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Wirth R, Verdon J, Frohnhofen H, Djukic M, Meisel M, Musolf M, Zinke A, Heppner HJ, Jamour M, Denkinger M, Trampisch US. Characterization of patients admitted to specialized geriatric acute care hospital units with the German version of the Standardized Evaluation and Intervention for Seniors at Risk (SEISAR) screening-instrument: a cross-sectional study. BMC Geriatr 2023; 23:613. [PMID: 37775729 PMCID: PMC10542688 DOI: 10.1186/s12877-023-04338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND The Standardized Evaluation and Intervention for Seniors at Risk (SEISAR) screening tool records major geriatric problems, originally applied in the emergency department. Particularly, the distinction of compensated and uncompensated problems is an interesting and new approach. Therefore, we translated the SEISAR in German language and used it to characterize patients in specialized geriatric hospital wards in Germany and to gather initial experience regarding its usability and practicability. METHODS The tool was translated by three independent specialists in geriatric medicine and backtranslated for quality-assurance by a non-medical English native speaker. In a second step, 8 acute care geriatric hospital departments used the translated version to characterize all consecutive patients admitted over a period of one month between December 2019 and May 2020 at time of admission. RESULTS Most of the 756 patients (78%) lived in an own apartment or house prior to hospital admission. Participants had on average 4 compensated and 6 uncompensated problems, a Barthel-Index of 40 pts. on admission with a median increase of 15 points during hospital stay, and a median length of stay of 16 days in the geriatric hospital department. CONCLUSION SEISAR is an interesting standardized brief comprehensive geriatric assessment tool for the identification of compensated and uncompensated health problems in older persons. The data of this study highlights the number, variability, and complexity of geriatric problems in patients treated in specialized acute care geriatric hospital wards in Germany. TRIAL REGISTRATION German Clinical trial register (DRKS-ID: DRKS00031354 on 27.02.2023).
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Affiliation(s)
- Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany
| | - J Verdon
- McGill University Health Center, Royal Victoria Hospital, Montreal, QC, Canada
| | - H Frohnhofen
- Department of Orthopedics and Traumasurgery, Heinrich Heine University, Düsseldorf, Germany
- Department of Health, University Witten-Herdecke, Witten, Germany
| | - M Djukic
- Department of Geriatric Medicine, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
| | - M Meisel
- MEDICLIN Heart-Center, Coswig, Germany
| | - M Musolf
- Department of Geriatric Medicine, Ev. Amalie Sieveking-Krankenhaus, Hamburg, Germany
| | - A Zinke
- Department of Geriatric Medicine, St. Marien- und St. Annastiftskrankenhaus, Ludwigshafen, Germany
| | - H J Heppner
- Department of Geriatric Medicine, Klinikum Bayreuth, Bayreuth, Germany
| | - M Jamour
- Department of Internal and Geriatric Medicine, Alb-Donau-Klinikum, Ehingen, Germany
| | - M Denkinger
- Geriatric Centre Ulm, Agaplesion Bethesda Clinic, Ulm University, Ulm, Germany
| | - U S Trampisch
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany.
