Dhayana Dallmeier, MD, PhD. | University of Ulm (original) (raw)

Papers by Dhayana Dallmeier, MD, PhD.

Research paper thumbnail of Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

Clinical chemistry, 2015

N-terminal pro B-type natriuretic peptide (NT-proBNP) has strong prognostic value for all-cause m... more N-terminal pro B-type natriuretic peptide (NT-proBNP) has strong prognostic value for all-cause mortality in the general population. High-sensitivity assays now allow detection of cardiac troponins even in asymptomatic populations. We examined the association between NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and hs-cTnI and all-cause mortality in older adults. We conducted a longitudinal cohort study [Activity and Function in the Elderly in Ulm (ActiFE Ulm)] including 1506 community-dwelling adults ≥65 years old with NT-proBNP, hs-cTnT, and hs-cTnI measured at baseline. We evaluated the associations between log-transformed biomarker concentrations and 4-year total mortality, accounting for possible confounders, with Cox proportional hazards models. We observed 125 deaths among 1422 participants (median follow-up 4 years). We detected effect modification by sex for all biomarkers (all P values <0.05) expressed as hazard ratio (HR) for death per 1-unit increment of ...

Research paper thumbnail of Frailty and risk of mortality in community dwelling older adults: results of the ActiFE study

Gemeinsame Jahrestagung – der Deutschen Gesellschaft für Epidemiologie e.V. (DGEpi), – der Deutschen Gesellschaft für Medizinische Soziologie e.V. (DGMS) und – der Deutschen Gesellschaft für Sozialmedizin und Prävention e.V. (DGSMP)

Research paper thumbnail of Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials

European Journal of Clinical Pharmacology

Research paper thumbnail of Fracture risk in patients with type 2 diabetes aged ≥50 years related to HbA1c, acute complications, BMI and SGLT2i-use in the DPV registry

Journal of Diabetes and its Complications

Research paper thumbnail of Factors associated with functional decline in hand and hip/knee osteoarthritis after a year’s time: Data from the eposa study

Arthritis Care & Research

Research paper thumbnail of The effectiveness and complexity of interventions targeting sedentary behaviour across the lifespan: a systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity

Background: Evidence suggests that sedentary behaviour (SB) is associated with poor health outcom... more Background: Evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes. SB at any age may have significant consequences for health and well-being and interventions targeting SB are accumulating. Therefore, the need to review the effects of multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential. Methods: A systematic review and meta-analysis were conducted investigating the impact of interventions targeting SB across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies. Results: A total of 77 adult studies (n=62, RCTs) and 84 studies (n=62, RCTs) in children were included. The findings demonstrated that interventions in adults when compared to active controls resulted in non-significant reductions in SB, although when compared to inactive controls significant reductions were found in both the short (MD-56.86; 95%CI-74.10,-39.63; n=4632; I 2 83%) and medium-to-long term (MD-20.14; 95%CI-34.13,-6.16; n=4537; I 2 65%). The findings demonstrated that interventions in children when compared to active controls may lead to relevant reductions in daily sedentary time in the short-term (MD-59.90; 95%CI-102.16,-17.65; n=267; I 2 86%), while interventions in children when compared to inactive controls may lead to relevant reductions in the short-term (MD-25.86; 95%CI-40.77,-10.96; n=9480; I 2 98%) and medium-to-long term (MD-14.02; 95%CI-19.49,-8.55; n=41, 138; I 2 98%). The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB, but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes.

Research paper thumbnail of Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

The Journals of Gerontology: Series A

Background Sedentary behavior (SB) and physical activity (PA) are important determinants of healt... more Background Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries. Method One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates. Results Older adults spent 78.8% of waking time in SB, 18.6% in lig...

Research paper thumbnail of Validierung des Geriatrie-Checks zur Identifikation geriatrischer Patienten in der Notaufnahme

Zeitschrift für Gerontologie und Geriatrie

Research paper thumbnail of Consequences of Choosing Different Settings When Processing Hip-Based Accelerometry Data From Older Adults: A Practical Approach Using Baseline Data From the SITLESS Study

Journal for the Measurement of Physical Behaviour

Accurately measuring older adults’ physical activity (PA) and sedentary behavior (SB) using accel... more Accurately measuring older adults’ physical activity (PA) and sedentary behavior (SB) using accelerometers is essential, as both are important markers of health. This study aimed to highlight how steps taken during data processing may affect key hip-based accelerometry outcomes in older adults, using a selection of baseline accelerometry data (n = 658) from the SITLESS study. Different analytical parameters tested included wear-time algorithms, use of low-frequency extension (LFE) filter, epoch length, and minimum and maximum daily wear-time thresholds. These were compared against vertical axis counts per minute (CPM), vector magnitude (VM) CPM, SB, light PA, moderate-to-vigorous PA, step counts, and wear-time percentage. Differences in settings across the analytical parameters were assessed using paired sample t-tests and repeated measures ANOVAs using Bonferroni correction. Using the “Choi” versus “Troiano” wear-time algorithm resulted in a higher percentage wear-time. Most SB and...

