a pandemic. This study's aim was to evaluate the impact of the COVID-19 pandemic in March 2020 on German psychiatrists and neurologists. METHODS: An e-mail and fax-based short survey of 2,072 practice-based psychiatrists and neurologists was performed including Likert-type questions on personal burden and concerns, anticipated risk of infection, practice management as well as anxiety and sleep problems. RESULTS: 396 physicians returned the questionnaire (19 %). More than 60 % of the participants felt restricted strongly or very strongly, more than 30 % were strongly and very strongly concerned. They anticipated a high own risk of infection. However, 91 % did not report any contact with patients positively screened for COVID-19, which they were aware of. One third felt financially threatened and loss of business volume was anticipated. 18 % reported, that the pandemic triggers substantial anxiety. Sleep problems, which occur at least almost every night, were rarely reported (9 %). CONCLUSION: Practice-based psychiatrists and neurologists are negatively affected by the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/psicologia , Neurologistas/psicologia , Pneumonia Viral/psicologia , Gerenciamento da Prática Profissional , Psiquiatria , Betacoronavirus , Alemanha , Humanos , Renda , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pandemias , Inquéritos e Questionários
11.
Aging Ment Health ; : 1-10, 2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32347107

RESUMO

Objectives: Previous work has shown that high mental demands are associated with better cognitive functioning in old age. As there is a lack of a general conceptual framework for this association, the aim of the study was to investigate how mental demands and other work-related factors relate to cognitive functioning as a foundation for developing such a framework.Methods: An expert panel discussion was conducted with the aim of determining relevant work-related factors, which were then tested in a survey with 346 employees aged 50+ years, who were actively working. Assessment of cognitive functioning comprised complex attention, executive function, learning/memory, language, perceptual-motor, and social cognition. Confirmatory factor analysis was conducted to confirm factor belonging. Associations with cognitive functioning were analyzed using structure equation modelling to confirm associations and to identify additional direct and indirect paths.Results: Only 42.3% (22/52) of the work-related factors and 19.0% (4/21) of the mediating paths suggested by the experts were significant with respect to cognitive functioning. Factor analysis and structural equation modeling indicated that high mental demands are only associated with better cognitive functioning in old age to the extent that they are intellectually stimulating and this effect is embedded in individual capacities and the social context.Conclusion: Based on the panel discussion and the empirical testing, we propose the Conceptual Framework of Social Dependency of Intellectual Stimulation on Cognitive Health. We recommend researchers and workplace health experts to pay attention to the component of this theory when assessing workplace risk.

12.
BMJ Open ; 10(4): e036034, 2020 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-32327480

RESUMO

INTRODUCTION: Internet-based and mobile-based interventions (IMIs) provide an innovative and efficient self-management tool for mental health problems. This systematic review aims to summarise and critically evaluate studies addressing the effectiveness and feasibility of IMIs for normal and complicated grief in bereaved adults. METHODS AND ANALYSIS: The databases MEDLINE, Cochrane Library, PsycINFO, Embase and Web of Science and Google Scholar (for 'grey' literature) will be systematically searched for feasibility studies or randomised controlled trials of IMIs for bereaved adults who were experiencing normal/complicated grief. Data will be extracted and evaluated independently by two reviewers from studies eligible for inclusion. Quality of evidence will be assessed, and results will be synthesised qualitatively and pooled meta-analytically, if sufficient outcome data are available. Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards and Grades of Recommendation, Assessment, Development and Evaluation methodology will be used. ETHICS AND DISSEMINATION: No primary data will be collected; thus, ethical approval is not required. The results will be disseminated through a peer-reviewed publication and conference presentations. TRIAL REGISTRATION NUMBER: CRD42019131428.

13.
Arch Gerontol Geriatr ; 89: 104072, 2020 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-32325306

RESUMO

OBJECTIVE: The objective of this study was to investigate the link between cognitive functioning and satisfaction with aging. METHODS: Data were drawn from a population-based sample, the German Ageing Survey (wave 5 and wave 6 with n = 6,384 in the analytical sample). The validated Philadelphia Geriatric Center Morale Scale was used to quantify satisfaction with aging. Cognitive functioning was measured using the digit symbol test. Linear fixed effects regressions were used. RESULTS: Adjusting for socioeconomics and various health-related covariates, regressions showed that decreases in cognitive functioning were associated with decreases in satisfaction with aging (ß = .002, p = .02). Furthermore, regressions showed that decreases in satisfaction with aging were associated with increases in age (ß=-.01, p < .001), decreases in physical functioning (ß = .002, p < .01), worsening self-rated health (ß=-.12, p < .001) and they were inversely associated with changes from employment to retirement (ß = .11, p < .001). CONCLUSION: Study findings stress the importance of maintaining cognitive functioning for sustaining satisfaction with ageing. Strategies to postpone cognitive decline among middle-aged and older adults may contribute to aging satisfaction and ultimately to successful aging.