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Pahmeier K, Denkinger M, Seufferlein T, Klaus J, Bauer J, Katus H, Bahrmann A, Geisler T, Muche R, Müller M, Suhr R, Frankenhauser-Mannuß J, Flagmeier AL, Dallmeier D, Leinert C, Wasem J, Biermann-Stallwitz J, Neumann A. Studiendesign – Gesundheitsökonomische Evaluation einer Interventionsstudie zur Delirreduktion (TRADE). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Pahmeier
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
| | - M Denkinger
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - T Seufferlein
- Universitätsklinikum Ulm, Klinik für Innere Medizin I
| | - J Klaus
- Universitätsklinikum Ulm, Klinik für Innere Medizin I
| | - J Bauer
- AGAPLESION BETHANIEN Krankenhaus Heidelberg, Klinik für Akutgeriatrie
| | - H Katus
- Universitätsklinikum Heidelberg, Klinik für Kardiologie, Angiologie, Pneumologie
| | - A Bahrmann
- Universitätsklinikum Heidelberg, Klinik für Kardiologie, Angiologie, Pneumologie
| | - T Geisler
- Universitätsklinikum Tübingen, Deutsches Herzkompetenzzentrum, Medizinische Klinik III
| | - R Muche
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie
| | - M Müller
- Technische Hochschule Rosenheim, Fakultät für Angewandte Gesundheits- und Sozialwissenschaften
| | - R Suhr
- Zentrum für Qualität in der Pflege
| | | | - AL Flagmeier
- AOK Baden-Württemberg, Rehabilitations- und Pflegeforschung
| | - D Dallmeier
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - C Leinert
- AGAPLESION Bethesda Klinik, Geriatrische Forschung der Universität Ulm
| | - J Wasem
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
| | | | - A Neumann
- Universität Duisburg-Essen, Lehrstuhl für Medizinmanagement
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Seibert M, Mühlbauer V, Holbrook J, Voigt-Radloff S, Brefka S, Dallmeier D, Denkinger M, Schönfeldt-Lecuona C, Klöppel S, von Arnim CAF. Efficacy and safety of pharmacotherapy for Alzheimer's disease and for behavioural and psychological symptoms of dementia in older patients with moderate and severe functional impairments: a systematic review of controlled trials. Alzheimers Res Ther 2021; 13:131. [PMID: 34271969 PMCID: PMC8285815 DOI: 10.1186/s13195-021-00867-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Many patients with Alzheimer's disease (AD) are physically frail or have substantial functional impairments. There is growing evidence that such patients are at higher risk for medication-induced adverse events. Furthermore, frailty seems to be more predictive of poor clinical outcomes than chronological age alone. To our knowledge, no systematic review of clinical trials examining drug therapy of AD or behavioural and psychological symptoms of dementia (BPSD) has specifically focused on the topic of physical frailty. Our objective was to evaluate the efficacy and safety of pharmacotherapy in AD patients with frailty or significant functional impairments. METHODS We performed a systematic literature search in MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of drug therapy of AD and BPSD in patients with significant functional impairments according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Cochrane research criteria. Significant functionally impaired patient populations were identified using the recommendations of the Medication and Quality of Life in frail older persons (MedQoL) Research Group. Screening, selection of studies, data extraction and risk of bias assessment were performed independently by two reviewers. Outcomes including functional status, cognitive function, changes in BPSD symptoms, clinical global impression and quality of life were analysed. For assessing harm, we assessed adverse events, drop-outs as a proxy for treatment tolerability and death. Results were analysed according to Cochrane standards and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Of 45,045 search results, 38,447 abstracts and 187 full texts were screened, and finally, 10 RCTs were included in the systematic review. Selected articles evaluated pharmacotherapy with acetylcholinesterase-inhibitors (AChEI), anticonvulsants, antidepressants and antipsychotics. Studies of AChEIs suggested that patients with significant functional impairments had slight but significant improvements in cognition and that AChEIs were generally well tolerated. Studies of antidepressants did not show significant improvements in depressive symptoms. Antipsychotics and anticonvulsants showed small effects on some BPSD items but also higher rates of adverse events. However, due to the very small number of identified trials, the quality of evidence for all outcomes was low to very low. Overall, the small number of eligible studies demonstrates that significantly functional impaired older patients have not been adequately taken into consideration in most clinical trials investigating drug therapy of AD and BPSD. CONCLUSION Due to lack of evidence, it is not possible to give specific recommendations for drug therapy of AD and BSPD in frail older patients or older patients with significant functional impairments. Therefore, clinical trials focussing on frail older adults are urgently required. A standardized approach to physical frailty in future clinical studies is highly desirable.