Research paper thumbnail of The pharmacological treatment of arterial hypertension in frail, older patients

Deutsches Aerzteblatt Online

Research paper thumbnail of European Academy for medicine of ageing session participants' report on malnutrition assessment and diagnostic methods; an international survey

Research paper thumbnail of Correction to: Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people

European Review of Aging and Physical Activity

Following publication of the original article [1], the authors reported an error in the author li... more Following publication of the original article [1], the authors reported an error in the author list. The study group has been listed with the authors in the pdf version. The correct presentation of the authors is shown below.

Research paper thumbnail of Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people

European Review of Aging and Physical Activity

Background The aim of this study was to assess the effect of day of the week and wearing a device... more Background The aim of this study was to assess the effect of day of the week and wearing a device (reactivity) on objectively measured physical activity (PA) in older people. Methods Walking duration as a measure for PA was recorded from 1333 German community-dwelling older people (≥65 years, 43.8% women) over 5 days using accelerometers (activPAL). Least-square means of PA with 95%-confidence intervals (95%-CI) from multi-level analysis were calculated for each day of the week and each measurement day (days after sensor attachment). Results Walking duration on Sundays was significantly lower compared to working days (Sunday vs. Monday-Friday: − 12.8 min (95%-CI: − 14.7; − 10.9)). No statistically significant difference compared to working days was present for Saturdays. The linear slope for measurement day and walking duration was marginal and not statistically significant. Conclusions Studies using PA sensors in older people should assess Sundays and working days to adequately det...

Research paper thumbnail of Sarcopenia in Acute Care Patients: Protocol for the European Collaboration of Geriatric Surveys: Sarcopenia 9+ EAMA Project

Journal of the American Medical Directors Association

Research paper thumbnail of Repeat Measurements of High Sensitivity Troponins for the Prediction of Recurrent Cardiovascular Events in Patients With Established Coronary Heart Disease: An Analysis From the KAROLA Study

Journal of the American Heart Association

Research paper thumbnail of Hs-cTroponins for the prediction of recurrent cardiovascular events in patients with established CHD – A comparative analysis from the KAROLA study

International Journal of Cardiology

Research paper thumbnail of Abstract P195: Systolic Blood Pressure and 8-Year Mortality in Community-Dwelling Older Adults. Does Frailty Modify This Effect?

Research paper thumbnail of Frailty index and sex-specific six-year mortality in community dwelling older people – the ActiFE Study

The Journals of Gerontology: Series A

Research paper thumbnail of Physical Activity and Sex Hormone-Binding Globulin in Older Adults

Journal of Aging and Physical Activity

Besides its known function as a transport protein for testosterone and other steroid hormones, se... more Besides its known function as a transport protein for testosterone and other steroid hormones, sex hormone–binding globulin (SHBG) is a biomarker associated with many adverse health effects. The aim of this study was to investigate the association of physical activity with SHBG serum levels in older adults. The physical activity and SHBG values for 1,259 older adults (43.4% female; 56.6% male) with a mean age of 75.6 ± 6.5 years were included in the analysis. The average daily walking duration was 104.2 ± 40.4 (mean ± SD) min. A positive dose–response relationship of daily walking duration with quartiles of SHBG was seen after adjustment for age, sex, history of cardiovascular diseases, diabetes, smoking, γ-glutamyl transferase, and C-reactive protein (p for trend = .010). However, this relationship disappeared after adjustment for body mass index (p for trend = .977). Body mass index seems to be an important determinant of SHBG and a possible confounding factor in the relationship ...

