Journal of health monitoring最新文献

Background: The longitudinal population-based study Gesundheit 65+ aimed to close data gaps on health and well-being of older adults in Germany in times of the COVID-19 pandemic.

Methods: The target population comprised persons 65 years and older permanently residing in Germany and with sufficient German language skills. Proxy interviews were possible and consent from legal representatives was obtained as necessary in order to enable participation of physically or cognitively impaired persons. A two-stage sampling process, was used to draw 128 primary sample points (PSUs) and within these PSUs sex- and age-stratified random samples were drawn from population registries. A mixed-mode design was applied to contact the study population and for data collection. Data were collected between June 2021 and April 2023. Participants were surveyed a total of four times at intervals of four months. At month 12 participants were offered a home visit including a non-invasive examination. Data on all-cause mortality and information on neighborhood social and built environment as well as health insurance data will be linked to primarily collected data at the individual level.

Discussion: Results will inform health politicians and other stakeholders in the care system on health and health care needs of older people in Germany.

Background: Dementia poses a growing challenge for individuals, healthcare, social support, and society amidst the ongoing ageing of populations. To evaluate the care requirements and social implications of dementia in Germany, reliable statistics regarding its current and future occurrence are necessary.

Methods: Using existing data sources and recent research results, this paper compiles and analyses relevant statistics on the occurrence of dementia in Germany, presents protective and risk factors, and options for care provision.

Results: Recent projections indicate a potential surge in the number of dementia patients in Germany, predicted to rise from 1.7 million at present to up to 3.0 million by the year 2070. Cognitive and motor deterioration and behavioural changes associated with dementia lower the ability to live independently. These changes are often tied to social exclusion and stigma and, particularly in the severe phase of the disease, necessitate extensive medical and care requirements. This contributes to dementia being one of the most costly diseases at old age from an overall societal perspective. Currently, there are no curative treatment options available.

Conclusions: To reduce the increase in the number of dementia patients and associated costs in the future, preventive approaches, particularly promoting a healthy lifestyle, may prove effective. Simultaneously, the healthcare system, society, and caregivers must prepare for the increasing number of dementia patients. Improved diagnostics, new forms of therapy, and social innovations that support those who are affected and their relatives can help reduce the burden of dementia and its associated costs.

Background: Living wills regulate medical decisions in emergency situations. Those who create a living will can have it registered voluntarily in the Central Register of Lasting Powers of Attorney. Little is known about the general prevalence of living wills.

Methods: The German Ageing Survey is an ongoing, population-representative study. 4,185 people aged 50 and older were surveyed about living wills in 2020/2021.

Results: 44.8 % of people aged 50 and older have a living will, women more often than men (50.1 % vs. 39.2 %), older people more often than middle-aged people. Educational differences do not exist.

Conclusions: Living wills increase the autonomy in medical emergency situations because the patient's wishes are specified in written form. People of all age groups should inform themselves about the significance of living wills and should seek advice about the contents, for example from the general practitioner or one's own health insurance.

Background: The demographic change makes comprehensive health reporting on health at older age an important topic.

Methods: Gesundheit 65+ is a longitudinal epidemiological study on the health status of persons aged 65 and older in Germany. Based on a two-stage stratified random sample from 128 local population registers, 3,694 persons participated in the baseline survey between June 2021 and April 2022 (47.9 % women, mean age 78.8 years). Weighted prevalences for 19 indicators of the baseline survey are presented overall and by age, sex, education and region of residence.

Results: Overall, 52.0 % of all participants of the baseline survey reported to be in good or very good health, and 78.5 % reported high or very high satisfaction with their life. This was in contrast to the large number of health/functional limitations whose prevalences ranged from 5.3 % for severe visual limitations to 69.2 % for multimorbidity. The health status of women was clearly worse than that of men, and the health status of persons aged 80 and older was worse than between 65 and 79 years of age. There was a clear educational gradient evident in the health status, but there were no differences between West and East Germany.

