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Author: Jens Bohlken (26)


Jan
2018

To provide pilot data for the safety and efficacy of EGb 761 in the oldest-old patients (aged 80 or older).
In a retrospective analysis, we compared treatment outcomes with EGb 761 or donepezil over 12 months in 189 patients aged 80 years or older suffering from Alzheimer's disease (AD).
Over 12 months, there was no significant difference in cognitive decline, measured with the mini-mental state examination (MMSE) score, between donepezil and EGb 761 (p = 0.

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Jan
2018

Supplementation of spermidine, an autophagy-inducing agent, has been shown to protect against neurodegeneration and cognitive decline in aged animal models. The present translational study aimed to determine safety and tolerability of a wheat germ extract containing enhanced spermidine concentrations. In a preclinical toxicity study, supplementation of spermidine using this extract did not result in morbidities or changes in behavior in BALBc/Rj mice during the 28-days repeated-dose tolerance study.

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Dec
2017

The aim of this study is to identify the prevalence and risk factors of documented delirium in general practices in Germany.
The present study includes 2,194 patients over the age of 65 years with delirium and 2,194 controls without delirium from a sample of 6,180,042 patients from 1,262 general practices. Multivariate logistic regression models were fitted with delirium as a dependent variable and other disorders and drugs as potential predictors.

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Nov
2017

In 2013 and 2014 dementia diagnoses in general practitioner (GP) practices dramatically increased, a phenomenon most likely caused by monetary incentives.
Which GP practice-dependent indicators are associated with the increase in dementia diagnoses and are thus decisive factors for the way in which physicians in GP practices respond to monetary incentives?
We performed a retrospective, longitudinal analysis of 856 GP practices. The increase in dementia diagnoses was calculated by comparing the number of newly diagnosed persons with dementia (PWD) per GP practice in 2012 and 2014.

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Aug
2017

In 2013, the incidence of patients with dementia (PwD) in primary care practices (PCP) drastically increased.
(1) Is the increase also detectable in a subsample, (2) was there a comparable increase in specialist practices (SP), and (3) did the increase affect diagnostics and therapy?We analyzed billing data from 874 PCP and 141 SP (2011 to 2015) pertaining to more than 14,000 PwD/year with regard to the incidence of dementia diagnoses (ICD-10: G30, F01, F03) and antidementia prescriptions.The incidence abruptly increased by 47 % (2013) and 73 % (2014) compared to 2012.

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Jun
2017

 The aim of the present study was to examine inpatients as well as patients living at home with respect to the frequency of antipsychotic medication use and to determine the factors leading to initial use of antipsychotics following dementia diagnosis. This study included patients aged 60 years and over with an initial diagnosis of all-cause dementia (index date) by German psychiatrists in Disease Analyzer database (IMS Health). The main outcome measure was the proportion of patients who initially received an antipsychotic prescription after the index date.

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May
2017

Did the diagnostic and treatment behavior of general practitioners and specialists in patients with dementia (PWD) change in Germany over a period of 11 years (2005 vs. 2015)?We performed a retrospective, database-based evaluation of diagnostic and prescription data from more than 398 general practices (GP) and 50 specialist practices (SP).Compared to 2005, in 2015, the number of PWD had increased by 40.

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Dec
1969

High adherence and persistence are important for the efficacy of anti-dementia treatments.
The goal of this study was to analyze the association between anti-dementia treatment persistence and daily dosage of the first prescription in patients treated in neuropsychiatric practices in Germany.
This study included patients aged 60 years or over who were diagnosed with Alzheimer's disease and received anti-dementia prescriptions (galantamine, donepezil, memantine, and rivastigmine) for the first time between 2005 and 2014.

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Dec
1969

In healthy older adults, resveratrol supplementation has been shown to improve long-term glucose control, resting-state functional connectivity (RSFC) of the hippocampus, and memory function. Here, we aimed to investigate if these beneficial effects extend to individuals at high-risk for dementia, i.e.

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Mar
2017

[The Influence of Caseload on Continuous Treatment with Antidementia Drugs].

Fortschr Neurol Psychiatr 2017 Mar 20;85(3):156-162. Epub 2017 Mar 20.
Jens Bohlken, Karel Kostev
 The goal of this study is to investigate the impact of the number of dementia cases in general and specialist practices on the continuity of treatment with antidementia drugs. Period between 2004 and 2013: 1116 general practices, 200 specialist practices, 37 178 dementia cases; observation period: 36 months. Practice groups with 1 - 9, 10 - 20, 21-s49, and ≥ 50 dementia cases.

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Dec
1969

Dementia is a chronic disease associated with numerous cardiovascular disorders.
To analyze the prevalence of cardiovascular drug use in dementia patients treated in general practices in Germany.
The present study included patients who were diagnosed with dementia (Alzheimer's disease, vascular dementia, or unspecified dementia) in 2015.