Research paper thumbnail of A Proposal for the Retrospective Identification and Categorization of Older People With Functional Impairments in Scientific Studies—Recommendations of the Medication and Quality of Life in Frail Older Persons (MedQoL) Research Group

Journal of the American Medical Directors Association

When treating older adults, a main factor to consider is physical frailty. Because specific asses... more When treating older adults, a main factor to consider is physical frailty. Because specific assessments in clinical trials are frequently lacking, critical appraisal of treatment evidence with respect to functional status is challenging. Our aim was to identify and categorize assessments for functional status given in clinical trials in older adults to allow for a retrospective characterization and indirect comparison of treatment evidence from these cohorts. We conducted 4 separate systematic reviews of randomized and nonrandomized controlled clinical trials in older people with hypertension, diabetes, depression, and dementia. All assessments identified that reflected functional status were analyzed. Assessments were categorized across 4 different functional status levels. These levels span from functionally not impaired, slightly impaired, significantly impaired, to severely impaired/disabled. If available from the literature, cutoffs for these 4 functioning levels were extracted. If not, or if the existing cutoffs did not match the predefined functional levels, cutoff points were defined by an expert group composed of geriatricians, pharmacists, pharmacologists, neurologists, psychiatrists, and epidemiologists using a patient-centered approach. We identified 51 instruments that included measures of functional status. Although some of the assessments had clearly defined cutoffs across our predefined categories, many others did not. In most cases, no cutoffs existed for slightly impaired or severely impaired older adults. Missing cutoffs or values to adjust were determined by the expert group and are presented as described. The functional status assessments that were identified and operationalized across 4 functional levels could now be used for a retrospective characterization of functional status in randomized controlled trials and observational The Medication and Quality of Life Research Group comprises Christine A

Research paper thumbnail of Sex-Specific Associations of Established and Emerging Cardiac Biomarkers with All-Cause Mortality in Older Adults: The ActiFE Study

Clinical chemistry, 2015

N-terminal pro B-type natriuretic peptide (NT-proBNP) has strong prognostic value for all-cause m... more N-terminal pro B-type natriuretic peptide (NT-proBNP) has strong prognostic value for all-cause mortality in the general population. High-sensitivity assays now allow detection of cardiac troponins even in asymptomatic populations. We examined the association between NT-proBNP, high-sensitivity cardiac troponin T (hs-cTnT), and hs-cTnI and all-cause mortality in older adults. We conducted a longitudinal cohort study [Activity and Function in the Elderly in Ulm (ActiFE Ulm)] including 1506 community-dwelling adults ≥65 years old with NT-proBNP, hs-cTnT, and hs-cTnI measured at baseline. We evaluated the associations between log-transformed biomarker concentrations and 4-year total mortality, accounting for possible confounders, with Cox proportional hazards models. We observed 125 deaths among 1422 participants (median follow-up 4 years). We detected effect modification by sex for all biomarkers (all P values <0.05) expressed as hazard ratio (HR) for death per 1-unit increment of ...

Research paper thumbnail of Frailty and risk of mortality in community dwelling older adults: results of the ActiFE study

Gemeinsame Jahrestagung – der Deutschen Gesellschaft für Epidemiologie e.V. (DGEpi), – der Deutschen Gesellschaft für Medizinische Soziologie e.V. (DGMS) und – der Deutschen Gesellschaft für Sozialmedizin und Prävention e.V. (DGSMP)

Research paper thumbnail of Current evidence on the impact of medication optimization or pharmacological interventions on frailty or aspects of frailty: a systematic review of randomized controlled trials

European Journal of Clinical Pharmacology

Research paper thumbnail of Fracture risk in patients with type 2 diabetes aged ≥50 years related to HbA1c, acute complications, BMI and SGLT2i-use in the DPV registry

Journal of Diabetes and its Complications

Research paper thumbnail of Factors associated with functional decline in hand and hip/knee osteoarthritis after a year’s time: Data from the eposa study

Arthritis Care & Research

Research paper thumbnail of The effectiveness and complexity of interventions targeting sedentary behaviour across the lifespan: a systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity

