Zeitschrift Fur Gerontologie Und Geriatrie最新文献

Grandparenthood in general and caring for grandchildren in particular are fields that are very well-illuminated in gerontological terms. Grandchild care is regarded as active aging in sociopolitical terms and is idealized. Grandparents themselves also attach great normative importance to it. Differentiated gerontological findings relativize the positive connotations and clearly refer to welfare and policy regimes as well as life situations as contexts. From the reported studies the article derives the need to supplement the previous findings with further inductive research, particularly from the perspective of grandparents with a low socioeconomic status.

Background: Neuroanatomical parameters deteriorate with age and this process varies among individuals. Gender differences in these parameters have been documented but their effects on cognition remain unclear. Physical activity, continuous learning and social interactions are recognized strategies to prevent cognitive decline.

Aim: This study investigated the effects of multidimensional training on selective attention and reaction speed in physically inactive but healthy older adults, exploring gender-specific differences in cognitive abilities.

Material and methods: The study employed a pre-post design and included a 24-week exercise program. A total of 60 participants (30 male, 30 female) aged 65-69 years completed the program, which consisted of 90 min of fitness and 90 min of recreational sports each week. Cognitive performance was assessed using the STROOP (a visual test for selective attention) and reaction time (RT) tests administered through the Vienna Test System.

Results: Significant gender differences were observed. Women were initially slower than men but significantly improved their reaction speed after the training (p < 0.001, d = 1.144). Conversely, men showed significant improvements in controlled and automated actions (p = 0.021, d = 0.5).

Discussion: Multidimensional training enhances cognitive performance in physically inactive older adults. Gender-specific differences in reaction time were confirmed, while differences in other cognitive domains were revealed. The underlying causes of these differences are still unclear, raising the question of whether training programs should be tailored differently for men and women.

Background: In recent decades social acceptance and legal equality of lesbian, gay and bisexual people (LGB) in Germany have improved. In particular, the debate on the possibility of marriage for same sex couples revealed broad social acceptance; however, health inequalities, such as in self-esteem, continue to exist in relation to heterosexual people. The LGB persons in the second half of life are particularly affected by these disadvantages because they grew up in times of greater discrimination.

Objective: This raises the central question: to what extent do improved overall social conditions affect the self-esteem of LGB people?

Material and methods: To answer this question 5 waves (2008, 2011, 2014, 2017, 2021) of the German Ageing Study (DEAS) are used to examine how the self-esteem of LGB people has changed over time and in comparison to heterosexual people. In addition to bivariate descriptions, random effects models are applied for the analysis.

Results: The self-esteem among LGB and heterosexual people increased until 2017 and then dropped slightly in 2021; however, the increase among LGB people is more pronounced, so that the difference compared to heterosexual people is no longer significant in 2017.

Conclusion: The analysis suggests that greater social openness and improved legal conditions for LGB people in the second half of life are positively related to their self-esteem, thus emphasizing the importance of public discourse for the well-being of stigmatized groups.

Complex changes of the innate and adaptive immune system occur in old age and contribute to the increased frequency and severity of infections in older adults. At the same time, chronic, subclinical inflammation occurs, which promotes age-related diseases. Age-associated changes in the immune system also influence the formation, growth and metastasis of malignant tumors. Furthermore, there are indications that the aging of the immune system contributes to the development of autoimmunity. Vaccinations are an important preventive measure for maintaining health and improving the quality of life, not only but especially in old age. The development of optimized and new vaccines for the older population has made great progress in recent years and decades; however, vaccination rates among older adults are well below target for all vaccinations.

Background: Health impairments in people in the second half of life are generally associated with lower online activities; however, during the COVID-19 pandemic individuals with health-related limitations in daily activities may have perceived an added benefit in internet use, potentially leading to a reduction in health-related digital inequalities.

Objective: The study examines whether and to what extent the COVID-19 pandemic has altered the relationship between limitations in daily activities and online access as well as the use of the internet for information seeking and maintaining social contacts.

Methods: Linear probability models were estimated using data from the German Ageing Survey (DEAS) from waves 6 (2017) and 7 (2020/2021).

Results: After controlling for gender, age, education, social network and income, it was found that health-related inequalities regarding internet access slightly decreased during the pandemic, while there was no significant effect of the wave on the relationship between health impairments and online activities for information seeking and maintaining contacts.

Conclusion: During the COVID-19 pandemic internet access rates and online activities increased among people with limitations in daily activities; however, health-related inequalities partially persisted. Reducing barriers to internet usage and ensuring social participation through analogue means must continue to be advanced.

