The internet has the potential to foster healthy lifestyles and to support chronic disease management. Older adults could benefit from using the internet and other information and communication ...technology to access health-related information and interventions available online.
The aim of this study was to investigate factors influencing internet use in older and oldest age groups and to determine the frequency of internet use for health-related purposes.
Using data from a nationally representative telephone survey of older adults aged 75 years and over, a sample of 999 people was assessed using structured clinical interviews. Descriptive and binary logistic regression analyses were performed.
Overall, 42.6% (418/999) of participants used the internet. Among those, 55.7% (233/417) searched the internet for health-related information. Regression analyses revealed that internet use was significantly associated with younger age (odds ratio OR 0.89, 95% CI 0.85-0.92; P<.001), male gender (OR 2.84, 95% CI 2.02-4.00; P<.001), higher education levels (OR 6.69, 95% CI 4.48-9.99; P<.001), a wider social network (OR 1.04, 95% CI 1.01-1.07; P=.01), higher health-related quality of life (OR 1.02, 95% CI 1.00-1.03; P=.006), lower levels of depressive symptoms (OR 0.89, 95% CI 0.80-0.99; P=.04), and higher rates of chronic illness (OR 1.12, 95% CI 1.04-1.21; P<.004).
This study provides population-representative data on internet use in old age in Germany. People in the older and oldest age groups participate in online activities. Understanding the factors that are associated with older adults internet use can contribute to developing tailored interventions and eHealth (electronic health) services to improve well-being in older adults.
Abstract
Background
Neuropsychiatric symptoms (NPS) are common in pre‐dementia state and are associated with an increased risk of dementia. The concept of Mild Behavioral Impairment (MBI) addresses ...this circumstance. However, to date, instruments that measure MBI in a standardized method are lacking. Therefore, the Mild Behavioral Impairment Checklist (MBI‐C) was developed on the basis of the MBI diagnostic criteria. Our aim was to psychometrically evaluate the German version of the MBI‐C.
Method
We interviewed 86 dyads of individuals with either subjective cognitive impairment (SCD), mild cognitive impairment (MCI), or cognitively healthy individuals, paired each of them with a relative and test the reliability, validity and acceptance of the MBI‐C.
Result
The internal consistency of both MBI‐C versions were at a questionable to acceptable level (α = 0.64‐0.86) and the interrater reliability was good to excellent (patients: ICC = 0.94, CI 0.91–0.96; informants: ICC = 0.86, CI 0.79–0.90). Informant‐rated MBI‐C correlated strongly with the Neuropsychiatric Inventory (NPI) total score (r = 0.51; p ≤.001). All participants found the MBI‐C acceptable.
Conclusion
The German MBI‐C is an instrument to assess MBI in healthy individuals, individuals with SCD, and those with MCI. It has acceptable psychometric properties. Further studies should address a larger sample of individuals in a pre‐dementia state to confirm the findings of our study. Moreover, the factor structure should be investigated.
Abstract
Background
Obesity is one of the most common and relevant health problems in need of urgent action in Germany. General practitioners (GPs) are the initial contact and thus one of the most ...important starting points for the successful treatment of overweight and obesity. The aim of the study was to assess the treatment practice and attitudes towards patients with obesity in primary health care in Germany.
Methods
Analyses were based on baseline data of the INTERACT trial of 47 GPs in central Germany. Stigmatizing attitudes were identified using the Fat Phobia Scale (FPS). In addition, questionnaires including sociodemographic information, attribution of causes of obesity, referral behavior and clinical activities were completed. Statistical investigations include descriptive analysis, principal component analysis, inference statistics and linear regression models.
Results
GPs rated the quality of medical care for patients with obesity in Germany as below average. The FPS score revealed a value of 3.70, showing that GPs’ attitudes towards patients with obesity are stigmatizing. Younger GP age, male gender and a lower number of referrals to specialists were associated with higher levels of stigmatizing attitudes.
Conclusion
Weight-related stigmatization has an impact on medical treatment. Obesity management guides would help to increase knowledge and reduce weight-related stigmatization in primary care, thereby improving medical care for obese and overweight patients.
To perform a systematic review and quantitative synthesis of studies on recent trends in dementia incidence in high-income countries (HIC), considering study quality.
PubMed and Web of Science were ...searched for eligible studies, that is, population-based/community-based prospective cohort studies investigating dementia incidence with similar methods over time, published after 1990. Study selection, data extraction, and quality assessment were performed independently by two investigators. Random-effect meta-analysis and meta-regression were used to estimate incidence change (IC) and to explore associations with study attributes. PRISMA standards were followed.
The systematic review included seven studies (42,485 individuals), and the meta-analysis included five studies of sufficient quality. Relating dementia incidence of later cohorts to earlier cohorts (reference) yielded a nonsignificant decrease across HIC (IC =0.82; 95% CI 0.51-1.33), with high heterogeneity (
=94.9%,
<0.001) and without publication bias (Egger's
=-1.77;
=0.18). Excluding the Japanese Hisayama study, the only study suggesting an increase, indicated borderline evidence for a decrease across Western HIC (IC =0.69; 95% CI 0.47-1.00;
=88.1%,
<0.001; Egger's
=-0.34,
=0.77), again with high heterogeneity. Meta-regression did not reveal an association of incidence rate with calendar year or study attributes; however, analyses were low powered.
