Steffi Riedel-Heller

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

Background Research shows that unemployed individuals are more often affected by mental illness, and that mental illness can impede an individual’s work ability, creating a significant obstacle to (re)entering the workforce. Aims The objective of this study is to examine the relationships between psychological symptoms and work ability in unemploy...

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...

The participation of representatives of patients and relatives in the development of guidelines is of central importance for the quality, feasibility and acceptance of guidelines. In Germany this has not been sufficiently implemented in the discipline of psychiatry, although in practice there are many examples for the benefits of the expertise of p...

Background Documented risk factors and prodromal features of dementia in primary care practices may support dementia prevention and early detection in routine care. Objective To identify documented prodromal features and risk factors of dementia before the incident dementia diagnosis in German primary care practices. Methods This case-control stu...

Zusammenfassung Ziel der Studie Psychisch erkrankte Menschen sollten selbstbestimmt in der Gemeinde wohnen, es findet sich starke Evidenz für diese Wohnform. In dieser Arbeit wurden die Wohnsituation von Menschen mit schweren psychischen Erkrankungen, die Inanspruchnahme und der Bedarf an Versorgungsangeboten analysiert. Methodik Es wurden Daten ei...

Rare coding single nucleotide variants (SNV) and short insertions or deletions (indels) contribute to Alzheimer disease (AD) genetic risk, from pathogenic variants in autosomal dominant genes to risk factors with diverse effects. In contrast, copy number variants (CNV) have been scarcely studied, with the exception of a few autosomal dominant examp...

Background While people with low socioeconomic status tend to have worse cognitive functioning, little is known about the impact of specific socioeconomic conditions. Aim of the present analysis was to investigate to what extent cognitive functioning differs by three socioeconomic conditions: low income, being without employment, and living alone....

Self-help can play an important supplementary role in the treatment of people with severe mental illness; however, little is known about the utilization of the various approaches. This study describes the use of various self-help options by patients with severe mental illness and examines potential predictors. As part of the observational cross-sec...

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...

Importance Poststroke cognitive impairment is common, but the cognitive trajectory following a first stroke, relative to prestroke cognitive function, remains unclear. Objective To map the trajectory of cognitive function before any stroke and after stroke in global cognition and in 4 cognitive domains, as well as to compare the cognitive trajecto...

Background The COVID-19 pandemic prompted a range of studies on mental health, with mixed results. While numerous studies reported worsened conditions in individuals with pre-existing mental disorders, others showed resilience and stability in mental health. However, longitudinal data focusing on the German population are sparse, especially regardi...

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...

Introduction: The prevalence of MCI and dementia is increasing as the oldest-old population grows, requiring a nuanced understanding of their care needs. Few studies have examined need profiles of oldest-old patients with MCI or dementia. Therefore, this study aims to identify patients' need profiles. Methods: The data analysis included cross-se...

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...

Queuosine (Q) is a hypermodified 7-deaza-guanosine nucleoside exclusively synthesized by bacteria. This micronutrient and its respective nucleobase form queuine (q) are salvaged by humans either from gut microflora or digested food. Depletion of Q-tRNA in human or mouse cells causes protein misfolding that triggers endoplasmic reticular stress and...

Background Blood-based biomarkers offer a promising, less invasive, and more cost-effective alternative for Alzheimer's disease screening compared to cerebrospinal fluid or imaging biomarkers. However, they have been extensively studied only in memory clinic-based cohorts. We aimed to validate them in a more heterogeneous, older patient population...

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...

Background and objectives: Previous randomized controlled trials and longitudinal studies have indicated that ongoing antihypertensive use in late life reduces all-cause dementia risk, but the specific impact on Alzheimer dementia (AD) and non-AD risk remains unclear. This study investigates whether previous hypertension or antihypertensive use mo...

Background/Aims Our current study aimed to investigate the determinants of dementia among the oldest old using longitudinal data from a representative sample covering both community-dwelling and institutionalized individuals. Methods/Design Longitudinal representative data were taken from the “Survey on quality of life and subjective well-being of...

Resilience is the capacity to adapt to stressful life events. As such, this trait is associated with physical and mental functions and conditions. Here, we aimed to identify the genetic factors contributing to shape resilience. We performed variant- and gene-based meta-analyses of genome-wide association studies from six German cohorts (N = 15822)...

Zusammenfassung Hintergrund Einsamkeit ist ein weitverbreitetes Phänomen und steht in Zusammenhang mit gesundheitlichen Beeinträchtigungen. Dabei stellen Arbeitslose mit psychischen Erkrankungen (ALPE) eine Hochrisikogruppe in Hinblick auf Gesundheit und berufliche Wiedereingliederung dar. Ziel dieser Studie ist ein besseres Verständnis der Zusamm...

Although people receiving means-tested benefits are regularly taken care of at the job center, little is known about their mental health situation and mental health care. The aim of the study was to describe the diagnostic spectrum and the functional status as well as the mental health care utilization of individuals with mental illnesses who are r...

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...

Depression questionnaire cutoffs are calibrated for screening accuracy and not to assess prevalence, but the Geriatric Depression Scale (GDS-15) is often used to estimate diagnostic prevalence among older adults, most commonly with scores of ≥ 5. We conducted an individual participant data meta-analysis to compare depression prevalence based on GDS...

