Abstract：
BACKGROUND:The number of multiple chronically ill older people is increasing and multimorbidity is associated with high utilization of health services. Integrated care management is increasingly used to address this problem; however, there is a substantial lack of reliable data on its effectiveness in this target group. OBJECTIVE:To assess the effectiveness of components of integrated care management in adults of all ages and to estimate the transferability to older, multimorbid people in Germany. METHODS:A systematic search was carried out in the Cochrane Library for Cochrane reviews (CR) on (a) the 13 most frequent health problems in old age, which (b) evaluated components of integrated care management in (c) adults of all ages. Experts assessed the transferability of the included CR to multiple chronically ill older people in Germany. RESULTS:Out of 1412 hits 126 CR were included. Regarding independence and functional health outcomes, 25 CR showed clinically relevant results with at least a moderate level of evidence. The following intervention components were estimated to be transferable and could be adapted to be part of an effective integrated care management for multimorbid chronically ill older people, specified by indications and taking identified barriers into account: (1) physical activation, (2) multidisciplinary interventions (3) interventions that enhance self-management, (4) cognitive therapy modalities, (5) telemedical interventions and (6) disease management programs. CONCLUSION:The effectiveness of the identified components in frail older patients should be assessed in care-related and patient-related randomized controlled studies. ZUSAMMENFASSUNG:HINTERGRUND: Die Anzahl multipel chronisch erkrankter Älterer steigt, und Multimorbidität geht mit hoher Inanspruchnahme von Gesundheitsleistungen einher. Um Selbstständigkeit und Verbleib in der Häuslichkeit zu erhalten, wird zunehmend ein integriertes Versorgungsmanagement eingesetzt. Zur Wirksamkeit in der Zielgruppe der multipel chronisch erkrankten Älteren liegen aber kaum belastbare Daten vor. ZIEL DER ARBEIT:Bewertung der Wirksamkeit von integriertem Versorgungsmanagement bei Erwachsenen und Abschätzung der Übertragbarkeit auf ältere, multimorbide Personen in Deutschland. METHODEN:Systematische Literaturrecherche in der Cochrane Library mit Einschluss von Cochrane-Reviews (CR) zu (a) den 13 häufigsten Gesundheitsproblemen im Alter, mit (b) Komponenten des integrierten Versorgungsmanagements bei (c) Erwachsenen jeden Alters. Experten schätzten die Übertragbarkeit der eingeschlossenen CR auf multipel chronisch erkrankte Ältere in Deutschland ein. ERGEBNISSE:Aus 1412 Treffern wurden 126 CR eingeschlossen. Zur Endpunktkategorie Selbstständigkeit und funktionale Gesundheit zeigten 25 CR klinisch relevante Ergebnisse mit moderater Evidenzqualität. Folgende Interventionskomponenten wurden – unter Berücksichtigung identifizierter Barrieren – als übertragbar eingeschätzt und könnten für ein effektives, indikationsspezifisch integriertes Versorgungsmanagement multipel chronisch erkrankter Älterer herangezogen werden: (1) körperliche Aktivierung, (2) multidisziplinäre Interventionen, (3) das Selbstmanagement verstärkende Interventionen, (4) kognitive Therapieverfahren, (5) telemedizinische Interventionen und (6) Disease-Management-Programme. SCHLUSSFOLGERUNGEN:Die identifizierten Komponenten sollten in versorgungs- und patientennahen randomisierten kontrollierten Studien auf Wirksamkeit bei gebrechlichen Älteren geprüft werden.