14.
Trials ; 21(1): 275, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32183897

RESUMO

BACKGROUND: The German guideline on psychosocial interventions for people with severe mental disorders recommends a broad spectrum of evidence-based treatments. Structured implementation of the associated patient version of the guideline is missing to date. The study aims to assess whether structured implementation of a patient guideline improves the empowerment of patients with severe mental disorders, as well as knowledge, attitudes and experiences regarding psychosocial interventions, service use, treatment satisfaction, treatment needs, quality of life and burden of care. METHODS: The study is a multicentre, cluster-randomised, controlled study with two parallel groups. Inpatients and day hospital patients (all sexes; 18-65 years) with severe mental disorders will be included. Additionally, relatives of patients with mental disorders (all sexes; ≥ 18 years) will be included. In the experimental group, the patient guideline will be implemented using a multimodal strategy. Participants in the control group will receive treatment as usual but will be made aware of the patient guideline. The primary outcome is the change of empowerment, assessed by using the 'empowerment in the process of psychiatric treatment of patients with affective and schizophrenia disorders' (EPAS) scale. In addition, knowledge, attitudes and experiences regarding psychosocial interventions will be assessed as secondary outcomes, as well as service use, satisfaction with care, patient need and quality of life and participation and social inclusion. For relatives, the perceived burden of care also will be recorded. Results will be analysed using hierarchical linear models. For the health economic evaluation, the incremental cost-utility ratios will be computed using the differences in total costs of illness and the differences in quality-adjusted life years (QALY) between study groups. DISCUSSION: The study will be the first to assess the effects of a structured implementation of the patient version of a psychiatric treatment guideline. The study has some limitations regarding the transferability of the results to other patients and other regions. Furthermore, problems with the recruitment of patients and relatives and with the implementation of intervention could occur during the study. TRIAL REGISTRATION: The study is registered in the German Clinical Trials Register (DRKS) and the WHO International Clinical Trials Registry Platform (ICTRP) under registration number DRKS00017577 (Date of registration: 23 October 2019.

15.
Aging Clin Exp Res ; 2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32108287

RESUMO

BACKGROUND: There are very few studies examining the determinants of frequent attendance in primary care among the oldest old. AIMS: The purpose of this study was to determine the characteristics of frequent attendance among individuals aged 85 years or older. METHODS: Cross-sectional data stem from the multicenter prospective cohort "Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients (85 +)" (AgeQualiDe). This study covers very old primary care patients (n = 861, mean age of 89.0 years ± 2.9; 85-100 years). The number of self-reported GP visits in the preceding 3 months was used to quantify frequent attenders. We defined patients in the top decile as frequent attenders. RESULTS: Multiple logistic regressions showed that frequent attendance was associated with more chronic diseases (adjusted OR 1.12, 95% CI 1.01-1.23), worse functioning (OR 0.97, 95% CI 0.95-0.99), worries about one's financial situation (OR 2.20, 95% CI 1.07-4.53) and it was inversely associated with depression (OR 0.26, 95% CI 0.08-0.80). DISCUSSION: In contrast to studies based on younger samples, different factors were associated with frequent users in our study, showing that it is important to study the determinants of frequent attendance among the oldest old. CONCLUSION: In Germany, among the group of the oldest old, frequent attendance was positively associated with worse physical health status (e.g., number of chronic diseases), but negatively with depression. This might indicate that the German health care system is responsive to the physical, but not psychological needs of the oldest old.

16.
Aging Ment Health ; : 1-7, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32081021

RESUMO

Objectives: This study aimed to examine aspects of help-seeking for psychological distress and its association with increased anxiety symptoms in the oldest old.Method: Baseline data from AgeQualiDe, a multicenter cohort study of people aged 85 and over recruited in primary care, were analyzed. Help-seeking for psychological distress (items from the Camberwell Assessment of Need for the Elderly) was analyzed using ordinal and logistic regression models as a function of increased anxiety symptoms (Geriatric Anxiety Inventory-Short Form ≥ 3), as well as relevant socio-demographic and health-related covariates.Results: N = 155 (18.1% of the sample) reported having experienced psychological distress recently and were thus included in the analysis. Among those, 26.5% reported experiencing increased anxiety symptoms. On a descriptive level, 76.8% sought informal, 29.0% sought formal, and 18.1% sought no help for psychological distress. In covariate-adjusted regression models, increased anxiety was significantly associated with increased use of informal support (OR: 2.92, 95% CI: 1.31-6.48), but was neither associated with formal (OR: 0.72, 95% CI: 0.26-1.97) nor no help-seeking (OR: 0.28, 95% CI: 0.08-1.05).Conclusion: A large proportion of those experiencing psychological distress sought support from informal sources in this study. Anxiety symptoms in the oldest old were associated with the increased use of informal support, but not formal support or no help-seeking. Training and support for people providing informal help to those with mental health problems should be promoted to reduce a possible burden. However, future research addressing underlying mechanisms is needed.