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 Obesity and depression both represent major public health challenges. The study aim is to investigate prevalence rates of depression, obesity and comorbid conditions and their associated factors in a German working-age population-based sample. Methods Analyses were conducted on n = 5784 participants (18-67 years) from the baseline sur...

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...

Introduction The purpose of this study is to investigate the exposure-risk relationship between psychosocial occupational stress and mental illness. In many countries, the so-called doubling dose is important for the recognition of a new occupational disease: if a specific exposure is associated with a doubling of the risk of disease, it can be ass...

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-...

Administration mode of patient-reported outcome measures (PROMs) may influence responses. We assessed if Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS) and Hospital Anxiety and Depression Scale – Depression subscale (HADS-D) item responses and scores were associated with administration mode. We compared (1) self...

Zusammenfassung Psychische Belastungen haben Einfluss auf den Studienerfolg und können sich in psychischen Erkrankungen manifestieren. Der vorliegende Beitrag beschäftigt sich mit der Verbreitung psychischer Krisen bei Studierenden in Deutschland sowie mit ihren Erwartungen an die Hochschule. Im Rahmen eines Präventionsworkshops zur psychischen Ges...

White matter hyperintensities (WMH) reflect cerebral small vessel disease (cSVD) a major brain pathology contributing to cognitive decline and dementia. Vascular risk factors including higher diastolic blood pressure (DBP) have been associated with the progression of WMH yet longitudinal studies have not comprehensively assessed these effects for a...

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...

INTRODUCTION The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS We combined data from...

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...

Background:Good social connections are proposed to positively influence the course of cognitive decline by stimulating cognitive reserve and buffering harmful stress-related health effects. Prior meta-analytic research has uncovered links between social connections and the risk of poor health outcomes such as mild cognitive impairment, dementia, an...

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...

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-...

Fachwissen in die Praxis der Gesundheitsversorgung bringen Viele Bereiche der Gesundheitsversorgung sind historisch gewachsen und viele Routinen sind seit vielen Jahren eingespielt. Mittlerweile gibt es viele Verbesserungsansätze und Ideen, die darauf warten, in die Praxis umgesetzt zu werden. Zum Wohle der Mitarbeitenden und der Patient*innen! Neu...

Background Depression is a known risk factor for dementia, and social support may lower the risk of depression in older adults. There is, however, a lack of longitudinal analyses examining the association between emotional versus instrumental support and depressive symptoms in older adults. We analyzed the association of emotional and instrumental...

Background Blood‐based biomarkers of Alzheimer’s disease (AD) may provide an avenue for early identification of individuals at risk for AD dementia, which is a crucial task for implementing upcoming disease‐modifying therapies in clinical practice. Among blood‐based biomarkers, P‐tau217 has shown a particular sensitivity to amyloid pathology and ut...

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 Blood‐based biomarkers offer a major benefit to Alzheimer’s disease screening because they are less invasive and costly than cerebrospinal fluid or imaging biomarkers, but they have been mainly studied in individuals from memory clinics often exhibiting only mild comorbidities. Therefore, it is necessary to validate plasma biomarkers in...

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...

Zusammenfassung Ziel Die Studie untersucht, wie gut die Beteiligung von Menschen mit psychischen Beeinträchtigungen und Angehörigen an der Entwicklung von psychiatrischen Leitlinien gegenwärtig gelingt. Methodik Ergebnisse einer Umfrage unter N=561 (Response 37%) Entwickler:innen werden vorgestellt. Ergebnisse Die Einbindung Betroffener gelingt häu...

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...

Objectives There are few studies investigating the determinants of psychosocial outcomes using data exclusively from the oldest old; and even fewer that use longitudinal data. Thus, our aim was to explore the determinants of psychosocial factors (in terms of life satisfaction, loneliness, and depressive symptoms) amongst the oldest old (also strati...

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 In this study, we assess how the first and second waves of the COVID-19 pandemic influenced the suicide risk of patients with severe mental disorders in Germany. Methods We analyzed German health insurance claims data to compare the suicide risk of patients with severe mental disorders before and during the pandemic. We included n = 690,84...

There is an empirical association between stress and symptoms of food addiction (FA), but it is still not clear which domains of stress are the most relevant when it comes to FA, limiting the ability of researchers and practitioners to address problematic eating‐related health outcomes. In order to address this gap in the literature, we analysed ho...

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...

We built a genetic risk score (GRS) from the most complete landscape of the Alzheimer disease (AD) genetics. We extended its analysis in 16 European countries and observed a consistent association of this GRS with AD risk, age at onset and cerebrospinal fluid (CSF) AD biomarker levels regardless of the Apolipoprotein E (APOE) genotype. This GRS was...

Purpose Major lockdowns were imposed in Germany from March until May 2020 and from December 2020 until May 2021. We studied the influence of these lockdowns, the strain on intensive care units and the strictness of COVID-19-related containment strategies on the utilization of mental health care among patients with severe mental disorders. Methods...

Zusammenfassung Hintergrund Nach einer aktuellen Prävalenzschätzung aus 2021 leben 1,8 Mio. Menschen mit Demenz (MmD) in Deutschland. Diese Schätzungen basieren auf Feldstudien und bilden nicht das Diagnosegeschehen der ärztlichen Versorgung ab. Analyseziel war daher die Prävalenz sowie die Altersverteilung der MmD in Hausarztpraxen (HA) mit der Pr...