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Projects: Gerontopsychiatry

EU - Europäische Union D.EU.0073: RECAGE. 01/2018-12/2023.

The RECAGE project will tackle one of the most challenging problem arising during the clinical course of dementia: the so-called Behavioural and Psychological Symptoms of Dementia (BPSD). The current state-of-the-art of the treatment of these symptoms is still unsatisfactory and there are many unmet needs in this area. The major objective of the project will be to assess the effectiveness of an intervention, the special medical care unit for patients with BPSD (SCU-B), that, albeit already implemented in some European countries, is not widespread and has not been sufficiently studied so far, although it seems to be promising for its short-term efficacy (alleviating BPSD and improving quality of life of PwD) and possibly for its long term efficacy. In order to achieve this goal, RECAGE will proceed in three steps: 1) A prospective cohort study, comparing the activity of the centres endowed with a typical SCU-B with that of the other participating centres lacking this facility; the efficacy and the cost-effectiveness of the proposed intervention will be tested in the prospective study. The expected benefits are socially appreciable: improving quality of life of persons with dementia, lessening caregivers' burden, possibly delaying institutionalisation 2) A conference aiming at adapting the SCU-B model in accordance with the results of the cohort study, not only regarding its main endpoints, but also comparing the experience and the different ways of operating of the participating centres and the different socio-political context in which they act 3) A plan for scaling up the intervention in the countries who take part in the study, but where SCU-Bs are absent or sporadic as Italy and Greece.

Hector II Stiftung : FRAILBRAIN: Reversing maladaptive reorganization in frail brains: sensorimotor training, brain plasticity and the role of BDNF. 10/2016-09/2019.

Hoell A. Nachwuchsakademie Versorungsforschung Baden-Württemberg: Evaluation des Deeskalationsprogrammes "OUTCOME" zum Umgang mit Aggression und Gewalt in der Psychiatrie. 12/2015-04/2017.

Aggression und Gewalt von Patienten sind in der Psychiatrie häufig zu beobachtende Phänomene. Die negativen Auswirkungen sind für alle Beteiligten (Mitarbeiter, Patienten, Einrichtungen, Krankenversicherung) deutlich zu spüren. Zur Eindämmung von Gewalt und Aggression gegen sich oder andere wird häufig auf die Anwendung von Zwangsmaßnahmen zurückgegriffen, oftmals auch gegen den ausdrücklichen Willen der Patienten. Zuletzt wurden Zwangsmaßnahmen von der UN-Behindertenrechtskonvention scharf angegriffen und mehr Patientenautonomie gefordert. Mit der Stärkung der Patientenrechte durch gesetzliche Beschlüsse und richterliche Urteile ist ein Umdenken in der Psychiatrie erforderlich geworden. Zwangsmaßnahmen sind derzeit in Deutschland weitestgehend einzuschränken, Zwangsbehandlungen gar richterlich zu genehmigen (Dreßing & Zink, 2014). Es müssen erst alle anderen milderen Maßnahmen ausgeschöpft werden, um ärztlich/pflegerisches Handeln mit der Autonomie der Patienten zu vereinbaren. Dazu werden vor allem Deeskalationstrainings gefordert (Deutsche Gesellschaft für Psychiatrie Psychotherapie und Nervenheilkunde (DGPPN), 2009b). Dennoch gehören Zwangsmaßnahmen nach wie vor zum Versorgungsalltag in der stationären Psychiatrie (Steinert, Schmid, & Arbeitskreis zur Prävention von Gewalt und Zwang, 2014). Vor diesem Hintergrund wurde ein multimodales Deeskalationsmanagement OUTCOME von den Pflegedienstleitungen des Zentralinstituts für Seelische Gesundheit (ZI) und des Zentrums für Psychiatrie (ZfP) Weinsberg entwickelt, welches einen ganzheitlichen, auf den Patienten fokussierten Ansatz verfolgt. Das Deeskalationsmanagement „OUTCOME“ soll in zwei psychiatrischen Kliniken auf beschützenden Stationen eingeführt und dessen Wirksamkeit geprüft werden. Dabei werden auf Stationsebene folgende Parameter überprüft: die Auftretenshäufigkeit schwerer Eskalationen und die Dauer von Patienten pro Zwangsmaßnahme in Stunden. Zusätzlich werden auf der Ebene der Stationsmitarbeiter das Ausmaß negativer Auswirkungen von Aggressionen, die Einstellung zur Anwendung von Zwangsmaßnahmen und die Sicherheit im Umgang mit Aggression und Gewalt gemessen.

