Melanie Luppa

Leipzig University · Institute for Social Medicine, Occupational Health and Public Health

Background Dementia risk scores have been suggested a promising surrogate outcome for lifestyle interventions targeting cognitive function and dementia risk. First evidence suggests beneficial effects of multidomain lifestyle interventions on dementia risk scores. We investigated effects of the multidomain AgeWell.de‐intervention on dementia risk,...

Background Recent research on preventing cognitive decline has focused on lifestyle interventions, with first studies indicating cognitive benefits and suggesting a positive link between adherence to the interventions and their effectiveness. The purpose of this study was to analyse possible predictors of this very adherence to single components of...

Zusammenfassung Diese Übersicht geht der Frage nach, ob laufende bevölkerungsrepäsentative Kohorten zukünftige Pandemieeffekte auf Menschen mit schweren psychischen Erkrankungen detektieren können. Literaturrecherche mit anschließender Analyse und Evaluation bezüglich relevanter Messungen und Kriterien. Keine der laufenden deutschen bevölkerungsbas...

INTRODUCTION The societal costs of dementia and cognitive decline are substantial and likely to increase during the next decades due to the increasing number of people in older age groups. The aim of this multicenter cluster‐randomized controlled trial was to assess the cost‐effectiveness of a multi‐domain intervention to prevent cognitive decline...

Purpose We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants’ diet. Methods Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitiv...

Introduction Health disparities pose a considerable challenge for older adults individuals, particularly those with a heightened risk of developing dementia. Discrepancies in health status among various income brackets are only partially attributable to structural factors such as working and living conditions or the quality of food. The aim of this...

Given the high prevalence of overweight and obesity and high comorbidity of depressive symptoms, there is a need for low-threshold, accessible care approaches for people with overweight/obesity aimed at improving mental health. Internet and mobile-based interventions (IMI) represent an innovative complementary treatment option. This review systemat...

Background Multimodal lifestyle interventions might help to maintain healthy cognition in older age and to delay onset of dementia. Here, we studied the effects of a multi-modal lifestyle-based intervention, based on the FINGER trial, on magnetic resonance imaging (MRI) markers of hippocampal-limbic atrophy and cerebral small vessel disease in olde...

Background: The impact of social isolation on social cognition is not entirely clear. Objective: The aim of the study is to investigate the association between social isolation and social cognition. Methods: In a population-based sample of 83 individuals aged 50+ years without dementia, we assessed the relationship between social isolation (me...

Background Social participation as a protective factor against cognitive decline was one of the targets in the AgeWell.de study, a multi-domain interventional trial in a sample of older adults at increased risk for dementia. This study aimed to examine differential effects of the intervention and other influencing factors on social participation th...

Zusammenfassung Hintergrund Bevölkerungsbasierte Studien zum Zusammenhang von sozialer Isolation und Adipositas, die auch jüngere Erwachsene einschließen, fehlen in Deutschland bisher. Ziel der vorliegenden Arbeit ist die Untersuchung der Prävalenzen sozialer Isolation bei Menschen mit und ohne Adipositas. Zudem werden sozial Isolierte mit und ohn...

Objectives: Various dementia risk scores exist that assess different factors. We investigated the association between the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score and modifiable risk factors in the Lifestyle for Brain Health (LIBRA) score in a German population at high risk of Alzheimer's disease. Method: Basel...

Background General practitioners (GPs) play a crucial role in identifying cognitive impairment and dementia and providing post-diagnostic care. This study investigates (1) how promising GP consider lifestyle changes to maintain cognitive performance in general, (2) GP beliefs about the power of modifiable health and lifestyle factors to maintain co...

Within occupational settings, mental health of employees can be affected by complex interactions between individuals and their work environment. The aim of this cross-sectional analysis was to investigate the association between person-environment fit and mental health in employees. Data of n = 568 participants from the LIFE adult cohort study was...

Zusammenfassung Ziel der Studie Ziel der Studie war die Untersuchung der Gesundheitskompetenz (GK) sowie verschiedener Versorgungsaspekte von Long-COVID-Betroffenen. Methodik Daher wurden 407 Long-COVID Betroffene mit langanhaltender neuropsychiatrischer Symptomatik im LIFE-Studienzentrum befragt. Mittels deskriptiver, sowie Regressionsanalysen wur...

