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Articles by T Luck
Total Records ( 2 ) for T Luck
  M Luppa , T Luck , S Weyerer , H. H Konig , E Brahler and S. G. Riedel Heller

Objective: in the past decades, many studies have examined predictors of nursing home placement (NHP) in the elderly. This study provides a systematic review of predictors of NHP in the general population of developed countries.

Design: relevant articles were identified by searching the databases MEDLINE, Web of Science, Cochrane Library and PSYNDEXplus. Studies based on population-based samples with prospective study design and identification of predictors by multivariate analyses were included. Quality of studies and evidence of predictors were determined.

Results: thirty-six studies were identified; one-third of the studies were of high quality. Predictors with strong evidence were increased age, low self-rated health status, functional and cognitive impairment, dementia, prior NHP and a high number of prescriptions. Predictors with inconsistent results were male gender, low education status, low income, stroke, hypertension, incontinence, depression and prior hospital use.

Conclusions: findings suggested that predictors of NHP are mainly based on underlying cognitive and/or functional impairment, and associated lack of support and assistance in daily living. However, the methodical quality of studies needs improvement. More theoretical embedding of risk models of NHP would help to establish more clarity in complex relationships in using nursing homes.

  F Jessen , B Wiese , C Bachmann , S Eifflaender Gorfer , F Haller , H Kolsch , T Luck , E Mosch , H van den Bussche , M Wagner , A Wollny , T Zimmermann , M Pentzek , S. G Riedel Heller , H. P Romberg , S Weyerer , H Kaduszkiewicz , W Maier , H Bickel and Cognition and Dementia in Primary Care Patients Study Group for the German Study on Aging

Context  Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD).

Objectives  To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI.

Design  Longitudinal cohort study with follow-up examinations at 11/2 and 3 years after baseline.

Setting  Primary care medical record registry sample.

Participants  A total of 2415 subjects without cognitive impairment 75 years or older in the German Study on Aging, Cognition and Dementia in Primary Care Patients.

Main Outcome Measures  Conversion to any dementia, dementia in AD, or vascular dementia at follow-up 1 or follow-up 2 predicted by SMI with or without worry at baseline and at follow-up 2 predicted by different courses of SMI at baseline and MCI at follow-up 1.

Results  In the first analysis, SMI with worry at baseline was associated with greatest risk for conversion to any dementia (hazard ratio [HR], 3.53; 95% confidence interval [CI], 2.07-6.03) or dementia in AD (6.54; 2.82-15.20) at follow-up 1 or follow-up 2. The sensitivity was 69.0% and the specificity was 74.3% conversion to dementia in AD. In the second analysis, SMI at baseline and MCI at follow-up 1 were associated with greatest risk for conversion to any dementia (odds ratio [OR], 8.92; 95% CI, 3.69-21.60) or dementia in AD (19.33; 5.29-70.81) at follow-up 2. Furthermore, SMI at baseline and amnestic MCI at follow-up 1 increased the risk for conversion to any dementia (OR, 29.24; 95% CI, 8.75-97.78) or dementia in AD (60.28; 12.23-297.10), with a sensitivity of 66.7% and a specificity of 98.3% for conversion to dementia in AD.

Conclusion  The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.

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