Frölich L. BMBF - Bundesministerium für Bildung und Forschung 01ED1203J: BIOMARKAPD: Joint Programming Neurodegenerative Disease: Biomarkers for Alzheimer’s disease and Parkinson’s disease. 07/2012-06/2015.

Alzheimer’s and Parkinson’s diseases (AD and PD) are the two most common neurodegenerative conditions. They cause major costs for the society and suffering and death for millions of patients around the globe. In Europe, more than 8 million individuals have AD or PD. Current treatments are symptomatic but do not stop the underlying disease process. Using biomarkers, we can detect biochemical changes that show when neurons start to die. There are also biochemical tests for brain changes that are specific to AD and PD. Studies suggest that such abnormalities start to appear 10-20 years before onset of symptoms. If we want to do something substantial about these diseases, we need to diagnose them early, before too many neurons have been lost, and then treat them with drugs that inhibit the destructive process. Such drugs are in development. However, in these disease stages we cannot rely on clinical symptoms, as they may be very subtle, or even absent. Instead, research tells us that we could use biomarkers for disease-specific pathologies. Established biomarkers exist for early AD and promising candidates are underway for PD. However, a major problem today is the lack of standardisation regarding exactly how to perform and use the biomarker tests. In BIOMARKAPD we detail how we will standardise the biomarker measurements across Europe, how to collect samples, how to perform the measurements and how to interpret the results. We will also create a biobank with samples from well characterised AD and PD patients, including patients in very early disease stages, as well as neurologically healthy controls. These samples will be used to develop new and better assays and to test new and better biomarker candidates. Finally, we will develop certified reference materials that can be used to harmonise assays that are used to measure the different biomarkers. The deliverables of the proposal will have a major influence on clinical research and drug development for neurodegenerative conditions in general and for AD and PD in particular. They will impact these types of efforts globally and make Europe world-leading in this arena.

Frölich L. BMBF - Bundesministerium für Bildung und Forschung 01KG0822: SIMaMCI-Study: Trial of Simvastatin in Amnestic Mild Cognitive Impairment (MCI) Patients (study site). 01/2009-12/2013.

Probands with MCI are at high risk to develop Alzheimer´s dementia (AD). Simvastatin may lower the production of Amyloid, a hallmark of AD in the brain. The primary hypothesis of the study is that Simvastatin significantly reduces the risk of conversion to Alzheimer's disease in individuals with MCI as compared to MCI receiving placebo.


The European LipiDiDiet project addresses the Impact of Nutritional Lipids on Neuronal and Cognitive Performance in Aging, Alzheimer’s disease and Vascular Dementia. This is based on previous observations that lipids change the risk for dementia. Especially some omega-3 lipids appear to lower the Alzheimer risk. It is our major aim to complement the currently existing medical therapy of Alzheimer’s disease with nutrition, especially at the very first stages of Alzheimer’s disease. But we do not stop at Alzheimer’s, we also develop dietary products that maintain and support the normal cognitive function in healthy aging in general and help reduce cerebrovascular risks. In addition to dietary products we also develop diet and life-style based health care advice for the elderly. The project is based on two elements; one is applied research documenting the value of nutritional support in persons at risk of getting Alzheimer’s disease. The other element is basic research generating more knowledge about the possible therapeutic and preventive effects of dietary lipids in model systems of Alzheimer’s disease and Vascular Dementia.

Zentralinstitut für Seelische Gesundheit (ZI) - https://www.zi-mannheim.de