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Horst Bickel

Bio: Horst Bickel is an academic researcher from Technische Universität München. The author has contributed to research in topics: Dementia & Cognitive decline. The author has an hindex of 46, co-authored 190 publications receiving 7497 citations.


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Journal ArticleDOI
TL;DR: The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.
Abstract: Context Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD). Objectives To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI. Design Longitudinal cohort study with follow-up examinations at 1½ and 3 years after baseline. Setting Primary care medical record registry sample. Participants A total of 2415 subjects without cognitive impairment 75 years or older in the German Study on Aging, Cognition and Dementia in Primary Care Patients. Main Outcome Measures Conversion to any dementia, dementia in AD, or vascular dementia at follow-up 1 or follow-up 2 predicted by SMI with or without worry at baseline and at follow-up 2 predicted by different courses of SMI at baseline and MCI at follow-up 1. Results In the first analysis, SMI with worry at baseline was associated with greatest risk for conversion to any dementia (hazard ratio [HR], 3.53; 95% confidence interval [CI], 2.07-6.03) or dementia in AD (6.54; 2.82-15.20) at follow-up 1 or follow-up 2. The sensitivity was 69.0% and the specificity was 74.3% conversion to dementia in AD. In the second analysis, SMI at baseline and MCI at follow-up 1 were associated with greatest risk for conversion to any dementia (odds ratio [OR], 8.92; 95% CI, 3.69-21.60) or dementia in AD (19.33; 5.29-70.81) at follow-up 2. Furthermore, SMI at baseline and amnestic MCI at follow-up 1 increased the risk for conversion to any dementia (OR, 29.24; 95% CI, 8.75-97.78) or dementia in AD (60.28; 12.23-297.10), with a sensitivity of 66.7% and a specificity of 98.3% for conversion to dementia in AD. Conclusion The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.

577 citations

Journal ArticleDOI
TL;DR: To compare the risk of developing Alzheimer's disease (AD) dementia in late mild cognitive impairment (LMCI), early MCI (EMCI), and subjective memory impairment (SMI) with normal test performance, three different approaches are considered.
Abstract: Objective To compare the risk of developing Alzheimer's disease (AD) dementia in late mild cognitive impairment (LMCI), early MCI (EMCI), and subjective memory impairment (SMI) with normal test performance. Methods The baseline sample (n = 2892) of the prospective cohort study in nondemented individuals (German Study on Aging, Cognition and Dementia in Primary Care Patients) was divided into LMCI, EMCI, SMI, and control subjects by delayed recall performance. These groups were subdivided by the presence of self-reported concerns associated with experienced memory impairment. AD dementia risk was assessed over 6 years. Results Across all groups, risk of AD dementia was greatest in LMCI. In those with self-reported concerns regarding their memory impairment, SMI and EMCI were associated with a similarly increased risk of AD dementia. In those subgroups without concerns, SMI was not associated with increased risk of AD dementia, but EMCI remained an at-risk condition. Conclusions SMI and EMCI with self-reported concerns were associated with the same risk of AD dementia, suggesting that pre-LMCI risk conditions should be extended to SMI with concerns.

407 citations

Journal ArticleDOI
TL;DR: Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 years in a large population-based cohort of elderly subjects.
Abstract: Background Data regarding the relationship between physical activity and cognitive impairment are limited and controversial. We examined whether physical activity is associated with incident cognitive impairment during follow-up. Methods As part of a community-based prospective cohort study in southern Bavaria, Germany, 3903 participants older than 55 years were enrolled between 2001 and 2003 and followed up for 2 years. Physical activity (classified as no activity, moderate activity [ Results At baseline, 418 participants (10.7%) had cognitive impairment. After a 2-year follow-up, 207 of 3485 initially unimpaired subjects (5.9%) developed incident cognitive impairment. Compared with participants without physical activity, fully adjusted multiple logistic regression analysis showed a significantly reduced risk of incident cognitive impairment after 2 years for participants with moderate or high physical activity at baseline (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37-0.87 [ P = .01]; and OR, 0.54; 95% CI, 0.35-0.83 [ P = .005]; respectively). Further subanalysis including participants (n = 2029) without functional impairment and without prodromal phase of dementia resulted in an even higher reduction of risk of incident cognitive impairment for participants with moderate or high physical activity (OR, 0.44; 95% CI, 0.24-0.83 [ P = .01]; and OR, 0.46; 95% CI, 0.25-0.85 [ P = .01]; respectively) compared with no activity. Conclusion Moderate or high physical activity is associated with a reduced incidence of cognitive impairment after 2 years in a large population-based cohort of elderly subjects.

245 citations

Journal ArticleDOI
TL;DR: The findings suggest that delirium does not simply persist for a certain time but also predicts a future cognitive decline with an increased risk of dementia.
Abstract: Background/Aims: The aim of the study was to investigate the association of postoperative delirium with the outcomes of cognitive impairment, functional disability and death. Methods: Hip surgery patients aged 60 years or over (n = 200) underwent preoperative and daily postoperative assessment of their cognitive status during hospital stay. Outcome variables were determined at an average of 8 and 38 months after discharge from hospital. Results: Fourty-one patients developed postoperative delirium. Delirium was a strong independent predictor of cognitive impairment and the occurrence of severe dependency in activities of daily living. The associations were more marked for the long- than for the short-term outcome. Thirty-eight months after discharge from hospital, 53.8% of the surviving patients with postoperative delirium suffered from cognitive impairment, as compared to only 4.4% of the nondelirious participants. Logistic regression analysis adjusted for age, sex, medical comorbidity and preoperative cognitive performance revealed highly significant associations between delirium and cognitive impairment (OR = 41.2; 95% CI = 4.3–396.2), subjective memory decline (OR = 6.2; 95% CI = 1.5–25.8) and incident need for long-term care (OR = 5.6; 95% CI = 1.6–19.7). Conclusion: The present study confirms a poor prognosis after delirium in elderly patients. The findings suggest that delirium does not simply persist for a certain time but also predicts a future cognitive decline with an increased risk of dementia.

227 citations

Journal ArticleDOI
TL;DR: To determine incidence and risk factors for the development of postoperative acute confusional state (ACS) in the elderly, a large number of patients with known or suspected Alzheimer's disease were surveyed.
Abstract: Objective To determine incidence and risk factors for the development of postoperative acute confusional state (ACS) in the elderly. Design A prospective cohort study. Setting University hospital. Patients One hundred and five consecutive patients without ACS at baseline who underwent hip surgery because of hip fracture or elective hip replacement. All patients were 60 years or older. Measurements All patients underwent preoperative and daily postoperative evaluation by a research psychiatrist. Standardized instruments were used for cognitive screening, baseline assessment of depression, screening for alcohol abuse, comorbidity, and functional status. ACS was diagnosed by using the Confusion Assessment Method (CAM). Additional medical data were taken from patients' charts and anaesthetic records. Results Postoperative ACS developed in 23.8% of the study sample, in 40.5% of the hip fracture group and in 14.7% of the hip joint replacement group. The prevalence was highest between postoperative days 2 and 5. Multiple logistic regression analysis demonstrated the following risk factors of ACS: higher age (OR = 1.14, 95% CI 1.07–1.22), prior cognitive impairment as measured by Mini-Mental State Examination (OR = 1.32 for each point less, 95% CI 1.06–1.64), depression (OR = 3.67, 95% CI 1.12–12.02), low educational level (OR = 3.59, 95% CI 1.14–11.25), and preoperative abnormal sodium (OR = 4.32, 95% CI 1.01–18.38). Other risk factors showing statistically significant differences in the univariate analyses were: living in nursing home, vision or hearing impairment, higher comorbidity, regular use of psychotropic drugs before admission, fracture on admission, preoperative leucocytosis. A considerable proportion of patients with ACS showed self-destructive behaviour postoperatively, whereas self-destructive behaviour was not observed among non-delirious patients. Conclusions ACS is common among elderly hip surgery patients. The occurrence of ACS is influenced by several predisposing and precipitating factors. Further knowledge of these risk factors will contribute to the early identification of high risk patients and to the development of preventive measures. Copyright © 2001 John Wiley & Sons, Ltd.

219 citations


Cited by
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TL;DR: WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Jiménez, ScD, SM Lori Chaffin Jordan,MD, PhD Suzanne E. Judd, PhD
Abstract: WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Blaha, MD, MPH Stephanie E. Chiuve, ScD Mary Cushman, MD, MSc, FAHA Sandeep R. Das, MD, MPH, FAHA Rajat Deo, MD, MTR Sarah D. de Ferranti, MD, MPH James Floyd, MD, MS Myriam Fornage, PhD, FAHA Cathleen Gillespie, MS Carmen R. Isasi, MD, PhD, FAHA Monik C. Jiménez, ScD, SM Lori Chaffin Jordan, MD, PhD Suzanne E. Judd, PhD Daniel Lackland, DrPH, FAHA Judith H. Lichtman, PhD, MPH, FAHA Lynda Lisabeth, PhD, MPH, FAHA Simin Liu, MD, ScD, FAHA Chris T. Longenecker, MD Rachel H. Mackey, PhD, MPH, FAHA Kunihiro Matsushita, MD, PhD, FAHA Dariush Mozaffarian, MD, DrPH, FAHA Michael E. Mussolino, PhD, FAHA Khurram Nasir, MD, MPH, FAHA Robert W. Neumar, MD, PhD, FAHA Latha Palaniappan, MD, MS, FAHA Dilip K. Pandey, MBBS, MS, PhD, FAHA Ravi R. Thiagarajan, MD, MPH Mathew J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Rodriguez, MD, MPH, FAHA Gregory A. Roth, MD, MPH Wayne D. Rosamond, PhD, FAHA Comilla Sasson, MD, PhD, FAHA Amytis Towfighi, MD Connie W. Tsao, MD, MPH Melanie B. Turner, MPH Salim S. Virani, MD, PhD, FAHA Jenifer H. Voeks, PhD Joshua Z. Willey, MD, MS John T. Wilkins, MD Jason HY. Wu, MSc, PhD, FAHA Heather M. Alger, PhD Sally S. Wong, PhD, RD, CDN, FAHA Paul Muntner, PhD, MHSc On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart Disease and Stroke Statistics—2017 Update

7,190 citations

Journal ArticleDOI
TL;DR: March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.
Abstract: March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Benjamin, MD, ScM, FAHA, Chair Paul Muntner, PhD, MHS, FAHA, Vice Chair Alvaro Alonso, MD, PhD, FAHA Marcio S. Bittencourt, MD, PhD, MPH Clifton W. Callaway, MD, FAHA April P. Carson, PhD, MSPH, FAHA Alanna M. Chamberlain, PhD Alexander R. Chang, MD, MS Susan Cheng, MD, MMSc, MPH, FAHA Sandeep R. Das, MD, MPH, MBA, FAHA Francesca N. Delling, MD, MPH Luc Djousse, MD, ScD, MPH Mitchell S.V. Elkind, MD, MS, FAHA Jane F. Ferguson, PhD, FAHA Myriam Fornage, PhD, FAHA Lori Chaffin Jordan, MD, PhD, FAHA Sadiya S. Khan, MD, MSc Brett M. Kissela, MD, MS Kristen L. Knutson, PhD Tak W. Kwan, MD, FAHA Daniel T. Lackland, DrPH, FAHA Tené T. Lewis, PhD Judith H. Lichtman, PhD, MPH, FAHA Chris T. Longenecker, MD Matthew Shane Loop, PhD Pamela L. Lutsey, PhD, MPH, FAHA Seth S. Martin, MD, MHS, FAHA Kunihiro Matsushita, MD, PhD, FAHA Andrew E. Moran, MD, MPH, FAHA Michael E. Mussolino, PhD, FAHA Martin O’Flaherty, MD, MSc, PhD Ambarish Pandey, MD, MSCS Amanda M. Perak, MD, MS Wayne D. Rosamond, PhD, MS, FAHA Gregory A. Roth, MD, MPH, FAHA Uchechukwu K.A. Sampson, MD, MBA, MPH, FAHA Gary M. Satou, MD, FAHA Emily B. Schroeder, MD, PhD, FAHA Svati H. Shah, MD, MHS, FAHA Nicole L. Spartano, PhD Andrew Stokes, PhD David L. Tirschwell, MD, MS, MSc, FAHA Connie W. Tsao, MD, MPH, Vice Chair Elect Mintu P. Turakhia, MD, MAS, FAHA Lisa B. VanWagner, MD, MSc, FAST John T. Wilkins, MD, MS, FAHA Sally S. Wong, PhD, RD, CDN, FAHA Salim S. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee

5,739 citations

Journal ArticleDOI
TL;DR: The Statistical Update represents the most up-to-date statistics related to heart disease, stroke, and the cardiovascular risk factors listed in the AHA's My Life Check - Life’s Simple 7, which include core health behaviors and health factors that contribute to cardiovascular health.
Abstract: Each chapter listed in the Table of Contents (see next page) is a hyperlink to that chapter. The reader clicks the chapter name to access that chapter. Each chapter listed here is a hyperlink. Click on the chapter name to be taken to that chapter. Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together in a single document the most up-to-date statistics related to heart disease, stroke, and the cardiovascular risk factors listed in the AHA’s My Life Check - Life’s Simple 7 (Figure1), which include core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure [BP], and glucose control) that contribute to cardiovascular health. The Statistical Update represents …

5,102 citations

Journal ArticleDOI
TL;DR: This year's edition of the Statistical Update includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals.
Abstract: Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovas...

5,078 citations