Elke Peters

Demografischer Wandel und Krankheitshäufigkeiten

Demographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.ZusammenfassungDer demografische Wandel und sein Einfluss auf die Krankenversorgung werden teilweise heftig diskutiert. Ziel dieser Arbeit ist die Projektion von Erkrankungsraten basierend auf der 11. koordinierten Bevölkerungsvorausberechnung und auf bevölkerungsbezogenen Daten zu wichtigen Erkrankungen. Bis 2050 wird die deutsche Bevölkerung insgesamt um etwa 16% schrumpfen. Gleichzeitig wird die Zahl der über 65-Jährigen um 38% und der über 80-Jährigen um 156% steigen. Dabei führen insbesondere die geburtenstarken Jahrgänge zu einer vertikalen Welle durch die Alterspyramide mit einem überproportional steigenden Anteil an älteren Menschen. Die Häufigkeit von Erkrankungen mit ausgeprägtem Altersbezug wie ambulant erworbene Pneumonie, altersbedingte Makuladegeneration, Demenz, Oberschenkelhalsfraktur und Herzinfarkt wird bis 2050 unter der Annahme gleich bleibender Erkrankungswahrscheinlichkeiten stark zunehmen. Zu den häufigsten Erkrankungen 2050 werden die Hypertonie und die Arthrose zählen. Langfristig wirkende gesundheitspolitische Weichenstellungen sollten jetzt vor dem Hintergrund dieser Projektionen verantwortungsvoll bedacht werden. Ein breit angelegter gesellschaftlicher Diskurs über Basisversorgung und Priorisierung scheint dringend erforderlich.AbstractDemographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.

Projection of Morbidity 2030 and 2050: Impact for the National Health System and Blood Supply.

Background: The German population will decrease by 16% until 2050, and the ratio of young to old people is shifting towards the elderly. Because risk of disease rises with age, an aging society will be confronted with a higher burden of diseases. Methods: A projection of status quo case numbers and crude rates of selected diseases was done for the years 2030 and 2050. Actual sex- and age-specific rates were transferred to the predicted population figures (11th coordinated population prediction). Results: Cancer incidence will rise from 461,000 (2007) to 588,000 cases (2050) (+27%). Crude incidence rate will increase by 52%. Number of femoral neck fractures will rise by 88% (rate +122%). For other diseases incidence and prevalence will increase up to 144%. Conclusion: Blood (products) will be necessary for the therapy of many of the presented diseases. Therefore, it can be assumed that future demand of blood will rise in a similar manner as the rising number of diseases. The projected developments describe an extraordinary challenge for the German health care system and in particular for transfusion medicine. It is necessary to develop new concepts to meet this future demands and to ensure a high-performance health care system.

Cohort Profile: A population-based cohort to study non-motor symptoms in parkinsonism (EPIPARK)

Parkinsons disease is increasingly viewed as a complex disorder including a range of typical non-motor symptoms in addition to the cardinal motor signs. This cohort was set up in 2010 to investigate the specificity of non-motor symptoms for Parkinsons disease. For this, we included several control groups with decreasing contrast from Parkinsons disease patients. Group definitions ranged from healthy control subjects to those with suspected early motor signs of parkinsonism. Using a mailed questionnaire, we screened 5838 inhabitants of Lübeck, Germany, out of a target population of 10 000 citizens, enquiring about motor impairment, pain, quality of life, comorbidities, somatization and demographics. Based on this information, participants were assigned to screening groups, and selected participants were invited for in-person examination (n = 623). The examination included cognitive examinations, transcranial ultrasound, a brief psychiatric interview and a standardized motor examination that was used to assign examination groups. In addition, all participants answered questionnaires addressing depression, anxiety, sleep and quality of life. The first-year follow-up examination was performed either in person using the same protocol or via mailed questionnaires. This study is ongoing and publications are in preparation, but you may contact the first author (meike.kasten@neuro.uni-luebeck.de) with suggestions for collaboration or data requests.

