Alternsforschung: Transnational und translational Gemeinsamer ...

0083
Predictors of institutionalisation in incident dementia – Results of
the German Study on Ageing, Cognition and Dementia in Primary
Care Patients (AgeCoDe study)
*M. Luppa 1 , S.G. Riedel-Heller 1 , J. Stein 1, *M. Schwarzbach 1 , H. Leicht 2 , H.-
H. König 2 , H. van den Bussche 3 , W. Maier 4 , M. Scherer 3 , H. Bickel 5 , E. Mösch 5 ,
J. Werle 6 , M. Pentzek 7 , A. Fuchs 7 , M. Eisele 3 , F. Jessen 4 , F. Tebarth 4 , B. Wiese 8 ,
S. Weyerer 6
1 University of Leipzig, Institute of Social Medicine, Occupational Health and
Public Health, Leipzig, Deutschland, 2 University Medical Center Hamburg-
Eppendorf, Department of Medical Sociology and Health Economics,
Hamburg, Deutschland, 3 University Medical Center Hamburg-Eppendorf,
Department of Primary Medical Care, Hamburg, Deutschland, 4 University
of Bonn, Department of Psychiatry, Bonn, Deutschland, 5 Technical University
of Munich, Department of Psychiatry, Munich, Deutschland, 6 Central
Institute of Mental Health, Mannheim, Deutschland, 7 Medical Faculty of the
Heinrich-Heine-University Düsseldorf, Institute of General Practice, Düsseldorf,
Deutschland, 8 Hannover Medical School, Institute for Biometrics,
Hannover, Deutschland
Background. In the past decades a number of studies investigated risk
factors of nursing home placement (NHP) in dementia patients. The
aim of the current study was to investigate risk factors of NHP in incident
dementia cases, considering characteristics at the time of the dementia
diagnosis.
Methods. Incident dementia cases in a German GP-sample of 3,327 subjects
aged 75 years which were assessed every 1.5 years over four waves
were included. A Cox proportional hazard regression model was used to
determine predictors of NHP. Kaplan-Meier survival curves were used
to evaluate the time until NHP.
Results. Of the 254 incident dementia cases, 77 (30%) were institutionalised
over the study course. The mean time until NHP was 4.1 years.
Significant characteristics of NHP at the time of the dementia diagnosis
were marital status (being single or widowed), higher severity of cognitive
impairment and mobility impairment.
Conclusions. Marital status seems to play a decisive role in NHP. Early
initiation of support of sufferers may ensure remaining in the familiar
surroundings as long as possible.
Acknowledgement. This study is part of the German Research Network
on Dementia (KND) and the German Research Network on Degenerative
Dementia (KNDD) and was funded by the German Federal Ministry
of Education and Research (grants KND: 01GI0102, 01GI0420,
01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, 01GI0434; grants
KNDD: 01GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715,
01GI0716, 01ET1006B).
0084
Direct costs associated with depressive symptoms in late life – A
4.5-year prospective study
M. Luppa 1 , H.-H. König 2 , D. Heider 2 , H. Leicht 2, *M. Schwarzbach 1 , T. Motzek
1 , G. Schomerus 3 , S.G. Riedel-Heller 1
1 University of Leipzig, Institute of Social Medicine, Occupational Health and
Public Health, Leipzig, Deutschland, 2 University Medical Center Hamburg-
Eppendorf, Department of Medical Sociology and Health Economics, Hamburg,
Deutschland, 3 Ernst-Moritz-Arndt University Greifswald, Department
of Psychiatry, Greifswald, Deutschland
Introduction. Depression in old age is common. Only few studies examined
the association of depressive symptoms and direct costs in the
elderly in a cross-sectional way. This study aims to investigate health
service use and direct costs over 4.5 years considering different courses
of depressive symptomatology.
Methods. 305 primary care patients aged 75+ were assessed face-to-face
regarding depressive symptoms (Geriatric Depression Scale), and service
use and costs at baseline and 4.5 years later. Resource utilisation was
monetarily valued using 2004/2005 prices.
Results. Mean annual direct costs of depressive individuals were almost
one third higher than of non-depressive and highest for individuals
with chronic depressive symptoms. Most relevant cost driver were costs
for inpatient care, pharmaceuticals and home care. Costs for home care
increased at most in individuals with chronic depressive symptoms.
Predictors of direct costs after 4.5 years were number of medications,
age, gender and depressive symptoms at baseline.
Discussion. Presence and persistence of depressive symptoms in old age
cause a substantial increase in direct costs even after adjustment for
somatic comorbidity. Further research and clinical efforts to establish
secondary prevention strategies are challenged to preserve quality of life
of sufferers and reduce economic burden.
Acknowledgement. This work is part of German Research Network on
Dementia (KND) and the German Research Network on Degenerative
Dementia (KNDD) and was funded by the German Federal Ministry of
Education and Research (AgeCoDe study, grant: 01GI431 and 01GI0714)
and is published in affiliation with the Study on Late-Life Depression in
Primary Care (AgeMooDe study, grant: 01GY1155A).
0086
Natural course of depressive symptoms in late life. An 8-year
population-based prospective study
M. Luppa 1 , T. Luck 1,2, *M. Schwarzbach 1 , H.-H. König 3 , M.C. Angermeyer 4,5 ,
S.G. Riedel-Heller 1
1 University of Leipzig, Institute of Social Medicine, Occupational Health
and Public Health, Leipzig, Deutschland, 2 University of Leipzig, LIFE Center,
Leipzig, Deutschland, 3 University Medical Center Hamburg-Eppendorf, Department
of Medical Sociology and Health Economics, Hamburg, Deutschland,
4 Center for Public Mental Health, Gösing a. W., Österreich, 5 University
of Cagliary, Department of Public Health, Cagliari, Italy, Österreich
Aims. The aim of the study was to follow the natural course of late-life
depressive symptoms within a German population-based study.
Methods. Within the Leipzig Longitudinal Study of the Aged (LEILA
75+), a representative sample of 1,265 individuals aged 75 years and older
were interviewed every 1.5 years over 8 years.
Results. The incidence of depressive symptoms was 34 per 1,000 personyears
(95% confidence interval 31-37). Female gender, poor self-rated
health status, stroke, risky alcohol consumption, a poor social network,
higher number of specialist visits, functional impairment, and CES-D
score at baseline increased the risk for future depressive symptoms. We
observed remission in 60%, an intermittent course in 17% and a chronic
course in 23% of the participants. No baseline characteristic distinguished
the remission group from the persistently depressed.
Discussion. Depressive symptoms in late life are common and highly
persistent. Recently encountered risk factors entailed numerous potentialities
for secondary prevention.
Acknowledgement. This work is published in affiliation with the Leipzig
Interdisciplinary Research Cluster of Genetic Factors, Clinical
Phenotypes and Environment (LIFE Center, Universität Leipzig), and
the Study on Late-Life Depression in Primary Care (AgeMooDe study,
grant: 01GY1155A).
Zeitschrift für Gerontologie und Geriatrie · Supplement 1 · 2012 |
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