%0 Journal Article %J J Alzheimers Dis %D 2023 %T Impact of Hearing Aids on Progression of Cognitive Decline, Depression, and Quality of Life Among People with Cognitive Impairment and Dementia. %A Atef, Roaa Zayed %A Michalowsky, Bernhard %A Raedke, Anika %A Platen, Moritz %A Mohr, Wiebke %A Mühlichen, Franka %A Thyrian, Jochen René %A Hoffmann, Wolfgang %K Aged %K Cognitive Dysfunction %K Deafness %K Dementia %K Depression %K Hearing Aids %K Humans %K Presbycusis %K Quality of Life %X

BACKGROUND: Hearing loss is common in people with dementia (PwD) and a modifiable risk factor for cognitive decline. Recent studies revealed that hearing loss could cause social isolation and depression, which is associated with health-related quality of life (HRQoL). However, there is a lack of knowledge about the impact of the utilization of hearing aids on these outcomes.

OBJECTIVE: To assess whether hearing aids use might be positively associated with the progression of cognitive function, depression, and HRQoL among PwD.

METHODS: We analyzed two-year follow-up data from 258 PwD (≥70 years, living at home). Cognitive decline was measured with Mini-Mental Status Examination (MMSE), depression using Geriatric Depression Scale (GDS), and HRQoL with Quality of Life in Alzheimer's Disease Scale (QoL-AD). The impact of hearing aid utilization on the progression of outcomes was assessed using multivariate regression models.

RESULTS: 123 patients had hearing loss (47.7%), from which n = 54 (43.9%) used hearing aids. Patients with hearing loss were older and had a lower HRQoL than those without hearing loss. Use of hearing aids in patients with hearing loss was associated with a lower increase in depressive symptoms (b = -0.74, CI95 -1.48 --0.01, p = 0.047) over time as compared to those not using hearing aids. There was no effect on PwD's cognition, and the association with higher HRQoL was significant after one, but not consistently over two years.

CONCLUSION: Early detection and intervention of presbycusis using hearing aids might improve mental health and HRQoL in dementia.

%B J Alzheimers Dis %V 92 %P 629-638 %8 2023 %G eng %N 2 %R 10.3233/JAD-220938 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Economic Analysis of Formal Care, Informal Care, and Productivity Losses in Primary Care Patients who Screened Positive for Dementia in Germany. %A Michalowsky, Bernhard %A Thyrian, Jochen René %A Eichler, Tilly %A Hertel, Johannes %A Wucherer, Diana %A Flessa, Steffen %A Hoffmann, Wolfgang %K Activities of Daily Living %K Aged %K Aged, 80 and over %K Caregivers %K Cost of Illness %K Cross-Sectional Studies %K Dementia %K Female %K Germany %K Health Care Costs %K Home Care Services %K Humans %K Male %K Patient Care %K Sensitivity and Specificity %K Surveys and Questionnaires %X

BACKGROUND: The majority of people with dementia (PwD) live at home and require professional formal care and informal care that is generally provided by close relatives.

OBJECTIVE: To determine the utilization and costs of formal and informal care for PwD, indirect costs because of productivity losses of caregivers, and the associations between cost, socio-demographic and clinical variables.

METHODS: The analysis includes the data of 262 community-dwelling PwD and their caregivers. Socio-demographics, clinical variables, and the utilization of formal care were assessed within the baseline assessment. To evaluate informal care costs, the Resource Utilization in Dementia (RUD) questionnaire was used. Costs were calculated from a social perspective. Associations were evaluated using multiple linear and logistic regression models.

RESULTS: Formal care services were utilized less (26.3%) than informal care (85.1%), resulting in a cost ratio of one to ten(1,646 €; 16,473 €, respectively). In total, 29% of caregivers were employed, and every seventh (14.3%) experienced productivity losses, which corresponded to 1,258 € annually. Whereas increasing deficits in daily living activities were associated with higher formal and higher informal costs, living alone was significantly associated with higher formal care costs and the employment of a caregiver was associated with lower informal care costs.

CONCLUSION: Informal care contributes the most to total care costs. Living alone is a major cost driver for formal costs because of the lower availability of potential informal care. The availability of informal care is limited and productivity losses are increased when a caregiver is employed.

%B J Alzheimers Dis %V 50 %P 47-59 %8 2016 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26639964?dopt=Abstract %R 10.3233/JAD-150600 %0 Journal Article %J J Alzheimers Dis %D 2016 %T Unmet Needs of Community-Dwelling Primary Care Patients with Dementia in Germany: Prevalence and Correlates. %A Eichler, Tilly %A Thyrian, Jochen René %A Hertel, Johannes %A Richter, Steffen %A Wucherer, Diana %A Michalowsky, Bernhard %A Teipel, Stefan %A Kilimann, Ingo %A Dreier, Adina %A Hoffmann, Wolfgang %K Aged, 80 and over %K Caregivers %K Cross-Sectional Studies %K Dementia %K Depression %K Female %K Germany %K Health Services Needs and Demand %K Humans %K Male %K Needs Assessment %K Prevalence %X

BACKGROUND: To provide an optimal care for persons with dementia (PWD), their individual unmet needs have to be identified and comprehensively addressed.

OBJECTIVES: Present analyses aim to describe the number and types of unmet needs of German primary care patients screened positive for dementia and factors associated with the number of unmet needs.

METHODS: DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized controlled intervention trial. Analyses are based on the baseline data of 227 PWD (≥70 years, living at home) of the intervention group who had screened positive for dementia (DemTect<9) and received a standardized computer-assisted needs assessment.

RESULTS: PWD had on average 8.77±5.04 unmet needs (Range = 0-31). More than 90% of the PWD had three or more unmet needs. Unmet needs were identified across all predefined 26 subcategories. The majority of unmet needs occurred in the domains "nursing treatment and care" (38%), "social counseling and legal support" (20%), and "pharmacological treatment and care" (15%). More impairment in the activities of daily living was the only factor that was significantly associated with a higher number of unmet needs, independent of age, gender, living situation, presence of an informal caregiver, cognitive impairment, and depression.

CONCLUSIONS: Present results demonstrate that community-dwelling PWD had a broad range of varying unmet needs. These findings emphasize the importance of a comprehensive needs assessment that allows the identification of individual needs as the basis for a tailored intervention- such as Dementia Care Management- that can address these needs.

%B J Alzheimers Dis %V 51 %P 847-55 %8 2016 %G eng %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/26890767?dopt=Abstract %R 10.3233/JAD-150935