Review

. 2020 Jul;53(4):340-346.

doi: 10.1007/s00391-020-01734-1. Epub 2020 May 19.

Neurogeriatrics-a vision for improved care and research for geriatric patients with predominating neurological disabilities

Andreas H Jacobs¹, Kirsten Emmert², Ralf Baron², Thorsten Bartsch², Juergen Bauer³, Clemens Becker⁴, Daniela Berg², Philipp Bergmann⁵, Kai Boetzel⁶, Cornelius Bollheimer⁷, Guenther Deuschl², Marija Djukic^{8

9}, Michael Drey¹⁰, Herbert Durwen¹¹, Georg Ebersbach¹², Morad Elshehabi², Johanna Geritz², Christoph Gisinger¹³, Thomas Guennewig¹⁴, Bjoern Hauptmann^{15

16}, Hans-Juergen Heppner^{17

18}, Markus A Hobert², Werner Hofmann¹⁹, Philipp Huellemann², Klaus Jahn^{20

21}, Jochen Klucken^{22

23}, Roland Kurth²⁴, Reinhard Lindner²⁵, Paul Lingor^{26

27}, Albert Lukas^{28

29}, Sara Maetzold², Thomas Mokrusch³⁰, Brit Mollenhauer^{31

27}, Roland Nau^{8

9}, Annika Plate⁶, Maria Cristina Polidori³², Tino Prell³³, Peter Schellinger³⁴, Dominik Spira³⁵, Ulrich Stephani³⁶, Simone Studt³⁷, Claudia Trenkwalder^{38

39}, Heinz L Unger⁴⁰, Peter Urban⁴¹, Christine A F von Arnim⁴², Tobias Warnecke⁴³, Michael Weiss⁴⁴, Andreas Wiedemann^{45