Background: Little is known about how younger and older hospitalized patients differ with respect to reasons for admission, comorbidities, diagnostics, treatment and intercurrent problems.

Objective: The aim of the study was to compare the previously named characteristics in the clinical profile of patients > 90 years old (nonagenarians) with a control group of patients 70-75 years old admitted to an emergency hospital department for internal medicine and cardiology.

Material and method: The study included all consecutive nonagenarians and gender-matched control patients who were admitted during 2011. The reason for admission, comorbidities, diagnostics, treatment, intercurrent problems and discharge medication were taken from the patient records. Data on 8‑year mortality were obtained by comparison of the death data.

Results: Nonagenarians (n = 117; 81 females) had a mean age of 92 ± 2.5 years and the control patients 72 ± 1.6 years. Nonagenarians were hospitalized more often because of neurological symptoms (19% vs. 7%), suffered more from kidney failure (85% vs. 67%), heart failure (35% vs. 21%), malignancies (29% vs. 8%), dementia (28% vs. 4%) and stroke (15% vs. 6%), developed confusion more often (27% vs. 7%) and fell more often (15% vs. 0%) than control patients. Control patients had a higher body mass index (29 ± 5.3 vs. 24 ± 4.1). Nonagenarians received fewer diagnostic measures (1.6 vs. 2.3), more often intravenous fluid (77% vs. 51%), diuretics (31% vs. 18%) and physiotherapy (24% vs. 8%). Polypharmacy (> 5 medications) in the discharge letter was frequent in both groups (67% vs. 75%). The yearly mortality of the nonagenarians was 27% and of the control group 6%.

Conclusion: Acute internal diseases in nonagenarians are frequently manifested with neurological symptoms. In hospitalized nonagenarians, prevention of falls and delirium are of clinical relevance. Polypharmacy is a relevant problem in nonagenarians as well as in control patients.

Background: Health limitations affect long-term care (LTC) needs differently. For instance, people with cognitive limitations require more organizational support, whereas those with functional limitations require more personal care. While the impact of singular health limitations on LTC has been widely studied, little attention has been given to the prevalences of co-occurring health limitations that drive LTC needs.

Objectives: Our exploratory study seeks to address the gap in understanding the prevalence of multiple, intertwining health limitations that contribute to the need for LTC.

Materials and methods: We used data from the German Medical Service (MD). The MD assesses LTC needs and assigns care grades, which serve as the basis for LTC insurance benefits. The available data contains all assessments in 2019 of adults living in Bavaria (the largest state in Germany), focusing on those with first-time LTC needs (N = 101,227). Using latent class analysis, we identified combinations of limitations across six health dimensions (e.g., mobility, cognition).

Results: Among first-time LTC recipients, 5 distinct classes of care needs were identified. Two classes reflect single limitations: mobility limitations, and the need for assistance with medical therapy. Three classes point to various combinations of limitations. While classes differed in size, they also varied significantly by age, gender, and care grade.

Conclusion: The co-occurrence of health limitations is not an exception but a central feature of LTC needs even at the initial stages of dependency, emphasizing the importance of tailored care strategies. These insights can help local authorities and care providers offer targeted LTC services more strategically.

Background: Models that actively involve people living with dementia and their relatives as well as experts from various healthcare settings in research have not yet been implemented in the context of health services research in the German language. Such models are necessary to actively involve the perspectives of "co-researchers" and address topics pertaining to the everyday lives of people living with dementia and their relatives as well as individuals working in healthcare practice.

Objective: The aim of this study is to develop a preliminary framework for joint research.

Material and methods: The procedure used in this research features a participatory approach involving stakeholders recruited from different groups of people, including people living with dementia, their relatives and experts from long-term and acute inpatient settings. A participatory research model was translated into German and discussed, debated and agreed upon in virtual meetings with the stakeholders. The results were discussed in a workshop with the goal of determining the types of support that were considered necessary for "co-researchers". All meetings were documented in protocols that were analyzed both deductively and inductively.

Results: A total of 13 stakeholders participated in this project. The preliminary framework for joint research contains basic principles, activities and support requirements for joint research.

Conclusion: In addition to experts from various healthcare settings, people living with dementia and their relatives both want to and can be actively involved in research. To refine the preliminary framework, it continues to be tested and developed in the context of participatory research projects at the German Center for Neurodegenerative Diseases (DZNE) site Witten.