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To investigate time-dependent predictors of institutionalization in old age using a longitudinal approach. In a representative survey of the German general population aged 75 years and older predictors of institutionalization were observed every 1.5 years over six waves. Conditional fixed-effects logistic regressions (with 201 individuals and 960 observations) were performed to estimate the effects of marital status, depression, dementia, and physical impairments (mobility, hearing and visual impairments) on the risk of admission to old-age home or nursing home. By exploiting the longitudinal data structure using panel econometric models, we were able to control for unobserved heterogeneity such as genetic predisposition and personality traits. The probability of institutionalization increased significantly with occurrence of widowhood, depression, dementia, as well as walking and hearing impairments. In particular, the occurrence of widowhood (OR = 78.3), dementia (OR = 154.1) and substantial mobility impairment (OR = 36.7) were strongly associated with institutionalization. Findings underline the strong influence of loss of spouse as well as dementia on institutionalization. This is relevant as the number of old people (a) living alone and (b) suffering from dementia is expected to increase rapidly in the next decades. Consequently, it is supposed that the demand for institutionalization among the elderly will increase considerably. Practitioners as well as policy makers should be aware of these upcoming challenges.

Although suicidal ideation is a significant issue among adolescents, previous studies have largely relied on cross-sectional data collected at a single time point or have been limited to individual countries, providing limited insight into temporal trends across diverse populations. Therefore, we aimed to examine temporal trends in suicidal ideation among adolescents across 23 countries. We analyzed data from the Global School-Based Student Health Survey (2003–2021), which included adolescents aged 13–15 years in 23 countries. Each participant participated in multiple surveys, and survey years varied by country. Prior to trend estimation, we compared linear and quadratic fits where more than three surveys were available to identify near-linear patterns. Temporal trend was quantified as the average annual percentage change (AAPC), which was calculated by weighted log-linear regression on the log prevalence rates of the survey years, applied separately to boys and girls. The study analyzed 185,941 school-attending adolescents (46.45% male) across 23 countries. The prevalence of suicidal ideation showed significant upward trends in six countries: Myanmar (AAPC, 32.04%/year; 2007–2016), Guyana (AAPC, 8.88%/year; 2010–2014), Saint Vincent and the Grenadines (AAPC, 3.87%/year; 2007–2018), Mongolia (AAPC, 3.67%/year; 2010–2013), Bolivia (AAPC, 3.02%/year; 2012–2018), and Seychelles (AAPC, 2.54%/year; 2007–2015). Conversely, five countries exhibited significant declines, including Benin (AAPC, -8.60%/year; 2009–2016), Kuwait (AAPC, -6.40%/year; 2011–2015), and the Maldives (AAPC, -4.33%/year; 2009–2014). Sex-specific differences in trends were nominally significant (p < 0.05) in six countries—Benin, Kuwait, Argentina, Saint Vincent and the Grenadines, Thailand, and Guyana—but only two (Saint Vincent and the Grenadines and Thailand) remained statistically significant after Bonferroni correction. In five of these countries (excluding Guyana), girls exhibited more unfavorable patterns, showing either a greater increase or a smaller decrease in suicidal ideation compared to boys. This study highlights divergent trends in adolescent suicidal ideation across 23 countries, with rising prevalence in some regions and notable sex differences. The findings underscore the need for continued surveillance and context-specific mental health interventions.

Thus far, some empirical studies have investigated the association between oral health and loneliness as well as social isolation. However, a systematic review and meta-analysis is lacking synthesizing this evidence. Hence, our purpose was to close this knowledge gap. Systematic review and meta-analysis. Observational studies examining the association between oral health and loneliness or social isolation were included. Disease-specific samples were excluded. We searched three electronic databases (PubMed, PsycINFO, CINAHL), and did an additional hand search. Data extraction covered methods, sample characteristics and main findings. To evaluate study quality/risk of bias, the NIH tool was used. Study selection, data extraction and assessment of study quality were each conducted by two reviewers. Seven studies were included in our current work. Several cross-sectional studies and one longitudinal study reported an association between poorer oral health and higher loneliness as well as higher social isolation. The quality of the studies was mostly fair, with two studies of high quality. The pooled OR was 1.47 (95% CI 1.24–1.75) among the studies with adult samples. Most of the included studies demonstrated an association between oral health and loneliness or social isolation. There is a lack of high quality studies on these associations; in particular, future studies should use longitudinal data to clarify the directionality between oral health and loneliness or social isolation. Prospero registration number CRD42021268116.