Conclusions: Gesundheit 65+ provides a comprehensive database for description of the health status of old and very old people in Germany, on the basis of which recommendations for action for policy and practice can be derived.

Background: UV radiation can cause serious skin and eye diseases, especially cancers. UV-related skin cancer incidences have been increasing for decades. The determining factor for this development is the individual UV exposure. Climate change-induced changes in atmospheric factors can influence individual UV exposure.

Methods: On the basis of a topic-specific literature research, a review paper was prepared and supplemented by as yet unpublished results of the authors' own studies. The need for scientific research and development is formulated as well as primary prevention recommendations.

Results: Climate change alters the factors influencing UV irradiance and annual UV dose in Germany. First evaluations of satellite data for Germany show an increase in mean peak UV irradiance and annual UV dose for the last decade compared to the last three decades.

Conclusions: The climate change-related influences on individual UV exposure and the associated individual disease incidence cannot yet be reliably predicted due to considerable uncertainties. However, the current UV-related burden of disease already requires primary preventive measures to prevent UV-related diseases.

Background: Climate change has already led to a significant temperature increase in Germany. The average temperature in the past decade was approximately 2°C above the pre-industrial level and eight of the ten hottest summers since the beginning of systematic weather records in 1881 were recorded in the last 30 years.

Methods: Based on a selective literature search and authors' own results, the article summarises the current state of knowledge on heat and its health impacts for Germany, addresses adaptation measures, and gives an outlook on implementation and research questions.

Results: Heat can aggravate pre-existing conditions such as diseases of the cardiovascular system, the respiratory tract, or the kidneys and trigger potentially harmful side effects for numerous medications. A significant increase in mortality is regularly observed during heat events. Previous approaches to mitigate the health impact of high temperatures include, for example, the heat alerts of the German Meteorological Service and recommendations for the preparation of heat-health action plans.

Conclusions: Evidence on health impacts of heat and awareness of the need for heat-related health protection have grown in recent years, but there is still a need for further action and research.

[This corrects the article on p. 103-121 in vol. 8, PMID: 37799533.].

Background: Climate change is a major threat to human health and has direct and indirect impacts on the human psyche.

Methods: To assess the state of knowledge on the impact of climate change on mental health in Germany, a scoping review was conducted for the focus topics extreme weather events, temperature increase, intra-psychological processing, sociological aspects, and resilience factors. Ten studies met the inclusion criteria of the searches in the databases Academic Search Complete, CINAHL, PubPsych, PubMed, and PsychInfo. The majority of the studies looked at correlative relationships in a cross-sectional design.

Results: There are indications of an accumulation of psychiatric disorders after extreme weather events; in addition, the risk of suicide increases with higher temperatures and it appears there is an increase in aggressive behaviour. The majority of people surveyed in Germany report concerns about the consequences of climate change, although these currently rarely lead to clinically significant impairments in mental health.

Conclusions: Overall, the evidence for Germany must be classified as insufficient. In addition to the absolute priority of climate protection (mitigation) by reducing emissions, there is a particular need for additional research with a focus on vulnerable groups and possibilities for prevention and adaptation.

Background: The impacts of air pollutants on health range from short-term health impairments to hospital admissions and deaths. Climate change is leading to an increase in air pollution.

Methods: This article addresses, based on selected literature, the relationship between climate change and air pollutants, the health effects of air pollutants and their modification by air temperature, with a focus on Germany.

Results: Poor air quality increases the risk of many diseases. Climate change is causing, among other things, more periods of extreme heat with simultaneously increased concentrations of air pollutants. The interactions between air temperature and air pollutants, as well as their combined effects on human health, have not yet been sufficiently studied. Limit, target, and guideline values are of particular importance for health protection.

Conclusions: Measures to reduce air pollutants and greenhouse gases must be more strictly implemented. An essential step towards improving air quality is setting stricter air quality limit values in Europe. Prevention and adaptation measures should be accelerated in Germany, as they contribute to climate-resilient and sustainable healthcare systems.