[Demographic change and disease rates: a projection until 2050].

Demographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.ZusammenfassungDer demografische Wandel und sein Einfluss auf die Krankenversorgung werden teilweise heftig diskutiert. Ziel dieser Arbeit ist die Projektion von Erkrankungsraten basierend auf der 11. koordinierten Bevölkerungsvorausberechnung und auf bevölkerungsbezogenen Daten zu wichtigen Erkrankungen. Bis 2050 wird die deutsche Bevölkerung insgesamt um etwa 16% schrumpfen. Gleichzeitig wird die Zahl der über 65-Jährigen um 38% und der über 80-Jährigen um 156% steigen. Dabei führen insbesondere die geburtenstarken Jahrgänge zu einer vertikalen Welle durch die Alterspyramide mit einem überproportional steigenden Anteil an älteren Menschen. Die Häufigkeit von Erkrankungen mit ausgeprägtem Altersbezug wie ambulant erworbene Pneumonie, altersbedingte Makuladegeneration, Demenz, Oberschenkelhalsfraktur und Herzinfarkt wird bis 2050 unter der Annahme gleich bleibender Erkrankungswahrscheinlichkeiten stark zunehmen. Zu den häufigsten Erkrankungen 2050 werden die Hypertonie und die Arthrose zählen. Langfristig wirkende gesundheitspolitische Weichenstellungen sollten jetzt vor dem Hintergrund dieser Projektionen verantwortungsvoll bedacht werden. Ein breit angelegter gesellschaftlicher Diskurs über Basisversorgung und Priorisierung scheint dringend erforderlich.AbstractDemographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.

Soziale Unterstützung als Ressource für Arbeitsfähigkeit

PURPOSE The study examined the association of social support with subjective work ability, subjective prognosis of gainful employment and general health perception. METHODS The analysis considered cross-sectional data from a sample of 2,983 employees (40-54 years) with sickness benefits in 2012. The postal survey was conducted in May 2013. RESULTS After adjustment for socio-demographic and work-related characteristics as well as personality factors low social support was significantly associated with lower work ability (b=- 2,7; 95% CI:-3,4 to 1,9), higher odds of poor employment prognosis (OR=2,0; 95% CI: 1,5 to 2,6) and poorer health perception (b=- 8,0; 95% CI:-10,1 to-5,9). CONCLUSIONS Low social support is potentially an independent predictor of lower work ability, employment prognosis and general health perception. To confirm causal relationships longitudinal data are needed, which will be assessed in 2015 and 2017.

Determinanten für intendierte Anträge auf medizinische Rehabilitation bei vorangegangenem Krankengeldbezug

OBJECTIVES The aim of the study was to identify determinants of intented applications for rehabilitation. MATERIAL AND METHODS We included persons paying pension contributions to the Federal German Pension Insurance who had received sickness benefits in the year before the first survey and had not applied or utilized rehabilitation services between 2009 and 2012. RESULTS 3,165 persons were considered for analysis. Intended applications were associated with low self-rated health, low self-rated work ability, frequent visits to physicians, professional and family support. These associations were relatively stable for different subgroups and were hardly moderated by sociodemographic characteristics. DISCUSSION The results emphasis the importance of professional and family support for the application for medical rehabilitation.

Betriebsärzte und Rehabilitation – Eine Querschnittsstudie zum betriebsärztlichen Handeln in Schleswig-Holstein und Baden-Württemberg

Objective Description and explanation of involvement of occupational health physicians in rehabilitation Methods Data were collected by a survey of occupational health physicians in Schleswig-Holstein and Baden-Württemberg. Logistic regression models were calculated to identify determinants of the involvement of occupational health physicians before, during and after rehabilitation. Results During the last year 70% of the occupational health physicians have supported at least one worker when applying for medical rehabilitation. About a half has had at least once contact to a rehabilitation facility during the rehabilitation treatment of an employee, and 9 out of 10 physicians have supported at least one employee after her or his rehabilitation when returning to work. Support by occupational health physicians is more likely when they feel responsible for rehabilitation, are well informed and frequently involved in occupational reintegration management. Conclusions Occupational health physicians may be important stakeholders for preparing and supporting rehabilitation.