Background The healthcare system is currently in a state of tension due to a shortage of physicians, the early retirement of health care professionals and an increasing need for care within an (aging) society. Therefore, the aim of the present study was to examine physicians’ attitudes towards retirement and possible influencing factors on their mo...

Background: People with dementia commonly have impaired social functioning and may not recognize this. This lack of awareness may result in worse outcomes for the person and their family carers. Objective: We aimed to characterize awareness of social functioning in dementia and describe its association with dementia severity. Methods: Multi-ce...

INTRODUCTION Dementia risk scores constitute promising surrogate outcomes for lifestyle interventions targeting cognitive function. We investigated whether dementia risk, assessed using the LIfestyle for BRAin health (LIBRA) index, was reduced by the AgeWell.de intervention. METHODS Secondary analyses of the AgeWell trial, testing a multicomponent...

Introduction Flexibility and autonomy of employees with regard to working hours are currently intensively discussed in many sectors. This study investigates how different aspects of working time autonomy are associated with health outcomes such as psychosomatic complaints in health care personnel. Method Based on data of the German BAuA Working Ti...

Background Aim of this study was to detect predictors of better adherence to the AgeWell.de-intervention, a two-year randomized multi-domain lifestyle intervention against cognitive decline. Methods Data of 317 intervention group-participants comprising a risk group for dementia (Cardiovascular Risk Factors, Ageing and Dementia (CAIDE) score of ≥...

Purpose The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups. Methods Data were derived from a prospective multicenter cohort study conducted in primary care – the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline...

Listing tools have been developed to improve medications in older patients, including the Fit fOR The Aged (FORTA) list, a clinically validated, positive-negative list of medication appropriateness. Here, we aim to validate MyFORTA, an automated tool for individualized application of the FORTA list. 331 participants of a multi-center cohort study (...

While regular physical-activity (PA) is beneficial, multimorbid individuals at increased dementia risk may exhibit reduced PA levels. Thus, a more comprehensive understanding of mediating factors responsible for inactivity in this population is needed. This study investigated the impact of a multimodal intervention on PA changes at 24-month follow-...

Purpose Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly prim...

Importance Physical diseases co-occur with late-life depression (LLD). The influence of physical diseases and the subjective perception of physical health (PPH) on treatment outcome in LLD, however, is not well understood. Objective To assess the association of physical diseases and PPH with the outcomes of 2 different types of psychotherapy in LL...

Background: Studies demonstrate associations between low social activity in older adults and cognitive decline. Little has been investigated regarding which factors are associated with low social activity in older adults at increased risk of dementia. Objective: We investigate which sociodemographic, psychological, health-related, and environmental...

Background In the light of personnel shortage, the health care sector is facing the challenge to combine increasing employees‘ as well as patients’ needs. The aim of this study was to investigate the association between working-time autonomy and health-related (fatigue, psychosomatic complaints and work ability), as well as occupational outcomes (j...

Introduction Differences between women and men matter in the prevalence and risk factors of dementia. We aimed to examine potential sex differences regarding the effectiveness by running a secondary analysis of the AgeWell.de trial, a cluster-randomized multicenter multi-domain lifestyle intervention to reduce cognitive decline. Methods Intention-...

Background:People with dementia commonly have impaired social functioning and may not recognise this. This lack of insight may result in worse outcomes for the person and their family carers. We aimed to characterise insight into social functioning in dementia, and describe its association with dementia severity. Methods:Observational cross-section...

Background Activities of daily living functioning (ADL) are relevant in the diagnosis of neurocognitive disorders (NCD). Currently, however, there has been no standardized and validated instrument based on DSM‐5 diagnosis criteria. Our aim was to psychometrically evaluate the differentiated assessment of ADL impairments due to NCD (A‐NKS). Method...

Background Neuropsychiatric symptoms (NPS) are common in pre‐dementia state and are associated with an increased risk of dementia. The concept of Mild Behavioral Impairment (MBI) addresses this circumstance. However, to date, instruments that measure MBI in a standardized method are lacking. Therefore, the Mild Behavioral Impairment Checklist (MBI‐...