Background: Evidence suggests that sedentary behaviour (SB) is associated with poor health outcom... more Background: Evidence suggests that sedentary behaviour (SB) is associated with poor health outcomes. SB at any age may have significant consequences for health and well-being and interventions targeting SB are accumulating. Therefore, the need to review the effects of multicomponent, complex interventions that incorporate effective strategies to reduce SB are essential. Methods: A systematic review and meta-analysis were conducted investigating the impact of interventions targeting SB across the lifespan. Six databases were searched and two review authors independently screened studies for eligibility, completed data extraction and assessed the risk of bias and complexity of each of the included studies. Results: A total of 77 adult studies (n=62, RCTs) and 84 studies (n=62, RCTs) in children were included. The findings demonstrated that interventions in adults when compared to active controls resulted in non-significant reductions in SB, although when compared to inactive controls significant reductions were found in both the short (MD-56.86; 95%CI-74.10,-39.63; n=4632; I 2 83%) and medium-to-long term (MD-20.14; 95%CI-34.13,-6.16; n=4537; I 2 65%). The findings demonstrated that interventions in children when compared to active controls may lead to relevant reductions in daily sedentary time in the short-term (MD-59.90; 95%CI-102.16,-17.65; n=267; I 2 86%), while interventions in children when compared to inactive controls may lead to relevant reductions in the short-term (MD-25.86; 95%CI-40.77,-10.96; n=9480; I 2 98%) and medium-to-long term (MD-14.02; 95%CI-19.49,-8.55; n=41, 138; I 2 98%). The assessment of complexity suggested that interventions may need to be suitably complex to address the challenges of a complex behaviour such as SB, but demonstrated that a higher complexity score is not necessarily associated with better outcomes in terms of sustained long-term changes.

Research paper thumbnail of Accelerometer-Measured Sedentary and Physical Activity Time and Their Correlates in European Older Adults: The SITLESS Study

The Journals of Gerontology: Series A

Background Sedentary behavior (SB) and physical activity (PA) are important determinants of healt... more Background Sedentary behavior (SB) and physical activity (PA) are important determinants of health in older adults. This study aimed to describe the composition of accelerometer-measured SB and PA in older adults, to explore self-reported context-specific SB, and to assess sociodemographic and functional correlates of engaging in higher levels of SB in participants of a multicenter study including four European countries. Method One thousand three hundred and sixty community-dwelling older adults from the SITLESS study (61.8% women; 75.3 ± 6.3 years) completed a self-reported SB questionnaire and wore an ActiGraph accelerometer for 7 days. Accelerometer-determined compositional descriptive statistics were calculated. A fixed-effects regression analysis was conducted to assess the sociodemographic (country, age, sex, civil status, education, and medications) and functional (body mass index and gait speed) correlates. Results Older adults spent 78.8% of waking time in SB, 18.6% in lig...

Research paper thumbnail of Validierung des Geriatrie-Checks zur Identifikation geriatrischer Patienten in der Notaufnahme

Zeitschrift für Gerontologie und Geriatrie

Research paper thumbnail of Consequences of Choosing Different Settings When Processing Hip-Based Accelerometry Data From Older Adults: A Practical Approach Using Baseline Data From the SITLESS Study

Journal for the Measurement of Physical Behaviour

Accurately measuring older adults’ physical activity (PA) and sedentary behavior (SB) using accel... more Accurately measuring older adults’ physical activity (PA) and sedentary behavior (SB) using accelerometers is essential, as both are important markers of health. This study aimed to highlight how steps taken during data processing may affect key hip-based accelerometry outcomes in older adults, using a selection of baseline accelerometry data (n = 658) from the SITLESS study. Different analytical parameters tested included wear-time algorithms, use of low-frequency extension (LFE) filter, epoch length, and minimum and maximum daily wear-time thresholds. These were compared against vertical axis counts per minute (CPM), vector magnitude (VM) CPM, SB, light PA, moderate-to-vigorous PA, step counts, and wear-time percentage. Differences in settings across the analytical parameters were assessed using paired sample t-tests and repeated measures ANOVAs using Bonferroni correction. Using the “Choi” versus “Troiano” wear-time algorithm resulted in a higher percentage wear-time. Most SB and...

Research paper thumbnail of The pharmacological treatment of arterial hypertension in frail, older patients

Deutsches Aerzteblatt Online

Research paper thumbnail of European Academy for medicine of ageing session participants' report on malnutrition assessment and diagnostic methods; an international survey

Research paper thumbnail of Correction to: Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people

European Review of Aging and Physical Activity

Following publication of the original article [1], the authors reported an error in the author li... more Following publication of the original article [1], the authors reported an error in the author list. The study group has been listed with the authors in the pdf version. The correct presentation of the authors is shown below.