While various antidiabetic drug classes are associated with differing infection risks, comprehensive evidence on infection risk across multidrug regimens remains limited. Therefore, this study aims to investigate the pharmacovigilance signal between antidiabetic drug use and infection risk, considering the number and patterns of drug use. This study evaluated the pharmacovigilance signal between antidiabetic drug use and infection utilizing the global pharmacovigilance database. To account for adverse events from multiple drug use, we restructured the database at the individual level using a unique demographic identifier, allowing assessment of infection risk by drug combination and count. Antidiabetic drugs include metformin, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), sodium-glucose cotransporter-2 (SGLT2) inhibitors, thiazolidinediones, alpha-glucosidase inhibitors, and insulin, with infections categorized by the system. The pharmacovigilance signal of adverse drug reactions was estimated using adjusted reporting odds ratios (aRORs) with 95% confidence intervals (CIs) through multivariable logistic regression. SGLT2 inhibitor users reported the highest frequency of infections ( n  = 13,570), followed by insulin ( n  = 11,322) and GLP-1 RAs ( n  = 5966). When analyzing only monotherapy, excluding combination use, urinary tract infections were significantly linked solely to SGLT2 inhibitors (aROR, 10.41 [95% CI, 9.76–11.09]), while hepatobiliary and pancreatic infections were associated with DPP-4 inhibitors (aROR, 1.72 [95% CI, 1.28–2.31]), with no significant pharmacovigilance signal observed for other drug classes. Compared to monotherapy, combination therapy with two drugs (aROR, 1.24 [95% CI, 1.20–1.29]) or three or more drugs (aROR, 1.42 [95% CI, 1.13–1.79]) was associated with infection. Although the results from disproportionality analysis did not indicate causal relationship, our findings indicate that infection types vary between monotherapy and combination therapy, highlighting the need for further investigation into these pharmacovigilance signal due to the increased susceptibility of individuals with diabetes.

People experiencing homelessness (PEH) are at risk of contracting and transmitting infectious diseases. Data on PEH blood-transmitted virus prevalence and vaccination coverage is needed to design targeted interventions. A nationwide multicentre cross-sectional study of PEH was conducted. Clinical data were collected through questionnaire-based interviews, and blood samples were tested by serology and qPCR. Latent class analysis (LCA) identified subgroups of PEH, while univariable regressions identified risk factors of viral hepatitis. 643 PEH from four metropolitan areas in Germany were included. LCA revealed national short-term, long-term and international short-term PEH subgroups. The prevalence of anti-HAV-IgG, anti-HBc, anti-HBsAg, anti-HCV, anti-HEV and anti-HIV was 44% (95%CI: 39–48%), 17% (95%CI: 14–21%), 25% (95%CI: 21–29%), 18% (95%CI: 15–22%), 29% (95%CI: 25–33%) and 0.7% (95%CI: 0.2–1.7%), respectively. Active HBV and HCV infection was detected in 1.4% (95%CI: 0.7–2.7%) and 12% (95%CI: 9.6–14%), respectively. Univariable logistic regression revealed PEH with former imprisonment had 13.24 times the odds of active or past HCV infection (95%CI: 6.28–27.90) that individuals without had. This study shows the high acquisition and transmission risks for HCV/HIV among PEH. Low vaccination coverage for HAV/HBV calls for revising vaccine recommendations. High HCV infection risk associated with imprisonment highlights the need to address health disparities faced by incarcerated individuals.

Purpose The aim of this study was to examine the longitudinal within-association between social support and health-related quality of life among the oldest old. Methods Longitudinal data (follow-up waves 7 to 9) were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85 +)” (AgeQualiDe). n  = 648 individuals were included in the analytical sample. At FU wave 7, mean age was 88.8 years (SD: 2.9 years, from 85 to 99 years). Social support was quantified using the Lubben Social Network Scale (6-item version). Health-related quality of life was assessed using the EQ-5D-3L including problems in five health dimensions, and its visual analogue scale (EQ VAS). It was adjusted for several covariates in conditional logistic and linear fixed effects regressions. Results Intraindividual decreases in social support were associated with an increased likelihood of developing problems in ‘self-care’, ‘usual activities’, ‘pain/discomfort’ and ‘anxiety/depression’ (within individuals over time). In contrast, intraindividual changes in social support were not associated with intraindividual changes in the EQ VAS score. Conclusion Findings indicate a longitudinal intraindividual association between social support and problems, but only in some health dimensions. Further research in this area based on longitudinal studies among the oldest old (from different countries) is required.

