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Aims: Aim of the current study was to describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) in a cohort of older men and women aged 60 years and above over the course of on average 7 years, since longitudinal data on this topic are scarce for this age group in Germany. Methods: Baseline data of 1671 participants of the Berlin Aging Study II (BASE‐II; 68.8 ± 3.7 years) and follow‐up data assessed 7.4 ± 1.5 years later were analysed. The BASE‐II is an exploratory, observational study on cross‐sectional and longitudinal data of an older population. T2D was diagnosed based on self‐report, antidiabetic medication use and laboratory parameters. T2D severity was determined by the diabetes complications severity index (DCSI). Prognostic capacity of laboratory parameters was evaluated. Results: The proportion of participants with T2D increased from 12.9% (37.3% women) at baseline to 17.1% (41.1% women) with 74 incident cases and 22.2% not being aware of the disease at follow‐up. The incidence rate is 10.7 new T2D diagnoses per 1000 person‐years. More than half of the 41 newly identified incident T2D cases were diagnosed solely by the 2 h‐plasma glucose test (OGTT) and diagnosis based on OGTT as the only criterion among incident cases was found more frequently in women (p = 0.028). T2D severity expressed by the DCSI significantly increased from baseline to follow‐up (mean DCSI 1.1 ± 1.2 vs. 2.0 ± 1.8; range 0–5 vs. 0–6). Cardiovascular complications had the highest impact (43.2% at baseline and 67.6% at follow‐up). Conclusions: A comprehensive picture of T2D with respect to prevalence, incidence, and severity in older people of the Berlin Aging Study II is provided. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are the main cause of mortality for women worldwide, yet their impact is frequently underestimated. To raise awareness for preventative lifestyle measures other contacts with the healthcare system should be exploited. We analyzed access patterns to other healthcare specialists and population screening measures to identify options for opportunistic counseling on cardiovascular risk. Materials and Methods: We enrolled 1062 randomly selected German urban women aged 25-74 years in 2012-2013, divided into 5 age bands. Women were asked about sociodemographic characteristics, clinical and gynecological history, physician attendance patterns, screening behavior and primary sources of health and preventative information, and clinical examination attendance. Results: Obstetrician/gynecologists (OBGYN) were the most frequently consulted physicians within the last 12 months (75.3%), more than general practitioners (GP; 74%). Attendance rates to OBGYNs were not affected by education or income, solely a body mass index (BMI) >30 associated with significantly reduced rates of attendance (OR = 0.4, CI 95% = 0.17-0.78, p = 0.009). Women with low to medium Framingham risk scores were more likely to attend an OBGYN than a GP if they attended only one specialist. Attendance of population screening measures is limited (<60% for all offers) and hence unsuitable for systematic cardiovascular counseling. Conclusion: OBGYN represent a very popular and equitable healthcare contact for women of all ages and this could be exploited for cardiovascular screening. Furthermore, the strikingly different sources of health information reported highlight a need for improved health communication and differentiation of messages. [ABSTRACT FROM AUTHOR]

Background: A new modular, outcome-based, interdisciplinary curriculum was introduced for undergraduate medical education at one of the largest European medical faculties. A key stated institutional goal was to systematically integrate sex and gender medicine and gender perspectives into the curriculum in order to foster adequate gender-related knowledge and skills for future doctors concerning the etiology, pathogenesis, clinical presentation, diagnosis, treatment, and research of diseases. Methods: A change agent was integrated directly into the curriculum development team to facilitate interactions with all key players of the curricular development process. The gender change agent established a supporting organizational framework of all stakeholders, and developed a 10-step approach including identification, selection, placing relevant sex and gender medicine-related issues in the curricular planning sessions, counseling of faculty members, and monitoring of the integration achieved. Results: With this approach, quantitatively sex and gender medicine-related content was widely integrated throughout all teaching and learning formats and from early basic science to later clinical modules (94 lectures, 33 seminars, and 16 practical courses). Gender perspectives involve 5% of the learning objectives and represent an integral part of the assessment program. Qualitatively, the relevance of gender (sociocultural) differences was combined with sex (biological) differences in disease manifestation throughout the curriculum. Conclusions: The appointment of a change agent facilitates the development of systematic approaches that can be a key and serve as practice models to successfully integrate new overarching curricular perspectives and dimensions-in this case sex and gender medicine-into a new medical curriculum. [ABSTRACT FROM AUTHOR]

Aim: Systolic chronic heart failure (CHF) is currently one of the most prevalent cardiac diseases. The present analysis sought to estimate the 1-year disease-related resource use and associated management costs of patients with CHF. Subject and methods: A total of 2,710 individuals with systolic CHF [mean age 62.9 years ± 13.6, 25.2% female, New York Heart Association (NYHA) I-IV] were included from the German Competence Network Heart Failure. Disease-related resource use was assessed with regard to outpatient contacts with physicians, hospitalizations including rehabilitation stays and drug utilization. Results: During 1 year, patients had on average 6.1 contacts with their general practitioner, 1.7 contacts with cardiologists and 0.8 hospital stays per year. Overall disease-related health care costs per patient were calculated at 3,150 € per year. The largest component related to hospitalizations (2,328 €, 74%), while costs of rehabilitation (294 €, 9%), medication (290 €, 9%) and outpatient contacts (238 €, 8%) were considerably lower. Compared with 2,474 € in NYHA class I, there was a cost increase in NYHA II, III and IV of 14, 48 and 71%, respectively. About 76% of this cost increase resulted from augmented hospital (inpatient) resource use. Conclusion: The present analysis demonstrates a high disease-related resource consumption of heart failure care. In particular, patients in higher NYHA classes require increased inpatient resources. Hence, improved treatment strategies need to be developed to optimize care thus reducing hospitalization rates. [ABSTRACT FROM AUTHOR]

Causal attributions made by patients for their coronary heart disease may contribute to gender differences in emotional adjustment. The purpose of this study was to determine gender differences in causal attributions and to analyze the associations between causal attributions and depressive symptomatology in patients undergoing coronary artery bypass graft (CABG) surgery. Nine hundred and seventy-nine patients (mean age 66.8 years, 19.9% women) completed a modified version of the Illness Perception Questionnaire (IPQ) and the depression module of the Patient Health Questionnaire (PHQ-9) 1-3 days before CABG-surgery and 1 year after surgery. Men were more likely to name their health behavior (men: 40.2%, women: 26.9%, P < .001) as a cause of disease, whereas women were more likely to cite destiny (women: 34.7%, men: 25.7%, P = .012). Regression analyses showed cross-sectional and longitudinal associations of attributions with depressive symptomatology which were independent of gender, sociodemographic and clinical variables. Attribution to personality and stress were associated with an increase in depressive symptomatology. Causal attributions may present a valuable approach for identifying patients at risk for depression and the implementation of targeted interventions. [ABSTRACT FROM AUTHOR]