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Affiliation(s)
- M Seibert
- Department of Neurology, University Clinic Ulm, Ulm, Germany
| | - V Mühlbauer
- Agaplesion Bethesda Clinic, Institute for Geriatric Research, Ulm University, Ulm, Germany
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - J Holbrook
- Department of Neurology, University Clinic Ulm, Ulm, Germany
| | - S Voigt-Radloff
- Center for Geriatric Medicine and Gerontology, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center and Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - S Brefka
- Agaplesion Bethesda Clinic, Institute for Geriatric Research, Ulm University, Ulm, Germany
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - D Dallmeier
- Agaplesion Bethesda Clinic, Institute for Geriatric Research, Ulm University, Ulm, Germany
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - M Denkinger
- Agaplesion Bethesda Clinic, Institute for Geriatric Research, Ulm University, Ulm, Germany
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - C Schönfeldt-Lecuona
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
- Department of Psychiatry and Psychotherapy III, University Clinic Ulm, Ulm, Germany
| | - S Klöppel
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - C A F von Arnim
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany.
- Division of Geriatrics, University Medical Centre, Georg August University, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
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Dallmeier D, Braisch U, Denkinger M, Koenig W, Rothenbacher D. P6246Three-year change in high-sensitivity cardiac troponin T and total mortality in older adults - The ActiFE Study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
High sensitivity cardiac troponin-T (hs-cTnT) levels in asymptomatic older adults have been associated with adverse outcomes such as total mortality. In this context little is known about the implications of changes over time in this population.
Purpose
We aimed to investigate the three-year change of hs-cTnT and its association with subsequent total mortality in a cohort of community dwelling older adults.
Methods
We measured hs-cTnT at baseline (BL) and at three-year follow-up (FU) in participants at the Activity and Function in the Elderly (ActiFE) Study. Having those with BL und FU hs-cTnT <5 ng/L (undetectable) as the reference group (Group 1, n=156) five categories were built among those with an increment of hs-cTnT overtime: For those with undetectable BL: FU 5 to <14 ng/L (Group 2, n=295), FU ≥14 ng/L (Group 3, n=24). Among those with BL levels between 5 to <14 ng/L: FU 5 to <14 ng/L (Group 4, n=101), FU ≥14 ng/L (Group 5, n=96). Group 6 included those with BL and FU >14 ng/L (n=74). Using Cox proportional hazards models we evaluated the association between the identified groups and total mortality adjusting for age, sex, education, history of cardiovascular disease (CVD), chronic kidney disease (CKD), number of medications, CRP, and NT-proBNP measured at FU.
Results
Among 746 participants (median age at FU 75.9 years, 58.9% male) we observed a total of 98 deaths (median FU 4.8 years) with a mortality rate of 28.6 [95% CI 23.5, 34.9] per 1000 person-years. Those with undetectable hs-cTnT levels at both time point (Group 1, reference group) had the lowest mortality rate (5.2 [95% CI 2.0, 13.9] per 1000 person-years) and were noted to be most likely younger, women, with BMI ≥18.5 but <30 kg/m2, and had less comorbidities. The highest mortality rates were observed in i) those who went from undetectable levels at BL to FU levels ≥14 ng/L (Group 3: 95.4 [95% CI 49.6, 183.4] per 1000 person-years), and in ii) those with hs-cTnT levels >14 ng/L at both time points (Group 6: 100.4 [95% CI 69.8, 144.5] per 1000 person-years). These both groups showed the highest median hs-cTnT at FU (16.7 and 30.1 ng/L respectively), and the highest incidence proportion from BL to FU of CVD and CKD. Highest FU median levels of CRP were measured in Group 3, of NT-proBNP in Group 6. In the multivariable analysis we observed a significant increased hazard for total mortality with a hazard ratio of 5.62 [95% CI 1.57, 20.14] for those in Group 3 and 3.87 [95% CI 1.17, 12.80] for those in Group 6, when compared to the reference group.
Conclusion
Evaluating trajectories of hs-cTnT even in asymptomatic older adults could help to identify those subjects with a high risk to die even after adjustment for other covariates including NT-proBNP. Further research is needed in order to identify pathophysiological mechanisms behind these changes in older adults, and the possible effect of preventive measures in the identified risk groups.
Acknowledgement/Funding
This work was supported by a grant from the Ministry of Science, Research and Arts, state of Baden-Wuerttemberg, Germany.
