General Adult Population In Germany Research Articles

Prevalence of Legal, Prescription, and Illegal Drugs Aiming at Cognitive Enhancement across Sociodemographic Groups in Germany

ABSTRACT There has been speculation about a growing demand for substances used without medical need for cognitive enhancement (CE). Thus, the prevalence rates and the identification of sociodemographic groups at risk of this behavior need further description and constant monitoring. We conducted a nationwide web-based representative sample (N = 22,101) (regarding sex, age, education, and federal state) of the general adult population in Germany. Results show a high past twelve months prevalence of consuming caffeinated drinks for CE (62.4% of respondents), followed by food supplements and home remedies (31.4%), and caffeine tablets (2.5%). The twelve-month prevalence of CE with prescription drugs was 3.7% (lifetime: 5.5%), of whom 29.1% reported using them 40 or more times; 40.5% of all respondents indicated some future intake willingness. Cannabis was the most frequently reported illegal drug for CE (past twelve months: 4.0%; lifetime: 10.7%), followed by the category amphetamine and methamphetamine (past twelve months: 1.0%; lifetime: 2.4%), and cocaine (past twelve months: 0.9; lifetime: 2.4%). We also show variation in the prevalence across multiple ascribed and achieved sociodemographic characteristics. These results can inform public policy and prevention strategies regarding the continued monitoring of the prevalence of CE and the identification of groups at risk of drug misuse.

How do individuals rate their health compared to others? findings based on a nationally representative sample in Germany

BackgroundThe aim of this study is to explore the determinants of health comparisons (i.e., how individuals rate their health compared to other individuals in their age bracket) in the general adult population (total sample and in different age groups).MethodsData were used from the general adult population in Germany (wave 46, n = 3,876 individuals; November 2021 to January 2022), based on the GESIS panel, which is a probability-based mixed-mode panel. Health comparisons were used as outcome measure. Socioeconomic, lifestyle-related and health-related determinants were included in regression analysis. Robustness checks were conducted.ResultsRegressions showed that more favorable health comparisons were associated with being male (among individuals up to 39 years), higher age (among the total sample), higher education (among the total sample and individuals up to 39 years), higher income (among the total sample and individuals aged 40 to 64 years), not “being married, and living together with a spouse” (among the total sample), never eating meat (among the total sample, individuals up to 39 years and particularly individuals aged 40 to 64 years), drinking alcohol (among the total sample, individuals aged 40 to 64 years and individuals aged 65 years and over), a higher frequency of sports activities (all groups) and a higher satisfaction with health (also in all groups).ConclusionIn addition to the evident link between health satisfaction and health comparisons, regression analysis revealed that certain socioeconomic factors, such as a higher income level, along with positive lifestyle-related factors - especially among middle-aged individuals - were significantly associated with more positive health comparisons. This knowledge is required in order to support individuals at risk for negative health comparisons. This is important because negative health comparisons can contribute to poor well-being and poor health outcomes.

Perceived Norms and Vaccination against COVID-19 among the General Adult Population in Germany: Results of a Nationally Representative Survey.

to examine whether perceived norms are associated with vaccination against COVID-19 (also stratified by age group). nationally representative survey. Data were taken from a sample of the general adult population (n = 3829, 16 to 94 years). Data collection took place from early July to early August 2021, and 3 different groups (1: not yet vaccinated and no intention to vaccinate against COVID-19; 2: not yet, but intended to vaccinate against COVID-19; 3: yes, at least one vaccination against COVID-19) were distinguished in the analyses. Data were adjusted for several sociodemographic and health-related factors. Perceived norms served as key independent variables (1: number of important friends and relatives who would like me to get vaccinated; 2: number of important friends and relatives who already have been vaccinated or still want to do so; 3: how your general practitioner (GP) thinks about Corona vaccination). Multiple logistic regression showed that, in particular, the number of important friends/relatives who would like an individual to get vaccinated is associated with the actual COVID-19 vaccination status among individuals aged 16 to 59 years. Interestingly, all 3 indicators for perceived norms are associated with the likelihood of COVID-19 vaccination status among individuals aged 60 years and over. Our study adds to the understanding of the association between perceived norms and COVID-19 vaccination status. This highlights potential pathways to increase vaccination rates to further combat the later stages of the pandemic.

