Differential Risk of Incident Alzheimer's Disease Dementia in Stable Versus Unstable Patterns of Subjective Cognitive Decline.

Background: It is unknown whether longitudinal stability versus instability in subjective cognitive decline (SCD) is a modifying factor of the association between SCD and risk of incident Alzheimer's disease (AD) dementia.

Objective: We tested the modifying role of temporal stability of the SCD report on AD dementia risk in cognitively normal elderly individuals.

Methods: We analyzed data of 1,990 cognitively normal participants from the longitudinal AgeCoDe Study.

Longitudinal Predictors of Institutionalization in Old Age.

Objective: To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach.

Methods: In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves.

Gender differences in the effect of social support on health-related quality of life: results of a population-based prospective cohort study in old age in Germany.

Purpose: The causality between social predictors and HRQoL in old age remains almost unclear as only a few studies have examined the influence of social support on HRQoL in a longitudinal setting. Moreover, available studies investigating gender differences in the effect of social support on HRQoL in old age have been solely cross-sectional. Consequently, the aim of this study was to examine whether social support affects health-related quality of life (HRQoL) in old age and whether this effect is moderated by gender.

Effectiveness of a primary care based complex intervention to promote self-management in patients presenting psychiatric symptoms: study protocol of a cluster-randomized controlled trial.

Background: Anxiety, Depression and Somatoform (ADSom) disorders are highly prevalent in primary care. Managing these disorders is time-consuming and requires strong commitment on behalf of the General Practitioners (GPs). Furthermore, the management of these patients is restricted by the high patient turnover rates in primary care practices, especially in the German health care system.

[Diagnosing and diagnosis coding of dementias in claims data from German statutory health insurance].

Objective: On the basis of data from one German Sickness Fund we analyzed which medical discipline coded the incident diagnosis of dementia in ambulatory medical care in Germany, which type of dementia was coded and how the initial code eventually changed during the year of incidence.

Methods: Claims data of 1,848 insured people aged ≥ 65 years in 2004 with incident dementia were analyzed by means of descriptive statistics.

Results: The diagnosis within the first quarter of the incidence year was coded by the GP in 71%, by a psychiatrist or neurologist in 14%, by both in 6% and by other disciplines in 9% of the cases.

Specialist involvement and referral patterns in ambulatory medical care for patients with dementia in Germany: results of a claims data based case-control study.

Background: To analyze the referral processes from general practitioners to specialists and among specialists for dementia patients in the time periods before, during and after the diagnosis in Germany.

Methods: In this case-control study claims data from 1,848 insurants with incident dementia aged 65 years and more and 7,392 matched controls were compared over a two-year period covering the pre-incidence, incidence and post-incidence time periods.

Results: We found an increase in referrals of 30% in the incidence quarter, mainly from general practice to neuropsychiatry and from there to radiology.

Antidementia drug prescription sources and patterns after the diagnosis of dementia in Germany: results of a claims data-based 1-year follow-up.

We examined the patterns of prescription for antidementia drugs by German physicians with special reference to source of prescription, appropriateness of drugs and dosages and continuity of prescription patterns. The study is based on claims data of all 1848 incident cases in persons aged 65 years and older from a nationwide operating statutory health insurance company in the years 2004-2006. Inclusion criteria were one International Statistical Classification of Diseases and Related Health Problems 10th Revision code for dementia in at least three of four consecutive quarters and four quarters without such a code beforehand.

Ambulatory health services utilization in patients with dementia - Is there an urban-rural difference?

Background: Due to demographic changes and an un-equal distribution of physicians, regional analyses of service utilization of elderly patients are crucial, especially for diseases with an impact like dementia. This paper focuses on dementia patients. The aim of the study is to identify differences in service utilization of incident dementia patients in urban and rural areas.

Utilization patterns of ambulatory medical care before and after the diagnosis of dementia in Germany--results of a case-control study.

Aims: To analyze how the diagnosis of dementia changes the utilization of the ambulatory medical care services in the German statutory health insurance.

Methods: In this case-control study, claims data of 1,848 insurants aged >or=65 years with incident dementia and 7,392 matched controls were compared regarding their utilization of ambulatory medical care services.

Results: We found an increase in the utilization of ambulatory medical care services by demented patients of 50% in the year before and of 40% in the year after the incidence, predominantly in primary care and neurology/psychiatry settings.