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Then F.S.,University of Leipzig | Luck T.,University of Leipzig | Angermeyer M.C.,Center for Public Mental Health | Angermeyer M.C.,University of Cagliary | Riedel-Heller S.G.,University of Leipzig
Age and Ageing | Year: 2016

Objectives: even though a great number of research studies have shown that high education has protective effects against dementia, some studies did not observe such a significant effect. In that respect, the aim of our study was to investigate and compare various operationalisation approaches of education and how they impact dementia risk within one sample.Methods: data were derived from the Leipzig longitudinal study of the aged (LEILA75+). Individuals aged 75 and older underwent six cognitive assessments at an interval of 1.5 years and a final follow-up 15 years after the baseline assessment. We operationalised education according to different approaches used in previous studies and analysed the impact on dementia incidence via multivariate cox regression modelling.Results: the results showed that whether education is identified as significant protector against dementia strongly depends on the operationalisation of education. Whereas the pure number of years of education showed statistically significant protective effects on dementia risk, other more complex categorical classification approaches did not. Moreover, completing >10 years of education or a tertiary level seems to be an important threshold to significantly reduce dementia risk.Conclusion: findings suggest a protective effect of more years of education on a lower dementia risk with a particular critical threshold of completing >10 years of education. Further, the findings highlight that, when examining risks and protective factors of dementia, a careful consideration of the underlying definitions and operationalisation approaches is required. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Lobner M.,University of Leipzig | Luppa M.,University of Leipzig | Matschinger H.,University of Leipzig | Konnopka A.,University of Hamburg | And 6 more authors.
Journal of Psychosomatic Research | Year: 2012

Objective: This study examines longitudinal depression and anxiety rates in disc surgery patients in comparison to the general population, the change and associated determinants of depression and anxiety over time. Methods: The longitudinal observational study refers to 305 consecutive disc surgery patients (age range: 18-55. years). Depression and anxiety was assessed with the Hospital Anxiety and Depression Scale. Random effects regression models for unbalanced panel data were used. Results: Depression and anxiety decreases significantly during nine months after surgery. Depression rates vary between 23.6% (T0), 9.6% (T1) and 13.1% (T2). Only at T0 the depression rate differs significantly from the general population. Anxiety rates range between 23.7% (T0), 10.9% (T1) and 11.1% (T2). Compared to the general population anxiety rates are significantly higher at all three assessment points. Risk factors for anxiety or depression at the time of the surgery are psychiatric comorbidity before surgery, higher age, female gender, lower educational level, lower physical health status and higher pain intensity. Regarding depression and anxiety in the course of time significant time interactions were found for the existence of other chronic diseases, higher pain intensity and vocational dissatisfaction. Conclusions: Compared to the general population patients undergoing herniated disc surgery are often affected by depression and anxiety during hospital treatment and also in the course of time. Multimodal diagnostics regarding psychological well-being, pain and physical health status may help to identify this risk group. The assistance by mental health professionals during hospital and rehabilitation treatment may reduce poor postoperative outcome. © 2011 Elsevier Inc.

Zieger M.,University of Leipzig | Luppa M.,University of Leipzig | Meisel H.J.,Berufsgenossenschaftliche Kliniken Bergmannstrost | Winkler D.,University of Leipzig | And 6 more authors.
Journal of Occupational Rehabilitation | Year: 2011

Introduction This study examines (1) return to work (RTW) and ability to work (ATW) rates, and the association with (2) psychiatric comorbidity and (3) socio-demographic, illness-related, vocational and rehabilitation-related characteristics in herniated disc surgery patients. Methods In this longitudinal observational study 305 consecutive patients took part in face-to-face interviews during hospital stay. 277 patients also participated in a 3-month follow-up survey via telephone (drop-out rate 9%). Psychiatric comorbidity was assessed with the Composite International Diagnostic Interview (CIDI-DIA-X). Calculations were conducted via Chi-Square tests, independent T-tests and binary logistic regression analyses. Results 40.1% of the herniated disc patients in this study were able to RTW, 44.4% had regained their ATW 3 months after surgery. Psychiatric comorbidity appeared to be an important risk factor for RTW and ATW. Other risk factors were lower educational qualification, unemployment status, a lower subjective prognosis of gainful employment, a higher number of herniated discs in medical history, cervical disc surgery, and the existence of other chronic diseases, a longer hospital stay and higher pain intensity. Patients who did not RTW, or did not regain their ATW participated more often in inpatient rehabilitation. Conclusions Identifying a high risk group for RTW and ATW at an early age is of utmost importance for the purpose of improving rehabilitation effects and to make a return to the work place easier. Specific interventions, such as social-medical counselling, pain therapy and management, as well as the assistance of mental health professionals during hospital and rehabilitation treatment are recommended for this risk group. © 2010 Springer Science+Business Media, LLC.