Fear of war and mental health in Germany

PurposeThe objective of this study was to clarify the association between fear of war (both conventional war and nuclear war) and mental health (in terms of probable depression and probable anxiety).MethodsData were used from the general adult population in Germany (n = 3091 individuals; 15th March–21st March 2022). Probable depression and probable anxiety were both quantified using validated tools (PHQ-9/GAD-7). Multiple logistic regressions were used, adjusting for several sociodemographic, lifestyle-related and health-related factors.ResultsIn total, 23.1% of the individuals had probable depression and 16.0% of the individuals had probable anxiety. Multiple logistic regression showed that the likelihood of probable depression was positively associated with fear of a conventional war (OR 1.25, 95% CI 1.14–1.37). Furthermore, it was associated with fear of a nuclear war (OR 1.22, 95% CI 1.12–1.33). Additionally, regressions showed that the likelihood of probable anxiety was positively associated with fear of a conventional war (OR 1.66, 95% CI 1.49–1.86). Moreover, it was associated with fear of a nuclear war (OR 1.54, 95% CI 1.39–1.71).ConclusionsOur findings stress the importance of fear of war for mental health in the general adult population in Germany. Upcoming research in this area is necessary.

Personality and oral health-related quality of life. Results from an online survey

BackgroundTo investigate the association between personality factors and oral health-related quality of life.MethodsData were taken from an online survey (representative for the general adult population in Germany in terms of region, sex and age group; n = 3,075) performed in late summer 2021. The well-established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. Moreover, the established 10 Item Big Five Inventory (BFI-10) was used to quantify personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience). Sex, age, family status, educational level, smoking status, alcohol consumption, sports activities, presence of chronic diseases and self-rated health were adjusted for in multiple linear regression analysis.ResultsPearson correlations between oral health-related quality of life and personality factors ranged from r =- 0.17 (conscientiousness) to r = 0.17 (neuroticism). Regressions revealed that low oral health-related quality of life is associated with higher neuroticism (β = 0.39, p < 0.001) and lower conscientiousness (β=-0.51, p < 0.001).ConclusionThis study revealed an association between personality factors (higher neuroticism and lower conscientiousness) and low oral health-related quality of life. Before dental treatment, it may be helpful to measure personality traits of patients in order to predict the expectations of patients, as well as their responses to intended treatments. This may support the identification of the most appropriate method of treatment.

Association between purpose in life and healthcare use among women and men in Germany: cross-sectional analysis of the nationally representative German Socio-Economic Panel (GSOEP) study

ObjectivesIt remains almost unknown whether purpose in life is associated with healthcare use (HCU) in general. Therefore, the goal of this study was to examine the association between purpose in...

Determinants of Outpatient Physician Visits in the General Adult German Population during Later Stages of the COVID-19 Pandemic.

The goal of this study was to investigate the determinants of outpatient physician visits in Germany during the later stages of the COVID-19 pandemic. Cross-sectional data were used from the general adult population in Germany with n = 3091 individuals (data collection in mid-March 2022). Determinants were selected based on the extended Andersen model. The number of GP visits as well as the number of specialist visits in the past 12 months were used as outcome measures. Negative binomial regressions showed that the number of GP visits was positively associated with a lower educational level, being retired, lower levels of loneliness, the presence of at least one chronic condition, lower self-rated health, being vaccinated against COVID-19, and the presence of depression. Moreover, negative binomial regressions showed that the number of specialist visits was positively associated with being female, a lower age, having children, being married, not being full-time employed, the presence of at least one chronic condition, lower self-rated health, the presence of depression, being vaccinated against COVID-19 and having a lower coronavirus anxiety. In conclusion, while our study showed that need factors are still a main driver of outpatient physician visits, our findings additionally showed that predisposing characteristics, enabling resources and psychosocial factors are also important for the number of outpatient physician visits in Germany during the COVID-19 pandemic. Knowledge about these determinants (e.g., vaccination status, loneliness or coronavirus anxiety) is also important to avoid under- or overuse of the healthcare system.