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Affiliation(s)
- D Dallmeier
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
| | - U Braisch
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
| | - M Denkinger
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
| | - W Koenig
- Deutsches Herzzentrum Muenchen Technical University of Munich, Munich, Germany
| | - D Rothenbacher
- University of Ulm, Institute of Epidemiology and Medical Biometry, Ulm, Germany
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Laszlo R, Konz H, Kunz K, Dallmeier D, Klenk J, Denkinger M, Koenig W, Rothenbacher D, Steinacker For The ActiFE Study Group JM. Evaluation of left and right ventricular systolic and diastolic electromechanical synchrony in older people: a population-based observational study. Physiol Res 2017; 66:933-948. [PMID: 28937256 DOI: 10.33549/physiolres.933453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
It is unknown whether physiological ageing also goes along with electromechanical asynchrony of contraction. Aim of the study was to evaluate synchrony of contraction in older people with ("non-healthy") or without ("healthy") evidence for structural cardiac disease. In 547 persons (age 76.7+/-5.5 years, 306 male, 241 female) recruited from a population-based cohort of the ActiFE-Ulm study including a random sample of people >/=65 years old living in the region of Ulm, Germany, various PW- and TDI-Doppler based markers for asynchrony were obtained by echocardiography. Within a subgroup of 84 healthy subjects, at most minimal systolic and diastolic asynchrony was found. Concerning systolic asynchrony, similar observations were made within the non-healthy subgroup. However, extent of diastolic left ventricular intraventricular asynchrony and also - by tendency - diastolic interventricular asynchrony was increased in comparison to the healthy subgroup. To conclude, no evidence that physiological ageing might go along with relevant left or right ventricular systolic or diastolic electromechanical asynchrony was found in our study. Furthermore, our population-based data support the results from other clinical studies with rather selected cohorts that structural heart diseases might go along with increased diastolic asynchrony.
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Affiliation(s)
- R Laszlo
- Division of Sports and Rehabilitation Medicine, Ulm University, Ulm, Germany.
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Dallmeier D, Braisch U, Koenig W, Denkinger M, Rothenbacher D. Longitudinal changes of N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) and total mortality in elderly people: the ActiFE Study. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D Dallmeier
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
| | - U Braisch
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
- Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
| | - W Koenig
- Ulm Universität, Innere Medizin II, Ulm
- Deutsches Herzzentrum München, München
| | - M Denkinger
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
| | - D Rothenbacher
- Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
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Dallmeier D, Braisch U, Klenk J, Rothenbacher D, Denkinger M. Frailty and risk of mortality in community dwelling older adults: results of the ActiFE study. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- D Dallmeier
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
| | - U Braisch
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
- Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
| | - J Klenk
- Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
| | - D Rothenbacher
- Ulm Universität, Inst. für Epidemiologie und medizinische Biometrie, Ulm
| | - M Denkinger
- Agaplesion Bethesda Klinik Ulm, Forschungsabteilung, Ulm
- Geriatrisches Zentrum Ulm/Alb-Donau, Ulm Universität, Ulm
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8
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Klenk J, Peter RS, Braisch U, Dallmeier D, Denkinger M, Rothenbacher D. Einfluss der Temperatur bei der Analyse von Änderungen der objektiv gemessenen körperlichen Aktivität über die Zeit in der ActiFE-Ulm Studie. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Klenk
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, Ulm
- Robert-Bosch-Krankenhaus Stuttgart, Abteilung für Geriatrie und Klinik für geriatrische Rehabilitation, Stuttgart
| | - RS Peter
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, Ulm
| | - U Braisch
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, Ulm
- Agaplesion Bethesda Klinik, Ulm