journal_name
Z Gerontol Geriatrjournal_title
Zeitschrift fur Gerontologie und Geriatrieauthors
Göhner A,Bitzer EM,Dreher E,Farin-Glattacker E,Heimbach B,Kohler K,Maun A,Metzner G,Voigt-Radloff Sdoi
10.1007/s00391-020-01796-1subject
Has Abstractpub_date
2021-02-01 00:00:00pages
54-60issue
1eissn
0948-6704issn
1435-1269pii
10.1007/s00391-020-01796-1journal_volume
54pub_type
杂志文章abstract：:Social inequality in Germany is discussed primarily with regard to educational or social welfare issues. There is a political consensus that more action should be taken to ensure equality of chances and fulfillment of basic needs for everyone. In long-term care these considerations have not yet taken place and there a...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-013-0500-1
更新日期：2013-06-01 00:00:00
abstract：:Alzheimer's disease (AD) is the most frequent form of dementia worldwide. The increasing incidence of AD is due to the dramatic rise in life expectancy. Generally, AD shows a multifactorial etiology and manifests itself only at an older age. However, a small percentage of cases have a monogenic cause, are inherited as...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-010-0101-1
更新日期：2010-06-01 00:00:00
abstract：:This contribution refers to the 2009 Council of Experts Report on health system development and discusses the special care requirements of old people. This includes the geriatric phenomenon of multimorbidity, polypharmacy in old people with multiple diseases, and the need for care. The probability and complexity of mu...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-009-0072-2
更新日期：2009-12-01 00:00:00
abstract：:Prolonged suboptimal intake of micronutrients leads via a series of mechanisms to impairment of cognitive performance. Supplementation can correct these deficits. Malnutrition impairs cognitive performance only when micronutrient levels fall below certain critical thresholds. Malnutrition in the elderly is commonly th...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 00:00:00
abstract：:According to Antonovsky, the sense of coherence (SOC) determines health and wellbeing. This life orientation is shaped up to the age of 30 and is supposed to remain constant up to senior age. In a field study, in which the SOC, psycho-social resources and subjective health were assessed at three points in time, it cou...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-006-0322-5
更新日期：2006-04-01 00:00:00
abstract：AIM OF THE STUDY:Analysis of differences between oncologic and non-oncologic patients in the first German hospital-based special care unit for palliative geriatrics. METHODS:Systematic analysis of patients' records according to a standardized protocol. RESULTS:A total of 217 patients from a hospital-based special car...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-010-0148-z
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:A relevant number of older persons with intellectual disability (ID) moves from residential settings in the disability sector to nursing homes. The study analyzes from the perspective of self-determination, which factors lead to moves to nursing homes and to what extent older persons with ID an...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-019-01536-0
更新日期：2019-05-01 00:00:00
abstract：:The treatment and care of individuals with dementia, who are admitted to general hospitals due to somatic diseases, often leads to crisis situations which not only compromise the therapeutic benefit, but also can be followed by avoidable institutionalization in nursing homes or psychiatric hospitals. With the model pr...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-008-0021-5
更新日期：2008-12-01 00:00:00
abstract：:Heating of food induces the formation of Maillard reaction products (MRPs) caused by the reaction of reducing sugars with proteins or amino acids. Analogous reactions occur in the human body, eventually forming "Advanced Glycation Endproducts" (AGEs). AGEs accumulate in aging tissues accelerating degenerative-inflamma...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-005-0263-4
更新日期：2005-10-01 00:00:00
abstract：:Results of a longitudinal study about the transition to retirement are presented. 329 persons were interviewed three times (quantitative study) and 20 persons conducted a semi-structured diary (qualitative study), covering in both groups a two-year period (from half a year before retirement to one and a half years aft...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s003910050168
更新日期：2000-04-01 00:00:00
abstract：:A large number of published overview and original articles provide evidence and declare the need for immediate, appropriate preventive lifestyle measures to prevent the development of dementia and Alzheimer's disease (AD). However, despite this, there are great difficulties in drafting effective guidelines in this fie...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-011-0263-5
更新日期：2012-01-01 00:00:00
abstract：:Nutritional problems and deficiencies are widespread in geriatric institutions. On the other hand, benefits of different interventions to improve the nutritional situation of elderly people--from amelioration of mealtime ambience to the use of artificial nutrition--have been shown in many studies. In recent years, sev...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-011-0174-5
更新日期：2011-04-01 00:00:00
abstract：:Nonpharmacological treatments can improve the quality of life of people with dementia. The objective of this review is to evaluate the effects of nonpharmacological treatments on quality of life and to analyze corresponding instruments by performing a systematic review of the literature. Candidate studies were first i...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00391-012-0341-3
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:Little is known about the prevalence of falls and the related risk factors in the general population of community-living older people in Germany. OBJECTIVES:To assess the prevalence and related predictors of different types of falls in a sample of community-dwelling 65 years and older people in Germany livi...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-008-0506-2
更新日期：2009-02-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to evaluate possible age-related changes in mesenteric artery and portal venous blood flow dynamics in relation to systemic haemodynamics in order to delineate putative haemodynamic changes relevant for postprandial hypotension in the elderly. Studies were performed over a wide age-...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-007-0431-9