Oral health-related quality of life, probable depression and probable anxiety: evidence from a representative survey in Germany

BackgroundThere is limited knowledge regarding the association between oral health-related quality of life and probable depression and anxiety. Our objective was to examine the association between oral health-related quality of life and probable depression and anxiety in the German population (stratified by sex).MethodsIn sum, n = 3,075 individuals took part in a nationally representative survey (August/September 2021). The well-established Patient Health Questionnaire-9 (PHQ-9; cut-off of 10) and the Generalized Anxiety Disorder-7 (GAD-7; cut-off of 10) were used to quantify probable depression and anxiety, respectively.ResultsThe likelihood of probable depression was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.21, 95% CI: 1.18–1.25) and in both women and men. Additionally, the likelihood of probable anxiety was significantly associated with lower oral health-related quality of life in the total sample (OR: 1.17, 95% CI: 1.14–1.21) and in both women and men.ConclusionsOur study emphasized the association between lower oral health-related quality of life and probable depression as well as anxiety in the general adult population in Germany. Future longitudinal studies are required to confirm our findings.

Barriers to the Large-Scale Adoption of a COVID-19 Contact Tracing App in Germany: Survey Study.

BackgroundDuring the COVID-19 pandemic, one way to reduce further transmissions of SARS-CoV-2 is the widespread use of contact tracing apps. Such apps keep track of proximity contacts and warn contacts of persons who tested positive for an infection.ObjectiveIn this study, we analyzed potential barriers to the large-scale adoption of the official contact tracing app that was introduced in Germany on June 16, 2020.MethodsSurvey data were collected from 3276 adults during the week the app was introduced using an offline-recruited, probability-based online panel of the general adult population in Germany.ResultsWe estimate that 81% of the population aged 18 to 77 years possess the devices and ability to install the official app and that 35% are also willing to install and use it. Potential spreaders show high access to devices required to install the app (92%) and high ability to install the app (91%) but low willingness (31%) to correctly adopt the app, whereas for vulnerable groups, the main barrier is access (62%).ConclusionsThe findings suggest a pessimistic view on the effectiveness of app-based contact tracing to contain the COVID-19 pandemic. We recommend targeting information campaigns at groups with a high potential to spread the virus but who are unwilling to install and correctly use the app, in particular men and those aged between 30 and 59 years. In addition, vulnerable groups, in particular older individuals and those in lower-income households, may be provided with equipment and support to overcome their barriers to app adoption.

Prevalence and Correlates of Individuals Screening Positive for Depression and Anxiety on the PHQ-4 in the German General Population: Findings from the Nationally Representative German Socio-Economic Panel (GSOEP).

Our aim was to estimate the prevalence and correlates of probable depression and anxiety in the general adult population in Germany. Repeated cross-sectional data (i.e., cross-sectional data observed at different time points: year 2012 and year 2014) were derived from the innovation sample of the German Socio-Economic Panel, a population-based study of German households. The validated Patient Health Questionnaire (PHQ-4) was used to measure probable depression and anxiety. In the analytical sample, n equaled 2952 individuals. According to the PHQ-4 cut-off values, 10.4% of the individuals had probable depression and 9.8% of the individuals had probable anxiety. Regressions revealed that the likelihood of depression was positively associated with lower age (OR: 0.98 (95% CI: 0.98–0.99)), being unmarried (and living together with spouse) (OR: 0.75 (0.58–0.98)), worse self-rated health (OR: 1.99 (1.73–2.27)), and more chronic diseases (OR: 1.18 (1.07–1.31)). Furthermore, the likelihood of anxiety was positively associated with being female (OR: 1.36 (95% CI: 1.04–1.76)), lower age (OR: 0.98 (95% CI: 0.97–0.99)), low education (medium education, OR: 0.69 (0.50–0.95)), worse self-rated health (OR: 2.00 (1.74–2.30)), and more chronic diseases (OR: 1.15 (1.03–1.27)). The magnitude of depression and anxiety was highlighted. Clinicians should be aware of the factors associated with probable depression and anxiety.

Determinants of Perceived Own Risk for Developing Dementia and the Perception That Memory Deterioration Is Preventable. Findings From the General Adult Population in Germany.

