Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Background: People with Down syndrome have a genetically increased risk of developing early onset Alzheimer's dementia. An interview study with healthcare providers, patient representatives and employees in residential and work facilities was conducted to identify deficits in the healthcare process and approaches to overcoming them.

Method: In this study 14 semi-structured interviews were conducted and analyzed using qualitative content analysis.

Results: A lack of knowledge and experience on the part of medical service providers in dealing with and providing medical care for people with Down syndrome was identified as a key challenge. In addition, the diagnosis of dementia in people with Down syndrome is difficult for various reasons (including lack of appropriate diagnostic tools in standard care and lack of time or financial resources). Doubts were expressed about the efficacy of antidementia medications and the reasons for the increased use of sedatives were discussed. Attentive observation of behavior and involvement of caregivers, regular review and reduction of polypharmacy and the use of alternative behavior modification techniques were mentioned as possible solutions.

Conclusion: The identified deficits in the medical care of the target population and the approaches to solving them will be incorporated into the development of health policy recommendations in order to optimize the care situation of those affected in the long term.

The article reports on the evaluation of the programmes offered by the "60+Tazelenme Üniversitesi" (University of Antalya's Senior Citizens' University) from the users' perspective. 174 users (from a population of 6000 people) evaluated in a differentiated according to 18 characteristics their expectations of the programme before enrolling in the four-semester study programme and the personal benefits of the programme after completing it. The results show a highly differentiated picture of the benefits realized with regard to areas of competence and quality of life. The empirical study is placed in the broader context of geragogics and universities of the third age.

There are currently 1.8 million people in Germany affected by dementia. Despite advances in research and new treatments, there is no cure for most cases of dementia. The evidence regarding the prevention of cognitive decline in old age is unclear. In addition to the optimized adjustment of drug treatment (e.g., arterial hypertension and diabetes mellitus), preventive measures that can be influenced by individuals themselves play an important role. These include areas such as physical and cognitive activity, remedying hearing loss, sleep, social contacts, abstaining from alcohol as well as tobacco consumption and nutrition. Multimodal concepts and digital approaches appear to be promising and an increase in evidence is expected in the coming years.

Background: Geriatric patients requiring rehabilitation and admitted to short-term care after an acute inpatient hospital stay seldom receive rehabilitative services later. Rehabilitative short-term care (REKUP) supplements short-term care with rehabilitative measures, aiming to prevent functional restrictions and long-term care.

Study objective: To conduct a cost and cost-effectiveness analyses of REKUP and provide data for a nationwide rollout.

Material and methods: A non-randomized controlled prospective study was carried out. The intervention group (IG) was paired 1:2 with a control group (KG), resulting in the formation of three collectives with follow-up periods of either 30, 90 or 180 days (each with IG and KG). Using administrative claims data from the AOK Baden-Württemberg, the mean total costs from the perspective of the health insurance were calculated. A potential impact of the intervention on costs was analyzed using the difference in differences approach.

Results: The analysis comprised 129 patients (IG 43; KG 86). During the follow-up periods, the IG presented higher rates of rehabilitation and lower rates of long-term care and mortality. Regarding costs, no statistically significant differences were found between the IG and KG in any of the three collectives. For nursing care and medication costs, costs were significantly higher in the follow-up period for the KG, whereas costs for rehabilitation were significantly higher for the IG (p < 0.001).

Discussion: Patients receiving REKUP utilize rehabilitation services more often and have a lower likelihood of requiring nursing care or dying with no statistically significant differences in costs. There are potential advantages of REKUP in the target population, which warrant further investigation due to methodological limitations.

The enormous potential of cardiovascular prevention in terms of expanding the life span and health span is presently nowhere near being realized. The five classical cardiovascular risk factors body mass index (BMI), systolic blood pressure, non-high-density lipoprotein (non-HDL) cholesterol, tobacco smoking, and diabetes mellitus account for more than half of the cases of incident cardiovascular diseases. Cardiovascular prevention is also effective and adequate in seemingly healthy individuals aged 70 years or above, although the association of several cardiovascular risk factors with cardiovascular diseases is less pronounced in old age. The cardiovascular risk of seemingly healthy persons aged 70 years or above can validly be determined using the Systematic COronary Risk Evaluation-Older Persons (SCORE2-OP), leading to risk-adjusted clear treatment recommendations. National and international guidelines advocate individualized cardiovascular prevention in several domains including diet, physical activity and risk factor management through to old age.

Cognitive disorders are multifaceted and the range of neuropsychological instruments is correspondingly extensive; however, most examiners have to limit themselves to a small selection in order to master them safely. In geriatric patients the various forms and stages of dementia dominate. Delirium must be distinguished from these as an acute life-threatening event. The personal and external medical history as well as clinical observation are the first steps in the assessment of cognition; the selection of test procedures is graduated and bears the patient's benefit in mind. When compiling a toolbox for use in one's own field of work, in addition to instruments focusing on different degrees of severity, alternatives should also be considered for use in the presence of comorbidities that reduce the validity (visual, hearing and fine motor disorders) and the examination situation should be taken into account.