Research paper thumbnail of Lazy Sundays: role of day of the week and reactivity on objectively measured physical activity in older people

European Review of Aging and Physical Activity

Background The aim of this study was to assess the effect of day of the week and wearing a device... more Background The aim of this study was to assess the effect of day of the week and wearing a device (reactivity) on objectively measured physical activity (PA) in older people. Methods Walking duration as a measure for PA was recorded from 1333 German community-dwelling older people (≥65 years, 43.8% women) over 5 days using accelerometers (activPAL). Least-square means of PA with 95%-confidence intervals (95%-CI) from multi-level analysis were calculated for each day of the week and each measurement day (days after sensor attachment). Results Walking duration on Sundays was significantly lower compared to working days (Sunday vs. Monday-Friday: − 12.8 min (95%-CI: − 14.7; − 10.9)). No statistically significant difference compared to working days was present for Saturdays. The linear slope for measurement day and walking duration was marginal and not statistically significant. Conclusions Studies using PA sensors in older people should assess Sundays and working days to adequately det...

Research paper thumbnail of Sarcopenia in Acute Care Patients: Protocol for the European Collaboration of Geriatric Surveys: Sarcopenia 9+ EAMA Project

Journal of the American Medical Directors Association

Research paper thumbnail of Repeat Measurements of High Sensitivity Troponins for the Prediction of Recurrent Cardiovascular Events in Patients With Established Coronary Heart Disease: An Analysis From the KAROLA Study

Journal of the American Heart Association

Research paper thumbnail of Hs-cTroponins for the prediction of recurrent cardiovascular events in patients with established CHD – A comparative analysis from the KAROLA study

International Journal of Cardiology

Research paper thumbnail of Abstract P195: Systolic Blood Pressure and 8-Year Mortality in Community-Dwelling Older Adults. Does Frailty Modify This Effect?

Research paper thumbnail of Frailty index and sex-specific six-year mortality in community dwelling older people – the ActiFE Study

The Journals of Gerontology: Series A

Research paper thumbnail of Physical Activity and Sex Hormone-Binding Globulin in Older Adults

Journal of Aging and Physical Activity

Besides its known function as a transport protein for testosterone and other steroid hormones, se... more Besides its known function as a transport protein for testosterone and other steroid hormones, sex hormone–binding globulin (SHBG) is a biomarker associated with many adverse health effects. The aim of this study was to investigate the association of physical activity with SHBG serum levels in older adults. The physical activity and SHBG values for 1,259 older adults (43.4% female; 56.6% male) with a mean age of 75.6 ± 6.5 years were included in the analysis. The average daily walking duration was 104.2 ± 40.4 (mean ± SD) min. A positive dose–response relationship of daily walking duration with quartiles of SHBG was seen after adjustment for age, sex, history of cardiovascular diseases, diabetes, smoking, γ-glutamyl transferase, and C-reactive protein (p for trend = .010). However, this relationship disappeared after adjustment for body mass index (p for trend = .977). Body mass index seems to be an important determinant of SHBG and a possible confounding factor in the relationship ...

Research paper thumbnail of A Proposal for the Retrospective Identification and Categorization of Older People With Functional Impairments in Scientific Studies—Recommendations of the Medication and Quality of Life in Frail Older Persons (MedQoL) Research Group

Journal of the American Medical Directors Association

When treating older adults, a main factor to consider is physical frailty. Because specific asses... more When treating older adults, a main factor to consider is physical frailty. Because specific assessments in clinical trials are frequently lacking, critical appraisal of treatment evidence with respect to functional status is challenging. Our aim was to identify and categorize assessments for functional status given in clinical trials in older adults to allow for a retrospective characterization and indirect comparison of treatment evidence from these cohorts. We conducted 4 separate systematic reviews of randomized and nonrandomized controlled clinical trials in older people with hypertension, diabetes, depression, and dementia. All assessments identified that reflected functional status were analyzed. Assessments were categorized across 4 different functional status levels. These levels span from functionally not impaired, slightly impaired, significantly impaired, to severely impaired/disabled. If available from the literature, cutoffs for these 4 functioning levels were extracted. If not, or if the existing cutoffs did not match the predefined functional levels, cutoff points were defined by an expert group composed of geriatricians, pharmacists, pharmacologists, neurologists, psychiatrists, and epidemiologists using a patient-centered approach. We identified 51 instruments that included measures of functional status. Although some of the assessments had clearly defined cutoffs across our predefined categories, many others did not. In most cases, no cutoffs existed for slightly impaired or severely impaired older adults. Missing cutoffs or values to adjust were determined by the expert group and are presented as described. The functional status assessments that were identified and operationalized across 4 functional levels could now be used for a retrospective characterization of functional status in randomized controlled trials and observational The Medication and Quality of Life Research Group comprises Christine A