Objective: To identify among the general population the determinants of (1) perceived own risk of developing dementia and (2) the perception that memory deterioration is preventable.Methods: For this study, cross-sectional data were taken from the German Socio-Economic Panel (innovation sample, year 2012), which is a population-based, longitudinal study of German households. There were 1,542 individuals included in our analytical sample.Results: Multiple linear regressions showed that an increased perceived own risk of developing dementia was associated with younger age, higher education, poor self-rated health, an increased number of chronic diseases, and an increased agreement that a diagnosis of dementia would ruin their life. An increased perceived modifiability of memory deterioration was associated with higher education, and not being employed, but not health-related variables.Conclusion: Several determinants of the perceived own risk of developing dementia and the perceived modifiability of memory deterioration have been identified. Addressing modifiable factors may be beneficial for changing these outcome measures.

Individual and interpersonal correlates of cardiorespiratory fitness in adults \u2013 Findings from the German Health Interview and Examination Survey

Cardiorespiratory fitness (CRF) is an established predictor of adverse health outcomes. The aim of this study is to investigate potential behavioral, interpersonal and socioeconomic correlates of CRF among men and women living in Germany using data from a population-based nationwide cross-sectional study. 1,439 men and 1,486 women aged 18–64 participated in the German Health Interview and Examination Survey (2008–2011) and completed a standardized sub-maximal cycle ergometer test. Maximal oxygen consumption (dot{V}{O}_{2}max) in ml·min−1·kg−1 was estimated. Mean values of VO2max for various anthropometric, behavioral, interpersonal, and sociodemographic variables were estimated. Linear regression analyses using multiple imputations technique for missing values was performed to analyze the influence of potential correlates on CRF. Women with high alcohol consumption had higher dot{V}{O}_{2}max, (β = 2.20; 95% CI 0.98 to 3.42) than women with low alcohol consumption and women with high occupational status had higher dot{V}{O}_{2}max (β = 1.83; 95% CI 0.21 to 3.44) in comparison to women with low occupational status. Among men, high fruit intake (β = 1.52; 95% CI 0.63 to 2.40), compared to low or medium fruit intake and performing at least 2.5 hours of total PA per week (β = 2.19; 95% CI 1.11 to 3.28), compared to less than 2.5 hours was associated with higher dot{V}{O}_{2}max. Among both men and women, lower body mass index, lower waist circumference and higher levels of physical exercise were considerably associated with higher dot{V}{O}_{2}max. Among women, those in higher age groups showed a considerably lower level of dot{V}{O}_{2}max compared with those aged 18–24. Furthermore, mean estimated dot{V}{O}_{2}max was higher among men (36.5; 95% CI 36.0 to 37.0) than among women (30.3; 95% CI 29.8 to 30.7). Despite the cross-sectional nature of the current study, we conclude that several behavioral, anthropometric, and sociodemographic factors are associated with CRF in the general adult population in Germany. These results can provide evidence to tailor prevention measures according to the needs of specific subgroups.

Assessment of Use and Preferences Regarding Internet-Based Health Care Delivery: Cross-Sectional Questionnaire Study.

BackgroundThere has been an incremental increase in the use of technology in health care delivery. Feasibility, acceptability, and efficacy of interventions based on internet technologies are supported by a growing body of evidence.ObjectiveThe aim of this study was to investigate use and preferences in the general adult population in Germany for remote, internet-based interaction (eg, email, videoconferencing, electronic medical records, apps).MethodsA nationwide cross-sectional questionnaire survey in adults that was representative in terms of age, sex and educational level was carried out.ResultsA total of 22.16% (538/2428) of survey participants reported not using the internet for work or private use. The nonuser phenotype can be described as being older, having lower educational and income status, and living in less populated areas. The majority of participants within the cohort of internet users reported that they would not consider using electronic medical records (973/1849, 52.62%), apps (988/1854, 53.29%), or emails to report symptoms (1040/1838, 56.58%); teleconference with one (1185/1852, 63.98%) or more experts (1239/1853, 66.86%); or participate in video psychotherapy (1476/1853, 79.65%) for the purpose of medical consultation or treatment. Older age and lower educational level were the most robust predictors of assumed future denial of use.ConclusionsOur results point toward low use and preference rates among the general population for the use of telemedicine. It also seems that those who might benefit from telemedical interventions the most, are, in fact, those who are most hesitating. These low use and preference rates of eHealth should be considered prior to designing and providing future telemedical care, supporting the need for easy-to-use, data secure solutions.