Cerdan O.,Bureau de Recherches Géologiques et Minières | Govers G.,Catholic University of Leuven | Le Bissonnais Y.,IRD Montpellier | Van Oost K.,University of Leuven la Neuve | And 14 more authors.
Geomorphology | Year: 2010

An extensive database of short to medium-term erosion rates as measured on erosion plots in Europe under natural rainfall was compiled from the literature. Statistical analysis confirmed the dominant influence of land use and cover on soil erosion rates. Sheet and rill erosion rates are highest on bare soil; vineyards show the second highest soil losses, followed by other arable lands (spring crops, orchards and winter crops). A land with a permanent vegetation cover (shrubs, grassland and forest) is characterised by soil losses which are generally more than an order of magnitude lower than those on arable land. Disturbance of permanent vegetation by fire leads to momentarily higher erosion rates but rates are still lower than those measured on arable land. We also noticed important regional differences in erosion rates. Erosion rates are generally much lower in the Mediterranean as compared to other areas in Europe; this is mainly attributed to the high soil stoniness in the Mediterranean. Measured erosion rates on arable and bare land were related to topography (slope steepness and length) and soil texture, while this was not the case for plots with a permanent land cover. We attribute this to a fundamental difference in runoff generation and sediment transfer according to land cover types.On the basis of these results we calculated mean sheet and rill erosion rates for the European area covered by the CORINE database: estimated rill and interrill erosion rates are ca. 1.2tha-1year-1 for the whole CORINE area and ca. 3.6tha-1year-1 for arable land. These estimates are much lower than some earlier estimates which were based on the erroneous extrapolation of small datasets. High erosion rates occur in areas dominated by vineyards, the hilly loess areas in West and Central Europe and the agricultural areas located in the piedmont areas of the major European mountain ranges. © 2010 Elsevier B.V.

Bartolini G.,University of Cagliary | Levant A.,Tel Aviv University | Plestan F.,University of Cagliary | Taleb M.,École Centrale Nantes | Punta E.,CNR Institute of Intelligent Systems for Automation
IMA Journal of Mathematical Control and Information | Year: 2013

Adaptive sliding-mode strategies of first and second sliding orders are developed for single-input singleoutput systems of the first and second relative degrees, respectively. Since the only concrete known uncertainty bounds are assumed to be the upper bounds of logarithmic derivatives, no standard slidingmode technique can solve the problem. © The authors 2012.

Luck T.,University of Leipzig | Luppa M.,University of Leipzig | Angermeyer M.C.,Center for Public Mental Health | Angermeyer M.C.,University of Cagliary | And 3 more authors.
Psychological Medicine | Year: 2011

Background Early diagnosis of dementia requires knowledge about associated predictors. The aim of this study was to determine the impact of mild cognitive impairment (MCI) and impairment in instrumental activities of daily living (IADL) on the time to an incident dementia diagnosis. Method Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based study of individuals aged ≥75 years. Kaplan-Meier survival analysis was used to determine time to incident dementia. Cox proportional hazards models were applied to determine the impact of MCI and IADL impairment on the time to incident dementia. Results In total, 180 (22.0%) of 819 initially dementia-free subjects developed dementia by the end of the study. Mean time to incident dementia was 6.7 years [95% confidence interval (CI) 6.5-6.9]. MCI combined with IADL impairment was associated with a higher conversion rate to dementia, a shorter time to clinically manifest diagnosis and a lower chance of reversibility to cognitive normal. The highest risk for a shorter time to incident dementia was found for amnestic MCI combined with IADL impairment. The mean time to incident dementia was 3.7 years (95% CI 2.9-4.4) and thus half as long as in subjects without MCI and IADL impairment. Conclusions Subjects with MCI and IADL impairment constitute a high-risk population for future dementia. The consideration of both - MCI and IADL impairment - might help to improve the prediction of dementia. © Cambridge University Press 2010.

Luck T.,University of Leipzig | Luppa M.,University of Leipzig | Matschinger H.,University of Leipzig | Jessen F.,University of Bonn | And 4 more authors.
Acta Psychiatrica Scandinavica | Year: 2015