Influence of social support among employees on mental health and work ability—a prospective cohort study in 2013–15

Background The study examined the association of social support with mental health, subjective work ability and psychological consultation. Methods The cohort study included 1886 German employees (40-54 years) with sickness absence exceeding six weeks in 2012. Postal surveys were carried out in 2013 and 2015. Results After adjustment for socio-demographic data, work-related characteristics and personality factors, persons with low social support compared to high social support had poorer mental health (b=-4.96; 95% CI: -7.11 to -2.81) and a lower work ability index (b=-1.10; 95% CI -2.00 to -0.21). Low social support was not associated with increased odds of consulting a psychologist (OR =1.30; 95% CI: 0.86-1.96). Conclusions Low social support is an independent predictor of poorer mental health and lower work ability. This study highlights the importance of identifying people who have limited access to social support.

Demografischer Wandel und Krankheitshäufigkeiten@@@Demographic change and disease rates: Eine Projektion bis 2050@@@A projection until 2050

Demographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.ZusammenfassungDer demografische Wandel und sein Einfluss auf die Krankenversorgung werden teilweise heftig diskutiert. Ziel dieser Arbeit ist die Projektion von Erkrankungsraten basierend auf der 11. koordinierten Bevölkerungsvorausberechnung und auf bevölkerungsbezogenen Daten zu wichtigen Erkrankungen. Bis 2050 wird die deutsche Bevölkerung insgesamt um etwa 16% schrumpfen. Gleichzeitig wird die Zahl der über 65-Jährigen um 38% und der über 80-Jährigen um 156% steigen. Dabei führen insbesondere die geburtenstarken Jahrgänge zu einer vertikalen Welle durch die Alterspyramide mit einem überproportional steigenden Anteil an älteren Menschen. Die Häufigkeit von Erkrankungen mit ausgeprägtem Altersbezug wie ambulant erworbene Pneumonie, altersbedingte Makuladegeneration, Demenz, Oberschenkelhalsfraktur und Herzinfarkt wird bis 2050 unter der Annahme gleich bleibender Erkrankungswahrscheinlichkeiten stark zunehmen. Zu den häufigsten Erkrankungen 2050 werden die Hypertonie und die Arthrose zählen. Langfristig wirkende gesundheitspolitische Weichenstellungen sollten jetzt vor dem Hintergrund dieser Projektionen verantwortungsvoll bedacht werden. Ein breit angelegter gesellschaftlicher Diskurs über Basisversorgung und Priorisierung scheint dringend erforderlich.AbstractDemographic change and its impact on the German healthcare system is a subject of great debate. The purpose of this paper is to make projections on disease rates based on the 11th coordinated demographic prediction and population-based data which take into consideration demographic developments. The German population will decrease by approximately 16% until 2050, while at the same time the number of persons aged over 65 years will increase by 38% and the number of individuals aged over 80 years will increase by 156%. Baby boomers cause a vertical wave in the population pyramid. The population pyramid itself will lead to an overproportional increase in the number of elderly persons. Assuming that disease probability stays the same, the incidence of diseases due to advanced age will rise dramatically. Especially diseases, such as community-acquired pneumonia, age-related macula degeneration, dementia, fracture of the femur neck, and myocardial infarction, will by then occur more often. By 2050, some of the most frequent diseases will be hypertension and arthrosis. Thus, the continuous cutting of resources seems rather short minded. It is highly recommended to reconsider the long-run effects before setting a health policy course. A proper social discourse about primary care and prioritization appears to be urgently needed.