Diet-independent relevance of serum uric acid for blood pressure in a representative population sample.

A direct relationship between serum uric acid and blood pressure (BP) has been reported, but the possible confounding impact of diet on this association is unclear. The authors performed a cross-sectional analysis in the representative German Health Interview and Examination Survey for Adults (n=6788, aged 18-79years). In adjusted regression models considering dietary factors, each 1-mg/dL higher uric acid value was associated with a 1.10-mmHg (P=.0002) and a 0.60-mmHg (P=.04) higher systolic BP among participants younger than 50years and participants 50years and older, respectively. For diastolic BP, uric acid was a significant predictor (β=0.71mmHg, P=.0001) among participants younger than 50years and for participants 50years and older without antihypertensive treatment. Adjusted odds ratios of hypertension for participants with hyperuricemia were broadly similar in younger (odds ratio, 1.71; P=.02) and older (odds ratio, 1.81; P=.0003) participants. Uric acid is a significant predictor of systolic BP and hypertension prevalence in the general adult population in Germany independently of several known dietary BP influences.

Excess costs from functional somatic syndromes in Germany — An analysis using entropy balancing

AimThe aim of this study was to calculate disorder-specific excess costs in patients with functional somatic syndromes (FSS). MethodsWe compared 6-month direct and indirect costs in a patient group with FSS (n=273) to a control group of the general adult population in Germany without FSS (n=2914). Data on the patient group were collected between 2007 and 2009 in a randomized controlled trial (speciAL). Data on the control group were obtained from a telephone survey, representative for the general German population, conducted in 2014. Covariate balance between the patient group and the control group was achieved using entropy balancing. Excess costs were calculated by estimating generalized linear models and two-part models for direct costs and indirect costs. Further, we estimated excess costs according to the level of somatic symptom severity (SSS). ResultsFSS patients differed significantly from the control group regarding 6-month costs of outpatient physicians (+€280) and other outpatient providers (+€74). According to SSS, significantly higher outpatient physician costs were found for mild (+€151), moderate (+€306) and severe (+€376) SSS. We also found significantly higher costs of other outpatient providers in patients with mild, moderate and severe SSS. Regarding costs of rehabilitation and hospital treatments, FSS patients did not differ significantly from the control group for any level of SSS. Indirect costs were significantly higher in patients with severe SSS (+€760). ConclusionFSS were of major importance in the outpatient sector. Further, we found significantly higher indirect costs in patients with severe SSS.

Diagnosed Depression and Utilization of Health Care Services and Preventive Measures in the General Adult Population in Germany - Results from a Nationwide Cross-Sectional Telephone Survey

To examine the association of diagnosed depression with the utilization of health care services and preventive measures among men and women in the general population in Germany. Cross-sectional analysis of data from a representative telephone survey (men N = 18,675, women N = 24,518, 18 years and older). Self-reported health professional-diagnosed depression (past 12 months) and the use of a range of health care and preventive services were assessed. Diagnosed depression was associated with increased health care service utilization in both sexes. Diagnosed depression was associated with higher utilization of some preventive services, such as general health check-ups (odds ratio [OR] 1.2), cancer screening (OR 1.2) and flu vaccination (OR 1.3) among women and cancer screening (OR 1.4) among men. Health professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. There was no indication for specific under-treatment with preventive measures among people with depression diagnosis.

Respondents\u2019 report of a clinician-diagnosed depression in health surveys: comparison with DSM-IV mental disorders in the general adult population in Germany

