Evidence map›Paper›PMID 27980691›Full record

ArticleEuropean review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity2016

Extremity injuries and dementia disproportionately increase the risk for long-term care at older age in an analysis of German Health Insurance routine data for the years 2006 to 2010.

Alexander Barth, Anja Vatterrott, Ying Zhou, Anne Fink, Gabriele Doblhammer

Open access · goldAbstract read
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In one paragraph

Article in European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Alexander BarthEmpirical Social Research and Demography, Institute of Sociology and Demography, University of Rostock, Ulmenstr. 69, 18057 Rostock, Germany.ORCID 0000-0002-8632-8255
Anja VatterrottEmpirical Social Research and Demography, Institute of Sociology and Demography, University of Rostock, Ulmenstr. 69, 18057 Rostock, Germany.
Ying ZhouEmpirical Social Research and Demography, Institute of Sociology and Demography, University of Rostock, Ulmenstr. 69, 18057 Rostock, Germany.
Anne FinkGerman Center for Neurodegenerative Diseases, Rostock, Germany.
Gabriele DoblhammerEmpirical Social Research and Demography, Institute of Sociology and Demography, University of Rostock, Ulmenstr. 69, 18057 Rostock, Germany ; Rostock Center for the Study of Demographic Change, Rostock, Germany ; German Center for Neurodegenerative Diseases, Bonn/Rostock, Germany.
University of Rostock · DEGerman Center for Neurodegenerative Diseases · DERostocker Zentrum zur Erforschung des Demografischen Wandels · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtremity injuries (EI) and dementia are important causes of long-term care (LTC), but they can also cause each other and are often present concurrently. Mobility-limiting EI can increase the risk of dementia, and dementia increases the risk for falls, which are often the cause of EI. When EI and dementia are present together, they can increase their negative effect on long-term care risk. This study aims to assess the strength of this interaction and the role of different body regions and severities of EI regarding LTC risk.

methodsWe use Cox proportional-hazard models on LTC as dependent variable. EI (primarily fractures) and dementia (all types) are the central independent variables. We control for age, sex, rehabilitation and 18 relevant comorbidities. Analyses are based on health claims records for 2004-2010 for a random sample of about 122.000 insurants of Germany's largest public health insurance "AOK" aged 65+, about 25.000 of whom entered LTC.

resultsWithout concurrent dementia, non-severe EI (NSEI) of the lower and both extremities and all kinds of severe EI (SEI) increase LTC risk (HR: hazard ratio with 95% confidence interval. Lower NSEI: HR = 1.09 [1.05-1.14]; both NSEI: HR = 1.36 [1.29-1.44]. Lower SEI: HR = 1.67 [1.57-1.79]; upper SEI: HR = 1.27 [1.19-1.37]; both SEI: HR = 1.94 [1.81-2.07]). Dementia alone increases LTC risk more than fourfold (HR = 4.23 [4.11-4.35]). Taking the interaction of EI and dementia into account, the concurrent presence of EI and dementia tends to increase the LTC risk more than expected for lower as well as upper NSEI and SEI. Summarily, when lower or upper EI and dementia are both present, the LTC risk tends to be higher than expected, suggesting synergistic effects.

conclusionsEI and dementia are important independent risk factors for long-term care. When lower or upper EI and dementia are present together, the resulting long-term care risk is increased disproportionately. Since the concurrent presence of both conditions increases the risk for care need, and a working treatment for dementia is not in sight, preventing EI, lessening the impact of EI and improving the outlook after an EI could help to reduce LTC need in the coming decades.

Indexed as

AgedDementiaExtremities, Mobility limitationLong-term care

Identifiers

PMID27980691
PMCPMC5139115
OpenAlexW2560589825

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.