更新日期：2007-02-01 00:00:00
abstract：:Although viewed critically in geriatrics, benzodiazepine use is still common among old people. Before reducing the dosage the following questions must be considered: 1. Are there indications for benzodiazepine treatment and will discontinuation cause relevant rebound symptoms of the initial disorder treated? 2. To wha...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-016-1171-5
更新日期：2017-02-01 00:00:00
abstract：BACKGROUND:The aim of palliative care is to help people with a progressive, probably fatal disease to achieve the highest possible quality of life. Any treatment is radically oriented towards the needs of the affected persons and their relatives. Although nursing institutions for seniors are the second most frequent pl...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-020-01803-5
更新日期：2021-02-01 00:00:00
abstract：:During recent years, a discussion on work activity of retirees has commenced also in Germany. First, this contribution presents a survey of the North American phenomenon of bridge employment and, second, complements leadoff empirical results on individual motives and favored basic conditions in Germany. Individual and...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-009-0047-3
更新日期：2009-08-01 00:00:00
abstract：:In 25 patients (10 male, 15 female) with systemic sclerosis aged between 28 and 79 years the biological age was determined. Alterations in the sense of "premature aging" were observed in the mean and developed stronger in male patients. They have to be counted in a greater part on the real process of disease. Compared...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：
更新日期：1996-05-01 00:00:00
abstract：:This article presents previous experiences regarding the study course Social Gerontology (bWSG) at the University of Dortmund. After a short historical outline the focus will be on a critical examination of the success of the study course. Finally, new developments at the University of Dortmund will be presented, amon...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-007-0497-4
更新日期：2007-12-01 00:00:00
abstract：:The number of elderly patients with non-Hodgkin's lymphomas (NHL) is continuously increasing. The diagnostic and staging procedures should be carried out in elderly patients as careful as in younger patients. Furthermore, for treatment decisions geriatric assessment and the patient's preferences concerning therapy are...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s003910170049
更新日期：2001-08-01 00:00:00
abstract：:After a pilot study in 2010 in segregated wards for patients with dementia in nursing homes (DWB) and in community-based living communities for older people with dementia (DWG), major differences in the proportion of mentally stressed employees were found (DWB: 57%, DWG: 26%) as well as in the proportion of employees ...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-020-01709-2
更新日期：2020-10-01 00:00:00
abstract：:Composition of staff and therapeutic offers of day-hospitals principally are identical with those of geriatric hospitals. But there are peculiarities in their working: They offer a well balanced combination of somato-, physio-, psycho- and sociotherapy which individually must be planned, perpetually controlled and if ...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：
更新日期：1995-03-01 00:00:00
abstract：:The incidence of hip fractures increases with increasing age. Besides the actual trauma, it is mainly the comorbidities and an increased postoperative complication rate in old patients that lead to increased mortality in this patient population. Around 25% of patients who had previously been living independently conti...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-011-0250-x
更新日期：2011-12-01 00:00:00
abstract：:This paper reports a qualitative study in which the aim was to examine older peoples' beliefs and risk perceptions regarding the use of innovative health technologies in end-of-life care and to relate these beliefs to their ideas about 'natural death'. Pictures, story boards and media extracts were used during intervi...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-003-0166-1
更新日期：2003-10-01 00:00:00
abstract：:The aim of the present study was to describe the course and outcome of rehabilitation using a national recommended assessment program (AGAST). In our study 162 patients with stroke were included. Nearly all patients had improvement of activities of daily living (Barthel Index) and mobility (Tinetti Gait and Balance Sc...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s003910050105
更新日期：1999-06-01 00:00:00
abstract：:In China, fundamental changes in population development have occurred during the past 50 years. The demographic transition in China required only a few years, while in most European countries this process took several decades. The fertility and mortality rates have declined very quickly, like in Japan and South Korea....
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章,评审
doi：10.1007/s00391-012-0401-8
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Anemia and hypoalbuminemia (HA) are acknowledged independent risk factors for morbidity and mortality in geriatric patients and are associated with nutritional status and frailty. Data exist regarding the association between albumin and frailty, anemia and frailty as well as frailty and nutritional status; h...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-015-0872-5
更新日期：2015-10-01 00:00:00
abstract：:Selected activities of daily living are used to describe the micro-area (dwelling), mezzo-area (quarter) and exo-area (outside the quarter). In a survey of 115 elderly people, the five-year-changes from 1985/86 to 1990/91 in their areas of mobility in a working class district are documented. Special interest is given ...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：
更新日期：1995-09-01 00:00:00
abstract：BACKGROUND:Over the last 10 years the German pension system has undergone several reforms including the abandonment of early retirement policies and an increase in the statutory retirement age. Consequently, the average retirement age has increased and future retiree cohorts have adjusted the retirement expectations an...
journal_title：Zeitschrift fur Gerontologie und Geriatrie
pub_type： 杂志文章
doi：10.1007/s00391-016-1053-x
更新日期：2018-01-01 00:00:00