BackgroundRespondents’ report of a previously diagnosed depression by a health professional is frequently used to estimate depression prevalence. This study contributes to a better understanding of survey results based on this measure by comparing it with a comprehensive standardized diagnostic interview.MethodsData came from the cross-sectional nationwide German Health Interview and Examination Survey for Adults (DEGS1) and its mental health module (DEGS1-MH, n = 4483). In DEGS1, participants were asked whether they have been diagnosed with depression by a physician or psychotherapist (last 12-month). DSM-IV-based 12-month major depressive disorder (MDD) and other mental disorders were assessed with the German version of the Composite International Diagnostic Interview (CIDI). Time lag between both assessments was 6 weeks (median).Results73.4% of participants reporting clinician-diagnosed depression met criteria for any mental disorder in the CIDI (any affective disorder: 51.8%, any anxiety disorder: 54.7%). The proportion of participants reporting a clinician-diagnosed depression who met MDD criteria was highest among those aged 18–29 years (62.6%) and decreased with age (65–79 years: 29.8%). Among participants with MDD, the proportion with clinician-diagnosed depression was 33.0%, highest among those aged 45–64 years (49.3%) and lowest among those aged 18–29 years (22.7%) and 30–44 years (20.3%). MDD severity was positively associated with clinician-diagnosed depression.ConclusionsRespondents’ report of a clinician-diagnosed depression and major depression assessed with the CIDI substantially differ. Concordance of both measures varies with age and severity of depressive symptoms. Health surveys should assess a range of depression indicators in order to cover a wide spectrum.

Diagnosed depression and utilization of healthcare and preventive services in the general adult population in Germany

IntroductionDepressive disorders have been related to increased health service utilization, but specific information about associations between health professional-diagnosed depression and the utilization of health care and preventive services in the general population is limited.ObjectivesTo compare the use of health care and preventive services among men and women with and without diagnosed depression in the general population in Germany.AimsTo examine the association of diagnosed depression with the utilization of healthcare and preventive services.MethodsCross-sectional analysis of data from the representative telephone survey German Health Update (GEDA) 2009 and 2010 (n = 43.312 residents in private households 18 years and older). We analyzed associations between self-reported health professional-diagnosed depression (past 12 months) and the use of a range of healthcare services and preventive services covered by statutory health insurances using multivariable regressions adjusted for age, socio-economic status, marital status, employment and number of chronic somatic conditions.ResultsTwelve-month diagnosed depression was associated with increased health care service utilization (physician contacts, hospital admissions, rehabilitation) in both sexes. Of the preventive services, diagnosed depression was associated with increased use of general health check-ups, cancer screening and flu vaccination among women, while there was no association with dental check-up and tetanus and pertussis vaccination. Among men, no association of diagnosed depression with any preventive service was found except for cancer screening.ConclusionsHealth professional-diagnosed depression is associated with increased health service utilization independent of somatic comorbidity and socio-demographic confounders. This includes some preventive services in women and only one preventive service in men.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence and acceptance of therapy with medical compression stockings

SummaryThe aim of this study was to assess the prevalence of use of medical compression stockings (MCS) in the general adult population in Germany, to comment the indications for which MCS therapy has been described and the patients’ experience with it. Methods: The survey is based on the Bonn Vein Study. The population of this cross-sectional study was randomly recruited between November 2000 and March 2002 from the registers of residents of the city of Bonn and two rural townships in the area. In total, 3.072 men and women were included in the trial. In addition to clinical examination and duplex-ultrasound, participants were asked whether any phlebological treatment had been carried out due to a leg disorder or disease.. If compression stockings had been worn, we asked for details such as compression class and length of stockings, wearing time, effectiveness, and recognition. Results: In total, 22.9% of people providing information (12.7% of male, 31.0% of female) mentioned having received a specific phlebological treatment in the past. Therapy with compression stockings had the highest prevalence with 14.6% in the general population (7.5% of males, 20.3% of females). The mean age at the first prescription was 45.5 years (SD = 14.3 years). With increasing severity of venous disease, as rated according to the CEAP classification, the prevalence increased from 1% in C0 patients to 82% in C5/C6 patients. Of 450 participants who had used compression stockings in the past, 309 (68.6%) did not wear CS at the time of the survey. The remainder had generally been wearing them on five or more days per week (73.0%) for 8 or more hours per day (89.4%). On average, 71.3% of the participants said that the disease for which MCS were prescribed, had improved as a result of MCS therapy. Improvement concerned a reduction of sensations of swelling (84.2%), of heaviness (89.4%), leg pain after long periods of standing (60.9), and tension in the legs (78.9).

Epidemiology of benign paroxysmal positional vertigo: a population based study

Objectives: To examine the prevalence and incidence, clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population. Methods: Cross-sectional, nationally representative neurotological survey...