17.
Neuroepidemiology ; 54(2): 157-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32018263

RESUMO

In recent years, a rapidly increasing collection of investigative methods in addition to changes in diagnostic criteria for dementia have followed "high-tech" trends in medicine, with the aim to better define the dementia syndrome and its biological substrates, mainly in order to predict risk prior to clinical expression. These approaches are not without challenge. A set of guidelines have been developed by a group of European experts in population-based cohort research through a series of workshops, funded by the Joint Program for Neurodegenerative Disorders (JPND). The aims of the guidelines are to assist policy makers and researchers to understand (1) What population studies for ageing populations should encompass and (2) How to interpret the findings from population studies. Such studies are essential to provide evidence relevant to the understanding of healthy and frail brain ageing, including the dementia syndrome for contemporary and future societies by drawing on the past.

18.
Aging Clin Exp Res ; 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32006387

RESUMO

BACKGROUND: It is almost unknown whether the driving status is associated with HRQOL among individuals in highest age. AIMS: Based on a multicenter prospective cohort study, the objective of this study was to examine whether the driving status is associated with health-related quality of life (HRQOL) among the oldest old in Germany. METHODS: Cross-sectional data from follow-up wave 9 (n = 544) were derived from the "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe). Average age was 90.3 years (± 2.7; 86 to 101 years). The current driver status (no; yes) was used in our analysis. The EuroQoL EQ-5D questionnaire was used to assess HRQOL in this study. RESULTS: Regression analysis showed that being a current driver was associated with the absence of problems in 'self-care' [OR 0.41 (95%-CI 0.17 to 0.98)], and 'usual activities' [OR 0.48 (0.26 to 0.90)], whereas it was not significantly associated with problems in 'pain/discomfort' [OR  0.82 (0.47 to 1.45)] and 'anxiety/depression' [OR  0.71 (0.36 to 1.39)]. Being a current driver was marginally significantly associated with the absence of problems in 'mobility' [OR 0.60 (0.34 to 1.06)]. While being a current driver was not associated with the EQ-VAS in the main model, it was positively associated with the driving status (ß = 5.00, p < .05) when functional impairment was removed from the main model. DISCUSSION: Our findings provide first evidence for an association between driving status and HRQOL among the oldest old. CONCLUSIONS: Future longitudinal studies are required to evaluate a possible causal relationship between driving status and HRQOL in very old individuals.

19.
J Occup Environ Med ; 62(5): 383-387, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32049874

RESUMO

OBJECTIVE: According to self-determination theory, autonomy and competence are two essential basic human needs. It is the aim of this study to show that mental demands at the workplace (WPMDs) that address those basic needs can protect employees against depressiveness. METHODS: Using a sample of 346 working participants (average age 56.2), we derived three WPMDs (Information Load, Time Control, and Exploration) via principal component analysis. We then analyzed how far they predict depressiveness, and how far this mechanism is mediated by perceived fit between job and person (PJF). RESULTS: Time Control and Exploration significantly reduced depressiveness, and the relationship between exploration and depressiveness was mediated by PJF. CONCLUSIONS: Our results emphasize the importance of addressing basic human needs at the workplace, and the relevance of PJF for employee mental health.

20.
Psychiatr Prax ; 47(1): 35-38, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910459

RESUMO

OBJECTIVE: Borderline Personality Disorder (BPD) appears to be the most stigmatized diagnosis among personality disorders. This study aims to assess attitudes of psychiatric nurses towards patients with BPD compared to patients with depressive disorder. METHOD: 37 psychiatric nurses were randomized to an experimental between-subject design, in form of two questionnaires with different vignettes. The vignettes examined main outcomes such as negative attitudes, social distance and emotional reactions. RESULTS: Significant moderate to large differences in terms of social distance (p = 0.033, d = -0.736) and single emotional reactions towards patients with BPD (p = 0.017, d = 0.82), e. g. "I have compassion with her" were found. CONCLUSION: Patients with BPD have a substantial need for support. Quality and standards of inpatient care of patients with a BPS disorder can only guaranteed by giving adequate information about the causes of the disorder and professional treatment of the patients. Personnel must be trained to be able to cope with the specifics of the symptoms in BPD patients.


Assuntos
Transtorno da Personalidade Borderline , Enfermagem Psiquiátrica , Estigma Social , Transtorno da Personalidade Borderline/psicologia , Feminino , Alemanha , Hospitalização , Humanos , Masculino , Apoio Social , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA