Antje Gößwald

German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

BackgroundThe German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources.Methods/designThe first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010.DiscussionDEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.

Determinants of tetanus and seasonal influenza vaccine uptake in adults living in Germany.

The primary objective of this study was to assess determinants of vaccine uptake in adults living in Germany exemplified by one standard vaccination (tetanus) and one vaccination targeting specific risk-groups (seasonal influenza). Data from 21,262 telephone household-interviews representative of the adult population in Germany were collected in 2009 and analysed. A total 73.1% of the adult population had a sufficient tetanus vaccination status according to national recommendations (i.e. last tetanus shot ≤10 years ago). Influenza vaccination coverage in the target population (i.e. persons ≥60 years, chronically ill, healthcare workers) was 44.1%. Persons who received professional vaccination advice within the past five years were more frequently vaccinated against tetanus and influenza than persons without (p

Prävalenz von Herzinfarkt und koronarer Herzkrankheit bei Erwachsenen im Alter von 40 bis 79 Jahren in Deutschland

In the German Health Interview and Examination Survey for Adults (DEGS1), data on the prevalence of myocardial infarction and coronary heart disease were collected from 2008-2011 in a representative population-based sample of 5,901 adults aged 40-79 years. The results of DEGS1 were compared with the prevalence estimates from the German National Health Interview and Examination Survey 1998 (GNHIES98). The lifetime prevalence of myocardial infarction amongst 40-79 year olds in DEGS1 is 4.7 % (women 2.5 %; men 7 %). In comparison with GNHIES98 a small increase was observed in men, but not in women. The lifetime prevalence of coronary heart disease in adults aged 40-79 years in DEGS1 is 9.3 % (women 6.4 %; men 12.3 %). In comparison to GNHIES98 there is a slight reduction only in women. There is a significant inverse relationship between disease prevalence and socioeconomic status. The trend in prevalence of coronary heart disease is comparable with that in other high-income countries. Given a falling incidence of myocardial infarction and a decrease in the mortality rates due to coronary heart disease, the basically stable prevalence rates indicate a positive development in the field of cardiovascular prevention and therapy. An English full-text version of this article is available at SpringerLink as supplemental.

Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany - results of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009

BackgroundDespite the major public health impact of diabetes, recent population-based data regarding its prevalence and comorbidity are sparse.MethodsThe prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. Information on physician-diagnosed diabetes and 20 other chronic health conditions was collected as part of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009. Overall, 51.2% of contacted persons participated. Among persons with diabetes, diabetes severity was defined according to the type and number of diabetes-concordant conditions: no diabetes-concordant condition (grade 1); hypertension and/or hyperlipidemia only (grade 2); one comorbidity likely to represent diabetes-related micro- or macrovascular end-organ damage (grade 3); several such comorbidities (grade 4). Determinants of diabetes severity were analyzed by multivariable ordinal regression.ResultsThe 12-month prevalence of diabetes was 13.6% with no significant difference between men and women. Persons with diabetes had a significantly higher prevalence and average number of diabetes-concordant as well as diabetes-discordant comorbidities than persons without diabetes. Among persons with diabetes, 10.2%, 46.8%, 35.6% and 7.4% were classified as having severity grade 1–4, respectively. Determinants of diabetes severity included age (cumulative odds ratio 1.05, 95% confidence interval 1.03-1.07, per year) and number of discordant comorbidities (1.40, 1.25-1.55). With respect to specific discordant comorbidities, diabetes severity was correlated to depression (2.15, 1.29-3.56), respiratory disease (2.75, 1.72-4.41), musculoskeletal disease (1.53, 1.06-2.21), and severe hearing impairment (3.00, 1.21-7.41).ConclusionsDiabetes is highly prevalent in the non-institutionalized German adult population 50 years and older. Diabetes comorbidities including diabetes-concordant and diabetes-discordant conditions need to be considered in epidemiological studies, in order to monitor disease burden and quality of diabetes care. Definitional standards of diabetes severity need to be refined and consented.

Verbreitung von Fettstoffwechselstörungen bei Erwachsenen in Deutschland

Interview and laboratory data from the first wave of the German health interview and examination survey for adults (DEGS1) from 2008 to 2011 were used to provide current estimates of the prevalence of dyslipidemia which are representative of the population in Germany 18 to 79 years of age. A total of 56.6 % of men and 60.5 % of women 18 to 79 years have elevated serum total cholesterol concentrations in excess of the currently recommended threshold of 190 mg/dL; 17.9 % of men and 20.3 % of women have highly elevated total cholesterol concentrations ≥ 240 mg/dL. A total of 19.3 % of men and 3.6 % of women have high density lipoprotein cholesterol concentrations below 40 mg/dL. The overall prevalence of dyslipidemia (total cholesterol ≥ 190 mg/dL or medical diagnosis of dyslipidemia) is 64.5 % for men and 65.7 % for women. Of these, more than half of both men and women have previously undiagnosed dyslipidemia. Among persons with known dyslipidemia, 30.8% take lipid-lowering medication. Dyslipidemia is widely prevalent among adults in Germany. More in-depth analyses will examine time trends in the prevalence of dyslipidemia in Germany and in an international comparison. An English full-text version of this article is available at SpringerLink as supplemental.

Prävalenz des Schlaganfalls bei Erwachsenen im Alter von 40 bis 79 Jahren in Deutschland

In the German Health Interview and Examination Survey (DEGS1), data on the prevalence of physician-diagnosed stroke were collected from 2008 to 2011 in a representative population-based sample of 5,901 adults aged 40-79 years. The stroke prevalence in DEGS1 was compared with prevalence estimates from the German National Health Interview and Examination Survey 1998 (GNHIES98). The lifetime prevalence of stroke in adults aged 40-79 years is 2.9 % (women: 2.5 %; men: 3.3 %). In both sexes, the prevalence increases continuously with age, up to 6.3 % in women and 8.1 % in men 70-79 years old. More pronounced in women than in men, the prevalence of stroke decreases with increasing socioeconomic status. Compared to GNHIES98, there is no evidence for a change in stroke prevalence over time. The prevalence of stroke in adults aged 40-79 years in Germany is comparable to prevalence estimates from other national and international studies. Further studies should examine the reasons behind stable prevalence rates, accounting for population ageing and changes in incidence, mortality and case fatality rates. An English full-text version of this article is available at SpringerLink as supplemental.

[The first wave of the German Health Interview and Examination Survey for Adults (DEGS1): participant recruitment, fieldwork, and quality management].

The purpose of the German Health Interview and Examination Survey for Adults (DEGS) is to repeatedly obtain representative nationwide health data for adults aged 18-79 years living in Germany. The first wave (DEGS1) was carried out by the Robert Koch Institute (RKI) from November 2008 to December 2011. The study has a mixed design, which permits both cross-sectional and longitudinal analysis. It was carried out on an up-to-date sample from the population registration office and on participants from the 1998 German National Health Interview and Examination Survey (GNHIES98), who were invited to take part again. All newly selected individuals, and those GNHIES98 participants living in the same locations as in 1998, were asked to undergo an interview and examination. GNHIES98 participants who had moved to a different location were asked to take part in a survey based on self-completion questionnaires and telephone interviews. This article describes the practicalities of recruiting participants, planning and carrying out fieldwork, managing data, and taking measures to ensure the quality of the process and data. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of dyslipidemia among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS 1)].

Interview and laboratory data from the first wave of the German health interview and examination survey for adults (DEGS1) from 2008 to 2011 were used to provide current estimates of the prevalence of dyslipidemia which are representative of the population in Germany 18 to 79 years of age. A total of 56.6 % of men and 60.5 % of women 18 to 79 years have elevated serum total cholesterol concentrations in excess of the currently recommended threshold of 190 mg/dL; 17.9 % of men and 20.3 % of women have highly elevated total cholesterol concentrations ≥ 240 mg/dL. A total of 19.3 % of men and 3.6 % of women have high density lipoprotein cholesterol concentrations below 40 mg/dL. The overall prevalence of dyslipidemia (total cholesterol ≥ 190 mg/dL or medical diagnosis of dyslipidemia) is 64.5 % for men and 65.7 % for women. Of these, more than half of both men and women have previously undiagnosed dyslipidemia. Among persons with known dyslipidemia, 30.8% take lipid-lowering medication. Dyslipidemia is widely prevalent among adults in Germany. More in-depth analyses will examine time trends in the prevalence of dyslipidemia in Germany and in an international comparison. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of myocardial infarction and coronary heart disease in adults aged 40-79 years in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

In the German Health Interview and Examination Survey for Adults (DEGS1), data on the prevalence of myocardial infarction and coronary heart disease were collected from 2008-2011 in a representative population-based sample of 5,901 adults aged 40-79 years. The results of DEGS1 were compared with the prevalence estimates from the German National Health Interview and Examination Survey 1998 (GNHIES98). The lifetime prevalence of myocardial infarction amongst 40-79 year olds in DEGS1 is 4.7 % (women 2.5 %; men 7 %). In comparison with GNHIES98 a small increase was observed in men, but not in women. The lifetime prevalence of coronary heart disease in adults aged 40-79 years in DEGS1 is 9.3 % (women 6.4 %; men 12.3 %). In comparison to GNHIES98 there is a slight reduction only in women. There is a significant inverse relationship between disease prevalence and socioeconomic status. The trend in prevalence of coronary heart disease is comparable with that in other high-income countries. Given a falling incidence of myocardial infarction and a decrease in the mortality rates due to coronary heart disease, the basically stable prevalence rates indicate a positive development in the field of cardiovascular prevention and therapy. An English full-text version of this article is available at SpringerLink as supplemental.

[Prevalence of stroke in adults aged 40 to 79 years in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

In the German Health Interview and Examination Survey (DEGS1), data on the prevalence of physician-diagnosed stroke were collected from 2008 to 2011 in a representative population-based sample of 5,901 adults aged 40-79 years. The stroke prevalence in DEGS1 was compared with prevalence estimates from the German National Health Interview and Examination Survey 1998 (GNHIES98). The lifetime prevalence of stroke in adults aged 40-79 years is 2.9 % (women: 2.5 %; men: 3.3 %). In both sexes, the prevalence increases continuously with age, up to 6.3 % in women and 8.1 % in men 70-79 years old. More pronounced in women than in men, the prevalence of stroke decreases with increasing socioeconomic status. Compared to GNHIES98, there is no evidence for a change in stroke prevalence over time. The prevalence of stroke in adults aged 40-79 years in Germany is comparable to prevalence estimates from other national and international studies. Further studies should examine the reasons behind stable prevalence rates, accounting for population ageing and changes in incidence, mortality and case fatality rates. An English full-text version of this article is available at SpringerLink as supplemental.