There is evidence of favorable trends in dementia incidence in Western HIC (stabilizing/decreasing). Reverse trends may occur in HIC of other regions, as exemplified by Japan. However, study number was small and heterogeneity was high. Further cohort studies using consistent methods are needed to draw definite conclusions. Our work may inform such future studies.
Assessment of the practicability and acceptance of a guide, which was created based on the Dialectic Behavioral Therapy (DBT) regarding interactions, attitudes and basically overarching therapeutic ...interventions (GiMa-Therapy-Basics, GMTB) METHODS: Written survey of clinic staff (n = 83) from different professions as experts based on training and experienced in using the guide.
Experts reported a high user acceptance. The applicability in psychiatry was estimated as high across psychiatric disorders.
Guides based on mindfulness such as the GMTB constitute a promising basis to improve the work with seriously ill patients in psychiatry.
Early during the pandemic and the following protective countermeasures, an interest in the consequences of the enacted restriction of social contacts for the mental health of the population arose. ...Loneliness describes the perceived quality of one's own contacts and relationships with other individuals. Several prior studies reported associations of loneliness with different somatic and psychiatric disorders.
To analyse the frequency of loneliness and its association with depression and anxiety symptoms in the first wave of the pandemic in Germany in May 2020.
The German National Cohort (NAKO) had recruited and examined 205,000 individuals aged 20 to 69 years in 18 study centres across Germany between 2014 and 2019. The follow-up examination was temporarily stopped due to the pandemic between March and July 2020. In this period a COVID-related questionnaire was developed and sent to all participants. We analysed the first 113,928 questionnaires that were sent back within four weeks in May 2020. Loneliness was assessed with the three-item UCLA Loneliness Scale and anxiety and depression symptoms were collected using the PHQ‑9 and GAD‑7 scales from the Patient Health Questionnaire.
Among the NAKO participants, 31.7% reported to be lonely in May 2020. Women and young adults reported more loneliness than men and older adults. With increasing scores of loneliness, the severity of depression and anxiety symptoms also steadily increased. Individuals who were lonely during the pandemic had already reported higher PHQ‑9 and GAD‑7 scores during the baseline examination on average 2.5 years earlier, compared to those who did not feel lonely.
Among participants of the German National Cohort, we observed an increase in loneliness during the first wave of the SARS-CoV‑2 pandemic in spring 2020 and a strong relationship of increasing loneliness with decreasing mental health.
Highlights • School nonresponse in a survey on students’ substance use (ESPAD study) was simulated. • Systematic exclusion of schools resulted in significant changes of prevalences. • The resulting ...changes were small overall. • Even a reduced number of schools may be sufficient to gain valid estimates.
This study investigates pathways from alcohol outcome expectancies to alcohol-related problems (ARPs), considering alcohol volume and episodic heavy drinking (EHD) as potential mediators. It is ...further examined whether these pathways vary by age. The population-based sample comprised 6,823 individuals aged 18 to 64 years reporting alcohol use in the past year. Direct and indirect effects of five alcohol expectancies (social assertiveness, tension reduction, sexual enhancement, cognitive impairment, aggression) and alcohol use (average daily intake, EHD) on a latent measure of ARPs (six items of the Alcohol Use Disorders Identification Test) were investigated. A multiple-group structural equation model with three age groups (18 to 24, 25 to 44, 45 to 64 years) was examined. In individuals aged 18 to 24 years, social assertiveness expectancies were positively associated with average intake and EHD, which in turn were associated with more ARPs. In addition, expectancies related to cognitive impairment and aggression were directly linked to more ARPs without mediation in this age group. In individuals aged 25 years and older, tension reduction expectancies were associated with more ARPs through increased average intake. In contrast, high scores on cognitive impairment were associated with lower average intake and in turn with fewer ARPs. Challenging expectancies of sociability in young and expectancies of relaxation in mid adulthood might help decrease high-risk drinking and subsequently ARPs. Considering negative alcohol expectancies may help to identify younger individuals at high risk for ARPs, even if they have not previously exhibited repeated excessive drinking.
In Sweden, alcohol abstention has increased over the last 20 years and consumption has recently decreased after a peak in 2004. To understand the dynamics of these trends the present study aims at ...estimating age, period and cohort (APC) effects on trends in alcohol use prevalence as well as overall and beverage-specific volume of drinking over the last three decades.
APC analysis of seven cross-sectional surveys from 1979 to 2011 was conducted using cross-classified random effects models (CCREMs) by gender. The nationally representative samples comprised 77,598 respondents aged 16-80 years. Outcome measures were 30-day prevalence of alcohol use and overall as well as beverage-specific alcohol volume.
Trends in prevalence, overall and beverage-specific volume were significantly affected by APC. The period effects of prevalence and overall volume show a small decline after an increase up to the year 2005. Mean beer and wine volume levelled off after a peak in 2005 and volume of spirits drinking decreased constantly. Predicted alcohol prevalence rates in male cohorts (1945-1985) remained generally at the same level, while they declined in post-World War II female generations. Results point to high overall and beverage-specific consumption among cohorts born in the 1940s, 1950s and 1980s.
High consuming cohorts of the 1940-1950s were key in rising consumption up to 2005. Progression through the life course of these cohorts, a decrease in prevalence and drinking volume in successive cohorts seem to have contributed to the recent downward trend in alcohol use in Sweden.
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