Background Mounting evidence suggests that dementia can be prevented. Targeting several risk factors simultaneously constitutes a promising strategy for preserving cognitive function. The AgeWell.de‐study was a cluster‐randomized trial applying a multi‐domain intervention to preserve cognitive function in older adults at risk for dementia in German...

Background: Activities of daily living (ADL) functioning are important in the diagnosis of neurocognitive disorders (NCD), yet no standardized and validated instrument exist based on international classification systems. Objective: We aimed to psychometrically evaluate the differentiated assessment of ADL and instrumental ADL (IADL) impairments...

Background Since the oldest-old population was identified as a high-risk group for a severe course of the coronavirus disease and higher mortality, it was assumed that they might be particularly psychologically burdened. The aim of the study is to analyze the development of anxiety and depressive symptoms over the course of the pandemic from 2020 t...

Background: Evidence on modifiable risk factors for dementia is accumulating rapidly, including e.g. smoking, hypertension, and diabetes. Comparing knowledge of risk factors for dementia and factors associated with knowledge and motivation to learn about dementia risk reduction in different countries may support the design of tailored public health...

Purpose The present study aims to investigate the prospective effect of depressive symptoms on overall QoL in the oldest age group, taking into account its different facets. Methods Data were derived from the multicenter prospective AgeCoDe/AgeQualiDe cohort study, including data from follow-up 7–9 and n = 580 individuals 85 years of age and older...

Background: Subjective memory complaints and family history of dementia are possibly intertwined risk factors for the own subsequent dementia risk and Alzheimer's disease. However, their interaction has rarely been studied. Objective: To study the association between subjective memory complaints and family history of dementia with regard to the...

INTRODUCTION We investigated the effectiveness of a multidomain intervention to preserve cognitive function in older adults at risk for dementia in Germany in a cluster‐randomized trial. METHODS Individuals with a Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) risk score ≥ 9 aged 60 to 77 years were recruited. After randomization of thei...

Zusammenfassung: Die Prävalenz von Demenzen nimmt zu. Lebensstilinterventionen, die das Risiko für Demenzen reduzieren, stellen einen vielversprechenden Ansatz für den Erhalt der kognitiven Leistungsfähigkeit in älteren Risikopopulationen dar. Neben diesen verhaltenspräventiven Maßnahmen für Risikogruppen sind Public Mental Health- Strategien und A...

Background So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level. Objective The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this...

To develop effective dementia prevention strategies, it is necessary to understand risk factors, associated factors and early signs of dementia. Subjective cognitive decline (SCD) is the earliest form of dementia. The aim of this study is to assess depression as a factor that is significantly associated with SCD. The data of 1030 general practition...

Background: Social isolation has been suggested to increase the risk to develop cognitive decline. However, our knowledge on causality and neurobiological underpinnings is still limited. Methods: In this preregistered analysis, we tested the impact of social isolation on central features of brain and cognitive ageing using a longitudinal populat...

Social isolation has been suggested to increase the risk to develop cognitive decline. However, our knowledge on causality and neurobiological underpinnings is still limited.

Introduction Internet-based and mobile-based interventions (IMIs) provide innovative low-threshold and cost-effective prevention and self-management options for mental health problems complementary to standard treatment. The objective of this systematic review is to summarise the effectiveness and to critically evaluate studies on IMIs addressing c...

Social isolation has been suggested to increase the risk to develop cognitive decline. However, our knowledge on causality and neurobiological underpinnings is still limited.

Social isolation has been suggested to increase the risk to develop cognitive decline. However, our knowledge on causality and neurobiological underpinnings is still limited.

Background With the outbreak of COVID-19, government measures including social distancing and restrictions of social contacts were imposed to slow the spread of the virus. Since older adults are at increased risk of severe disease, they were particularly affected by these restrictions. These may negatively affect mental health by loneliness and soc...