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Apr
2017

To study the impact of the use of antidepressants on dementia in German patients with depression treated in general (GPs) or psychiatric practices (PPs).
Patients with a first-time documentation of depression with known severity level between 2010 and 2013 (index date) were identified by 1,126 general practitioners and 176 psychiatrists in the IMS Disease Analyzer database. We included patients between the ages of 60 and 80 years who had not previously received prescriptions for antidepressant drugs and had not been diagnosed with all-cause dementia prior to or on the index date.

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Dec
1969

Mild cognitive impairment (MCI) is a common mental disorder affecting around 16% of elderly people without dementia. MCI is considered an intermediate state between normal cognition and dementia.
To analyze risk factors for the development of MCI in German primary care practices.

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Jan
2017

To analyze prescription patterns and drug costs in German patients with dementia who are in home-care settings and nursing homes.
The present retrospective study based on the Disease Analyzer epidemiological database and included 41,064 patients treated by general practitioners (GPs) and 20,649 patients treated by psychiatric practitioners (PPs), who were diagnosed with dementia in 2014. Four different types of antidementia therapy were included in the analysis.

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Jan
2017

 To estimate the rate of progression of mild cognitive impairment (MCI) to dementia and to identify potential risk factors in patients in German primary-care practices. From those seen at 723 general physicians' practices, this study included 4057 patients aged 40 years and above who were initially diagnosed with MCI between 2000 and 2014. The primary outcome was diagnosis of all-cause dementia recorded between the index date and the end of the five-year follow-up.

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Nov
2016

To analyze the duration of treatment with antipsychotics in German dementia patients.
This study included patients aged 60 years and over with dementia who received a first-time antipsychotic prescription by psychiatrists between 2009 and 2013. The main outcome measure was the treatment rate for more than 6 months following the index date.

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Oct
2016

The goal of this study was to estimate the rate of the progression of mild cognitive impairment to dementia and identify the potential risk factors in German specialist practices from 2005 to 2015. This study included 4633 patients aged 40 years and over from 203 neuropsychiatric practices, who were initially diagnosed with mild cognitive impairment between 2005 and 2013. The primary outcome was diagnosis of all-cause dementia recorded in the database until the end of the five-year follow-up period.

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Nov
2016

The goal of this study was to estimate the prevalence of and risk factors for diagnosed depression in heart failure (HF) patients in German primary care practices.
This study was a retrospective database analysis in Germany utilizing the Disease Analyzer® Database (IMS Health, Germany). The study population included 132,994 patients between 40 and 90 years of age from 1,072 primary care practices.

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May
2016

The aims of the present study are to determine what proportion of patients with dementia receives antidepressants, how long the treatment is administered, and what factors increase the risk of discontinuation.
The study was based on Disease Analyzer database and included 1,203 general practitioners (GP) and 209 neurologists/psychiatrists (NP). 12,281 patients with a diagnosis of dementia and an initial prescription of an antidepressant drug between January 2004 and December 2013 were included.

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Apr
2016

Low-normal concentrations of vitamin B-12 (VitB12) may be associated with worse cognition. However, previous evidence has been mixed, and the underlying mechanisms remain unclear.
We determined whether serum VitB12 concentrations within the normal range were linked to memory functions and related neuronal structures in patients with mild cognitive impairment (MCI).

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Dec
1969

Dementia is a psychiatric condition the development of which is associated with numerous aspects of life. Our aim was to estimate dementia risk factors in German primary care patients.
The case-control study included primary care patients (70-90 years) with first diagnosis of dementia (all-cause) during the index period (01/2010-12/2014) (Disease Analyzer, Germany), and controls without dementia matched (1:1) to cases on the basis of age, sex, type of health insurance, and physician.

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Oct
2017

The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance.

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Dec
2015

In 2011, about 1.1-1.4 million patients with dementia were living in Germany, a number expected to rise to three million by 2050.

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Aug
2015

Continuous treatment is an important indicator of medication adherence in dementia. However, long-term studies in larger clinical settings are lacking, and little is known about moderating effects of patient and service characteristics.
Data from 12,910 outpatients with dementia (mean age 79.

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Aug
2011

To compare the benefits and harms of a Dutch 10-session Community Occupational Therapy programme for patients with Alzheimer's disease with the impact of a one session consultation at home in German routine healthcare.
A seven-centre, parallel group, active controlled randomised controlled trial. Patients and carers were not masked.

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Jul
2011

The objective of this study was to detect regional variability in anti-dementia drug prescriptions in metropolitan and rural regions of Germany in order to assess the widespread assumption that dementia treatment coverage is lower in rural areas because of the lower physician density in ambulatory care, especially for neuropsychiatrists.
We compared the 2007 prescription rates for Donepezil, Rivastigmine, Galantamine and Memantine in defined daily doses per capita in the population aged 65 and older insured in the German Statutory Health Insurance. The prescription data for the States of Berlin and Hamburg were compared with those in the adjacent rural-type States of Brandenburg and Lower Saxony.

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