Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice - a Survey Study.

Introduction: Multimorbidity challenges quality and sustainability of healthcare systems. Care groups were introduced in the Netherlands to promote integration of chronic primary care, but it remains unknown to which degree they facilitate this. This study therefore aims to determine whether Dutch general practices perceive themselves to be capable of delivering integrated chronic care and uncover the role of care groups.

Functional and vascular neuroimaging in maritime pilots with long-term sleep disruption.

The mechanism underlying the possible causal association between long-term sleep disruption and Alzheimer's disease remains unclear Musiek et al. 2015. A hypothesised pathway through increased brain amyloid load was not confirmed in previous work in our cohort of maritime pilots with long-term work-related sleep disruption Thomas et al.

Social Gaming to Decrease Loneliness in Older Adults: Recruitment Challenges and Attrition Analysis in a Digital Mixed Methods Feasibility Study.

Background: Digital mental health interventions could sustainably and scalably prevent and reduce loneliness in older adults. We designed an app containing 29 text-based games and a questionnaire-administering chatbot to stimulate intergenerational contact.

Objective: This study aims to evaluate the feasibility of a social gaming app in reducing loneliness among older adults by evaluating recruitment strategies, data collection procedures, and gameplay activity.

The Power of a Complex Systems Perspective to Elucidate Aging.

It is becoming highly accepted that aging, age-related diseases, and geriatric healthcare can move forward if reductionist research is complemented by integrative research uniting knowledge on specific aging mechanisms, multiple biomedical, social, psychological, lifestyle, and environmental factors and their interactions. In this special issue, we present exciting papers that illustrate how complexity science theory and practice can be applied to aging research and provide a better understanding and quantification of healthy aging and vulnerability to disease. Recent insights on biomarkers, clocks of aging, frailty, and resilience are covered and studied in interaction with a dynamic multiscale perspective.

Experiences and preliminary effects of the Comprehensive chrOnic caRe outpatiEnt (CORE) clinic for patients with multimorbidity in the hospital setting.

Rationale: Healthcare systems remain disease oriented despite growing sustainability concerns caused by inadequate management of patients with multimorbidity. Comprehensive care programmes (CCPs) can play an important role in streamlining care delivery, but large differences in setup and results hinder firm conclusions on their effectiveness. Many elements for successful implementation of CCPs are identified, but strategies to overcome barriers and embed programmes within health systems remain unknown.

ERASE: a feasible early warning tool for elder abuse, developed for use in the Dutch emergency department.

Background: Elder abuse is a worldwide problem with serious consequences for individuals and society. To effectively deal with elder abuse, a timely identification of signals as well as a systematic approach towards (suspected) elder abuse is necessary. This study aimed to develop and test the acceptability and appropriateness of ERASE (EldeR AbuSE) in the emergency department (ED) setting.

Prognostic Information on Progression to Dementia: Quantification of the Impact on Quality of Life.

Background: The increasing interest in early identification of people at risk of developing dementia, has led to the development of numerous models aimed at estimating the likelihood of progression from mild cognitive impairment (MCI) to dementia. It is important to study both the need for and possible outcomes related with such prediction models, including the impact of risk predictions on perceived quality of life (QoL).

Objective: This study aimed to quantify the impact that receiving a risk prediction on progression from MCI to dementia has on QoL.

The need for systems thinking to advance Alzheimer's disease research.

Despite extensive research efforts to mechanistically understand late-onset Alzheimer's disease (LOAD) and other complex mental health disorders, curative treatments remain elusive. We emphasize the multiscale multicausality inherent to LOAD, highlighting the interplay between interconnected pathophysiological processes and risk factors. Systems thinking methods, such as causal loop diagrams and systems dynamic models, offer powerful means to capture and study this complexity.

Exploring the potential impact of multi-factor precision interventions in Alzheimer's disease with system dynamics.

Numerous clinical trials based on a single-cause paradigm have not resulted in efficacious treatments for Alzheimer's disease (AD). Recently, prevention trials that simultaneously intervened on multiple risk factors have shown mixed results, suggesting that careful design is necessary. Moreover, intensive pilot precision medicine (PM) trial results have been promising but may not generalize to a broader population.

Determinants of quality of life in family caregivers in MCI: a comparison with mild dementia.

Objectives: The aim of the current study was to investigate the health-related quality of life (HRQol) of the family caregiver in MCI, explore possible determinants and study possible differences with mild dementia.

Methods: This secondary data analysis included 145 persons with MCI and 154 persons with dementia and their family caregivers from two Dutch cohort studies. HRQoL was measured with the VAS of the EuroQol-5D-3L version.

DementiaNet facilitates a sustainable transition toward integrated primary dementia care: A long-term evaluation.

Introduction: Care integration is a promising strategy to achieve sustainable health-care systems. With DementiaNet, a 2-year program, we facilitated collaboration between primary health-care professionals. We studied changes in primary dementia care integration during and after DementiaNet participation.

A complex systems approach to aging biology.

Having made substantial progress understanding molecules, cells, genes and pathways, aging biology research is now moving toward integration of these parts, attempting to understand how their joint dynamics may contribute to aging. Such a shift of perspective requires the adoption of a formal complex systems framework, a transition being facilitated by large-scale data collection and new analytical tools. Here, we provide a theoretical framework to orient researchers around key concepts for this transition, notably emergence, interaction networks and resilience.

Construct Validation of the Rainbow Model of Integrated Care Measurement Tool in Dutch Primary Care for Older Adults.

Introduction: Care integration in primary elderly care is suboptimal. Validated instruments are needed to enable the implementation of integrated primary care. We aimed to assess construct validity of the Rainbow Model of Integrated Care measurement tool (RMIC-MT) for healthcare professionals working in an integrated primary elderly care setting in the Netherlands.

Simulating the multicausality of Alzheimer's disease with system dynamics.

Introduction: In Alzheimer's disease (AD), cognitive decline is driven by various interlinking causal factors. Systems thinking could help elucidate this multicausality and identify opportune intervention targets.

Methods: We developed a system dynamics model (SDM) of sporadic AD with 33 factors and 148 causal links calibrated with empirical data from two studies.

Digital resilience monitoring of informal caregivers of persons with dementia for early detection of overburden: Development and pilot testing.

Objectives: Informal caregiving is becoming increasingly important in dementia care, but causes a considerable burden on caregivers which impacts their wellbeing. We aimed to develop and pilot test a digital monitoring tool (REsilience Monitor for INformal caregivers in Dementia [REMIND]) for wellbeing and resilience of informal caregivers to provide timely support and thereby prevent their overburden and eventually crises admissions of persons with dementia.

Methods: A human-centered design method based on co-creation with informal caregivers and professionals was used to design REMIND.

Call for Emergency Action to Limit Global Temperature Increases, Restore Biodiversity, and Protect Health.

Objective: It is known that impaired energy metabolism contributes to the neuropathology of bipolar disorder (BD). This study aimed to compare the levels of glucagon-like peptide-1 (GLP-1), adropin, and desnutrin, which have many metabolic functions besides the regulation of energy metabolism, between patients with BD and healthy controls and to investigate the related factors.

Methods: In the study group, 73 age- and sex-matched participants were included.