Zusammenfassung Veränderungen der Arbeitswelt hinsichtlich innovativer Arbeitszeitmodelle erreichen zunehmend auch die Patient:innenversorgung, so steigt beispielsweise die Zahl der in Teilzeit arbeitenden Ärzt:innen kontinuierlich an. Gleichzeitig führt eine allgemeine Zunahme chronischer Erkrankungen und multimorbider Leiden, als auch der steigen...

Background: The scientific state of knowledge on modifiable risk factors for dementia has greatly improved in recent years. The established risk and protective factors include physical and social inactivity, hypertension, diabetes mellitus, excessive alcohol consumption and smoking; however, it is assumed that this knowledge is so far insufficient...

Background Early detection of dementia provides numerous benefits for those living with dementia and their relatives and healthcare systems at large. Methods available for early diagnosis have improved significantly over the past years. Therefore, we examined whether support for offering an early diagnosis of dementia and willingness to pursue a re...

Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare. Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), bo...

Objective The aim of this study was to determine the association of mental health issues associated with BMI and gender in the oldest old population (secondary data analyses). Method The data were taken from the second follow-up of a long-term study investigating the impact of the COVID-19 pandemic on health in oldest old individuals (range: 77–96...

Bereitstellung eines Instrumentes für die Erfassung von Alltagsbeeinträchtigungen bei Neurokognitiven Störungen (A-NKS)

(1) Background: The prevalence of dementia increases and so does the number of interventions that address modifiable risk factors for dementia. Recent evidence suggests that there are gender differences in the prevalence of those lifestyle factors as well as in the effectiveness of interventions. This study aims to identify differences in factors t...

Background According to new estimates, the health care sector will suffer a shortage of physicians in primary and specialty care. In this context, work engagement and burnout are two constructs that have gained attention recently. The aim of this study was to investigate how these constructs are related to work hour preference. Method The present...

Our study aims to examine the associations of sociodemographic factors, social support, resilience, and perceptions of the COVID-19 pandemic with late-life depression and anxiety symptoms in a cardiovascular risk group and a matched sample from the German general population during the beginning of the pandemic and draw a comparison regarding psycho...

Zusammenfassung Hintergrund Die Bevölkerungsgruppe der Hochaltrigen gehört zu den Hochrisikogruppen in Bezug auf einen schweren Erkrankungsverlauf und erhöhte Mortalität bei Ansteckung mit dem Coronavirus SARS-CoV-2 (engl.: Severe Acute Raspiratory Syndrom Coronavirus 2). Sie ist durch die COVID-19-Pandemie selbst, aber auch durch Maßnahmen des Ge...

Introduction Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserv...

BACKGROUND: The number of people living with dementia worldwide is increasing rapidly. Preventive approaches constitute a promising strategy to counter the dementia epidemic, and growing numbers of lifestyle interventions are conducted around the globe. Gender differences with respect to modifiable risk factors for dementia have been reported, howe...

Background Evidence on potentially modifiable risk factors for dementia is accumulating rapidly, including e.g. physical inactivity, hypertension, or diabetes. It is unclear to what extent these risk factors are known among the general population in Germany. We investigated knowledge on risk and protective factors for dementia and openness to eHeal...

Introduction: Subjective cognitive decline (SCD) and depressive symptoms (DS) frequently co-occur prior to dementia. However, the temporal sequence of their emergence and their combined prognostic value for cognitive decline and dementia is unclear. Methods: Temporal relationships of SCD, DS and memory decline were examined by latent difference...

This study aims to describe social network and social participation and to assess associations with depressive symptoms in older persons with increased risk for dementia in Germany. We conducted a cross-sectional observational study in primary care patients (aged 60–77) as part of a multicenter cluster-randomized controlled trial (AgeWell.de). We p...

Purpose Higher Fit fOR The Aged (FORTA) scores have been shown to be negatively associated with adverse clinical outcomes in older hospitalized patients. This has not been evaluated in other health care settings. The aim of this study was to examine the association of the FORTA score with relevant outcomes in the prospective AgeCoDe–AgeQualiDe coho...

Aim The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods We used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older in...

Background Changes in everyday work with regard to working time models have reached the medical profession. The number of physicians working part-time is steadily increasing. At the same time, however, the population's need for care is also rising. This can reinforce the impending shortage of doctors in the future. The aim was to investigate differ...