| | | | | | - D Rothenbacher
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, Ulm
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Grund S, Denkinger M, Braisch U, Marburger C, Runge M, Jamour M. UTILITY OF THE SPPB FOR SHORT-TERM OUTCOME PREDICTION OF MULTIMORBID GERIATRIC REHABILITANTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.3328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S. Grund
- Diakonissenkrankenhaus Mannheim, Mannheim, Germany,
- Agaplesion Bethesda Klinik Ulm, Ulm, Germany
| | | | - U. Braisch
- Biometrie Universität Ulm, Ulm, Germany,
- Agaplesion Bethesda Klinik Ulm, Ulm, Germany
| | | | - M. Runge
- Privatpraxis, Esslingen am Neckar, Germany,
| | - M. Jamour
- Geriatrische Rehabilitationsklinik Ehingen, Ehingen, Germany,
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Garfinkel D, Denkinger M, Wehling M. PRESIDENTIAL SYMPOSIUM: INTERNATIONAL EFFORTS TO ADDRESS POLYPHARMACY THROUGH POLICY AND HEALTH AUTHORITIES: IGRIMUP SYMPOSIUM 2. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D. Garfinkel
- Homecare Hospice & Geriatric-Palliative Service, Israel Cancer Association &Wolfson Medical Center &, Bat - Yam, Israel
| | | | - M. Wehling
- Medical Faculty Mannheim Ruprecht-Karls-University Heidelberg
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Denkinger M, Dallmeier D, Brefka S, Klöppel S, Voigt-Radloff S, Schönfeldt-Lecuona C, von Arnim C, Bauer J. EVIDENCE MAPS FOR DRUG THERAPY IN FRAIL OLDER ADULTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Denkinger
- Agaplesion Bethesda Clinic Ulm, Geriatric Medicine Ulm University, Ulm, Germany,
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany,
| | - D. Dallmeier
- Agaplesion Bethesda Clinic Ulm, Geriatric Medicine Ulm University, Ulm, Germany,
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany,
| | - S. Brefka
- Agaplesion Bethesda Clinic Ulm, Geriatric Medicine Ulm University, Ulm, Germany,
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany,
| | - S. Klöppel
- Centre for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Freiburg i. Br., Germany,
| | - S. Voigt-Radloff
- Centre for Geriatric Medicine and Gerontology, University Medical Center Freiburg, Freiburg i. Br., Germany,
| | | | - C. von Arnim
- Department of Neurology, Ulm University Hospital, Ulm, Germany,
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany,
| | - J. Bauer
- Department of Geriatric Medicine, Klinikum Oldenburg, Oldenburg, Germany,
- Centre of geriatrics, University of Oldenburg, Oldenburg, Germany,
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Leins H, Denkinger M, Schirmbeck R, Geiger H. RESTORING YOUTHFUL CELLULAR IMMUNITY BY REJUVENATION OF AGED HEMATOPOIETIC STEM CELLS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H. Leins
- Institute for Molecular Medicine, Ulm, Germany,
- AGAPLESION Bethesda Clinic, Geriatric Research Unit, Ulm, Germany,
- Internal Medicine I, Ulm, Germany,
| | - M. Denkinger
- AGAPLESION Bethesda Clinic, Geriatric Research Unit, Ulm, Germany,
- Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | | | - H. Geiger
- Institute for Molecular Medicine, Ulm, Germany,
- Experimental Hematology and Cancer Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio,
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13
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Schwandt A, Denkinger M, Fasching P, Pfeifer M, Wagner C, Weiland J, Zeyfang A, Holl RW. Welche der Formeln Cockcroft-Gault, MDRD und CKD-EPI schätzt die gemessene glomeruläre Funktion am besten? Ergebnisse einer multizentrischen Studie mit 36.507 erwachsenen Patienten mit Typ 1 oder Typ 2 Diabetes aus der DPV-Datenbank. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schwandt
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, ZIBMT, Ulm, Germany
| | - M Denkinger
- AGAPLESION Bethesda Klinik, Geriatrie der Universität Ulm, Ulm, Germany
| | - P Fasching
- Wilhelminenspital, 5. Medizinischen Abteilung, Wien, Austria
| | - M Pfeifer
- Klinik Tettnang, Diabeteszentrum, Tettnang, Germany
| | - C Wagner
- Diabeteszentrum, Saaldorf-Surheim, Germany
| | - J Weiland
- Klinik Bad Reichenhall, Insitut für Innere Medizin, Bad Reichenhall, Germany
| | - A Zeyfang
- Sana Klinik Bethesda, Stuttgart, Germany
| | - RW Holl
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, ZIBMT, Ulm, Germany