Background Thus far, only a few longitudinal studies investigated the impact of social engagement on health-related quality of life (HRQoL) and depressive symptoms in old age. Therefore, we aimed to examine the impact of social engagement on HRQoL and depressive symptoms in late life. Methods Individuals aged 75 years and over at baseline were interviewed every 1.5 years in a multicenter prospective cohort study in Germany. While HRQoL was quantified by using the Visual Analogue Scale (EQ VAS) of the EQ-5D instrument, depressive symptoms was assessed by using the Geriatric Depression Scale (GDS). Individuals reported the frequency (“never” to “every day”) of social engagement (e.g., engagement in the church, as a volunteer, in a party, or in a club) in the last four weeks. Fixed effects regressions were used to estimate the effect of social engagement on the outcome variables. Results After adjusting for age, marital status, functional status and chronic diseases, fixed effects regressions revealed that the onset of social engagement markedly increased HRQoL and considerably decreased depressive symptoms in the total sample and in women, but not men. Conclusions Our findings corroborate the relevance of social engagement for HRQoL and depressive symptoms in old age. Encouraging the individuals to start, maintain and expand social engagement in late life might help to maintain and improve HRQoL and decrease depressive symptoms.

BackgroundIt is almost unknown whether the driving status is associated with HRQOL among individuals in highest age.AimsBased on a multicenter prospective cohort study, the objective of this study was to examine whether the driving status is associated with health-related quality of life (HRQOL) among the oldest old in Germany.MethodsCross-sectional data from follow-up wave 9 (n = 544) were derived from the “Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe). Average age was 90.3 years (± 2.7; 86 to 101 years). The current driver status (no; yes) was used in our analysis. The EuroQoL EQ-5D questionnaire was used to assess HRQOL in this study.ResultsRegression analysis showed that being a current driver was associated with the absence of problems in ‘self-care’ [OR 0.41 (95%-CI 0.17 to 0.98)], and ‘usual activities’ [OR 0.48 (0.26 to 0.90)], whereas it was not significantly associated with problems in ‘pain/discomfort’ [OR 0.82 (0.47 to 1.45)] and ‘anxiety/depression’ [OR 0.71 (0.36 to 1.39)]. Being a current driver was marginally significantly associated with the absence of problems in ‘mobility’ [OR 0.60 (0.34 to 1.06)]. While being a current driver was not associated with the EQ-VAS in the main model, it was positively associated with the driving status (β = 5.00, p < .05) when functional impairment was removed from the main model.DiscussionOur findings provide first evidence for an association between driving status and HRQOL among the oldest old.ConclusionsFuture longitudinal studies are required to evaluate a possible causal relationship between driving status and HRQOL in very old individuals.

This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. n = 47 studies on heterogeneous research questions were included, with sample sizes ranging from n = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. n = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.

Purpose To describe health status and health state utilities measured by the EQ-5D-3L in a population-based sample of individuals aged 85 + in Germany, and to analyze associations with basic socio-demographic variables. Methods Cross-sectional data from follow-up wave 7 ( n  = 761) of the German AgeCoDe Study were used. The EQ-5D-3L questionnaire was used to record problems in five health dimensions, its visual analogue scale (EQ VAS) was used to record self-rated health status, and the German EQ-5D-3L index was used to derive health state utilities. Results Mean age of respondents was 88.9 years (SD 2.9; range 85 to 100), 67.4% were female. 81.9% reported problems in at least one of the EQ-5D dimensions, with 15.3% reporting extreme problems. Most frequent were problems with pain/discomfort (64.8%), followed by mobility (62.5%), usual activities (42.6%), self-care (28.2%), and anxiety/depression (20.5%). Mean EQ VAS score was 62.4 (SD 18.8), and mean EQ-5D index was 0.77 (SD 0.24). Multiple regression analysis showed associations of problem frequency in various EQ-5D dimensions with age, gender, living situation, marital status, and education. The EQ VAS score was negatively associated with age ( β  =  − 0.56; p  < 0.05) and female gender ( β  =  − 3.49; p  < 0.05). The EQ-5D index was negatively associated with not living in the community ( β  =  − 0.10; p  < 0.001) and being single ( β  =  − 0.09; p  < 0.05). Conclusions The results show a substantially impaired health status of the oldest-old population. The data can be used for comparing health status of population groups as well as for health economic models.