Objective: In this study, we aimed to analyze the association between new-incident-subjective memory complaints (SMC) and risk of subsequent dementia in a general population sample aged 75+ years. Method: Data were derived from follow-up (FUP) waves I-V of the population-based Leipzig Longitudinal Study of the Aged (LEILA75+). We used the Kaplan-Meier survival method to estimate dementia-free survival times of individuals with and without incident SMC and multivariable Cox proportional hazards regression to assess the association between incident SMC and risk of subsequent dementia, controlled for covariates. Results: Of 443 non-demented individuals, 58 (13.1%) developed dementia during a subsequent 5.4-year follow-up period. Participants with incident SMC showed a significantly higher progression to dementia (18.5% vs. 10.0%; P = 0.010) and a significantly shorter mean dementia-free survival time than those without (6.2 vs. 6.8 years; P = 0.008). The association between incident SMC and risk of subsequent dementia remained significant in the multivariable Cox analysis (adjusted hazard ratio = 1.8; P = 0.028). Conclusion: Our findings suggest higher progression to dementia and shorter dementia-free survival in older individuals with incident SMC. These findings support the notion that such subjective complaints should be taken seriously in clinical practice as possible early indicators of incipient dementia. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Then F.S.,University of Leipzig | Luppa M.,University of Leipzig | Schroeter M.L.,University of Leipzig | Schroeter M.L.,Max Planck Institute for Human Cognitive and Brain Sciences | And 4 more authors.
PLoS ONE | Year: 2013

Background:The high incidence of cognitive impairments in the aging population together with the challenges it imposes on health systems raise the question of what effect working life has on cognitive abilities. Animal models have demonstrated that so called enriched environments protect against neurodegenerative diseases, such as dementia. The aim was to investigate the impact of enriched environment at work on the incidence of dementia.Methods:The Leipzig Longitudinal Study of the Aged (LEILA 75+) is an ongoing representative population cohort study that examines cognitive functioning and dementia in individuals aged 75 years and older. The participants' occupational information was matched to O*NET SOC codes and the relevant job descriptors were used to create occupational context indices describing enriched environment at work.Results:Results of logistic regression modeling suggest that a higher level of the index Executive was associated with a lower risk of incident dementia (odds ratio = 0.61, 95% confidence interval = 0.47-0.79, p<0.001). Adjustment for various confounders did not alter the association. The cognitive stimulation indices were only significant in univariate analysis. The Novelty-index remained non-significant.Conclusions:The results suggest that occupational contexts enriched with independent planning/performance of work tasks might decrease the risk of developing dementia. A protective effect of enriched environment at work in general, namely high cognitive stimulation or confrontation with new tasks, could not be confirmed by the results. © 2013 Then et al.

Luppa M.,University of Leipzig | Luck T.,University of Leipzig | Luck T.,McGill University | Ritschel F.,University of Leipzig | And 4 more authors.
PLoS ONE | Year: 2013

Aims: The aim of the study was to investigate the impact of depression (categorical diagnosis; major depression, MD) and depressive symptoms (dimensional diagnosis and symptom patterns) on incident dementia in the German general population. Methods: Within the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative sample of 1,265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years (mean observation time 4.3 years; mean number of visits 4.2). Cox proportional hazards and binary logistic regressions were used to estimate the effect of baseline depression and depressive symptoms on incident dementia. Results: The incidence of dementia was 48 per 1,000 person-years (95% confidence interval (CI) 45-51). Depressive symptoms (Hazard ratio HR 1.03, 95% CI 1.01-1.05), and in particular mood-related symptoms (HR 1.08, 95% CI 1.03-1.14), showed a significant impact on the incidence of dementia only in univariate analysis, but not after adjustment for cognitive and functional impairment. MD showed only a significant impact on incidence of dementia in Cox proportional hazards regression, but not in binary logistic regression models. Discussion: The present study using different diagnostic measures of depression on future dementia found no clear significant associations of depression and incident dementia. Further in-depth investigation would help to understand the nature of depression in the context of incident dementia. © 2013 Luppa et al.

Luppa M.,University of Leipzig | Luck T.,University of Leipzig | Luck T.,McGill University | Konig H.-H.,University of Hamburg | And 3 more authors.
Journal of Affective Disorders | Year: 2012

Aims: The aim of the study was to follow the natural course of late-life depressive symptoms within a German population-based study. Methods: Within the Leipzig Longitudinal Study of the Aged (LEILA 75), a representative sample of 1265 individuals aged 75 years and older were interviewed every 1.5 years over 8 years. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D, German-specific cut-off score ≥23). Results: The incidence of depressive symptoms was 34 per 1000 person-years (95% confidence interval 31-37). In a multivariate regression model, female gender, poor self-rated health status, stroke, risky alcohol consumption, a poor social network, higher number of specialist visits, functional impairment, and CES-D score at baseline were significant risk factors of future depressive symptoms. We observed remission in 60%, an intermittent course in 17% and a chronic course in 23% of the participants. No baseline characteristic distinguished the remission group from the persistently depressed. Conclusion: Depressive symptoms in late life are common and highly persistent. In the present study encountered risk factors entailed potentialities for secondary prevention. © 2012 Elsevier B.V.

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