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van Schoor NM, Zambon S, Castell MV, Cooper C, Denkinger M, Dennison EM, Edwards MH, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen NL, Peter R, Schaap LA, Rijnhart JJM, van der Pas S, Deeg DJH. Impact of clinical osteoarthritis of the hip, knee and hand on self-rated health in six European countries: the European Project on OSteoArthritis. Qual Life Res 2016; 25:1423-32. [PMID: 26547441 PMCID: PMC4870285 DOI: 10.1007/s11136-015-1171-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE Osteoarthritis (OA) has been shown to be associated with decreased physical function, which may impact upon a person's self-rated health (SRH). Only a few studies have examined the association between OA and SRH in the general population, but to date none have used a clinical definition of OA. The objectives are: (1) To examine the cross-sectional association between clinical OA and fair-to-poor SRH in the general population; (2) To examine whether this association differs between countries; (3) To examine whether physical function is a mediator in the association between clinical OA and SRH. METHODS Baseline data of the European Project on OSteoArthritis (EPOSA) were used, which includes pre-harmonized data from six European cohort studies (n = 2709). Clinical OA was defined according to the American College of Rheumatology criteria. SRH was assessed using one question: How is your health in general? Physical function was assessed using the Western Ontario and McMaster Universities OA Index and Australian/Canadian OA Hand Index. RESULTS The prevalence of fair-to-poor SRH ranged from 19.8 % in the United Kingdom to 63.5 % in Italy. Although country differences in the strength of the associations were observed, clinical OA of the hip, knee and hand were significantly associated with fair-to-poor SRH in five out of six European countries. In most countries and at most sites, the association between clinical OA and fair-to-poor SRH was partly or fully mediated by physical function. CONCLUSIONS Clinical OA at different sites was related to fair-to-poor SRH in the general population. Most associations were (partly) mediated by physical functioning, indicating that deteriorating physical function in patients with OA should be a point of attention in patient care.
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Affiliation(s)
- N M van Schoor
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - S Zambon
- Department of Medical and Surgical Sciences, University of Padova, Padua, Italy
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M V Castell
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M Denkinger
- Bethesda Geriatric Clinic, University of Ulm, Ulm, Germany
| | - E M Dennison
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - M H Edwards
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Southampton, UK
| | - F Herbolsheimer
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - S Maggi
- National Research Council, Aging Branch, Institute of Neuroscience, Padua, Italy
| | - M Sánchez-Martinez
- Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - N L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R Peter
- Institute of the History, Philosophy and Ethics of Medicine, University of Ulm, Ulm, Germany
| | - L A Schaap
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - J J M Rijnhart
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - S van der Pas
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - D J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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15
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van der Pas S, Schaap L, Castell M, Cooper C, Denkinger M, Edwards M, Herbolsheimer F, Maggi S, Sánchez-Martinez M, Pedersen N, Peter R, Zambon S, Wiegersma S, Dekker J, Dennison E, Deeg D. Availability and use of neighborhood resources by older people with osteoarthritis: Results from the European Project on OSteoArthritis. Health Place 2016; 37:1-7. [DOI: 10.1016/j.healthplace.2015.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 09/28/2015] [Accepted: 10/11/2015] [Indexed: 11/15/2022]
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16
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Lukas A, Schuler M, Fischer T, Gibson S, Savvas S, Nikolaus T, Denkinger M. Pain and dementia. Z Gerontol Geriatr 2012; 45:45-9. [DOI: 10.1007/s00391-011-0272-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 10/21/2011] [Indexed: 11/30/2022]
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17
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Hancke K, Denkinger M, König J, Kurzeder C, Kreienberg R. Brustkrebs bei über 70-jährigen Frauen–Abweichen von der leitliniengerechten Therapie senkt Überleben und rezidivfreie Zeit. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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