46}, Rainer Wirth⁴⁷, Karsten Witt⁴⁸, Richard Dodel⁴⁹, Walter Maetzler⁵⁰

Affiliations

¹ Department for Geriatric Medicine and Neurology, Johanniter Hospital, Bonn and European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.
² Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Arnold-Heller-Str. 3, House D, 24105, Kiel, Germany.
³ Center for Geriatric Medicine, University of Heidelberg and Agaplesion Bethanien Hospital, Heidelberg, Germany.
⁴ Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany.
⁵ Department of Internal Medicine I, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
⁶ Department of Neurology, University Hospital LMU Munich, Munich, Germany.
⁷ Department of Geriatric Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
⁸ Department of Neuropathology, University Medical Center Göttingen, Göttingen, Germany.
⁹ Department of Geriatrics, Protestant Hospital Göttingen-Weende, Göttingen, Germany.
¹⁰ Department of Medicine IV, University Hospital LMU Munich, Munich, Germany.
¹¹ Department of Geriatric Medicine, St. Martinus Hospital Düsseldorf, Düsseldorf, Germany.
¹² Hospital for Movement Disorders/Parkinson's Disease, Beelitz-Heilstätten, Beelitz, Germany.
¹³ Center for Geriatric Medicine and Geriatric Nursing, Danube University Krems, Krems an der Donau, Austria.
¹⁴ Department of Geriatrics and Neurology, Elisabeth Hospital Recklinghausen, Recklinghausen, Germany.
¹⁵ Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany.
¹⁶ Department of Therapeutic Sciences, MSH Medical School Hamburg, Hamburg, Germany.
¹⁷ Department of Geriatrics, University Witten/Herdecke, Schwelm, Germany.
¹⁸ Helios Clinic Schwelm, Schwelm, Germany.
¹⁹ Geriatric Center Neumünster and Bad Bramstedt, Friedrich-Ebert-Hospital Neumünster, Neumünster, Germany.
²⁰ Schön Klinik Bad Aibling, Bad Aibling, Germany.
²¹ German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Munich, Germany.
²² Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
²³ Research Group Digital Health Pathways, Fraunhofer IIS, Erlangen, Germany.
²⁴ Neurological Practice Roland Kurth, Kiel, Germany.
²⁵ Institute for Social Work, University of Kassel, Kassel, Germany.
²⁶ Department of Neurology, Technical University of Munich, Munich, Germany.
²⁷ Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.
²⁸ Agaplesion Bethesda Clinic, Competence Centre of Geriatrics and Aging Research, University of Ulm, Ulm, Germany.
²⁹ Malteser Hospital Bonn, Geriatric Centre, Academic Teaching Hospital, University of Bonn, Bonn, Germany.
³⁰ Department of Neurology and Early Neurological Rehabilitation, MediClin Hedon Klinik Lingen, Lingen, Germany.
³¹ Paracelsus-Elena-Klinik Kassel, Kassel, Germany.
³² Ageing Clinical Research, Dpt. II Internal Medicine, University Hospital of Cologne, and Cologne Cluster of Excellence in Cellular Stress Responses in Aging-associated Diseases, Cologne, Germany.
³³ Department of Neurology, Jena University Hospital, Jena, Germany.
³⁴ Departments of Neurology and Neurogeriatry, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany.
³⁵ Department of Endocrinology and Metabolism, Charité-University Medical Center, Berlin, Germany.
³⁶ Department of Neuropediatrics, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
³⁷ Gerontopsychiatry, Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
³⁸ Clinic of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany.
³⁹ Paracelsus-Elena Klinik, Kassel, Germany.
⁴⁰ Department of Geriatrics and Early Rehabilitation, Evangelical Hospital Kalk Cologne, Cologne, Germany.
⁴¹ Department of Neurology, Asklepios Klinik Barmbek, Hamburg, Germany.
⁴² Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany.
⁴³ Department of Neurology, University of Münster, Münster, Germany.
⁴⁴ Clinic for Neurology and Clinical Neurophysiology, Schön Klinik Neustadt, Neustadt, Germany.
⁴⁵ Department of Urology, Evangelical Hospital Witten, Witten, Germany.
⁴⁶ Department of Geriatrics, Witten-Herdecke University, Witten, Germany.
⁴⁷ Department of Geriatric Medicine, Marien Hospital Herne, University Hospital Ruhr University Bochum, Bochum, Germany.
⁴⁸ Department of Neurology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
⁴⁹ Chair of Geriatrics, University Hospital Essen and Geriatriezentrum Haus Berge, Contilia Group, Essen, Germany.
⁵⁰ Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Arnold-Heller-Str. 3, House D, 24105, Kiel, Germany. w.maetzler@neurologie.uni-kiel.de.

PMID: 32430766
PMCID: PMC7311516
DOI: 10.1007/s00391-020-01734-1

Review

Neurogeriatrics-a vision for improved care and research for geriatric patients with predominating neurological disabilities

Andreas H Jacobs et al. Z Gerontol Geriatr. 2020 Jul.

. 2020 Jul;53(4):340-346.

doi: 10.1007/s00391-020-01734-1. Epub 2020 May 19.

Authors

Affiliations

¹ Department for Geriatric Medicine and Neurology, Johanniter Hospital, Bonn and European Institute for Molecular Imaging (EIMI), University of Münster, Münster, Germany.
² Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Arnold-Heller-Str. 3, House D, 24105, Kiel, Germany.
³ Center for Geriatric Medicine, University of Heidelberg and Agaplesion Bethanien Hospital, Heidelberg, Germany.
⁴ Department of Clinical Gerontology, Robert Bosch Hospital, Stuttgart, Germany.
⁵ Department of Internal Medicine I, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
⁶ Department of Neurology, University Hospital LMU Munich, Munich, Germany.
⁷ Department of Geriatric Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany.
⁸ Department of Neuropathology, University Medical Center Göttingen, Göttingen, Germany.
⁹ Department of Geriatrics, Protestant Hospital Göttingen-Weende, Göttingen, Germany.
¹⁰ Department of Medicine IV, University Hospital LMU Munich, Munich, Germany.
¹¹ Department of Geriatric Medicine, St. Martinus Hospital Düsseldorf, Düsseldorf, Germany.
¹² Hospital for Movement Disorders/Parkinson's Disease, Beelitz-Heilstätten, Beelitz, Germany.
¹³ Center for Geriatric Medicine and Geriatric Nursing, Danube University Krems, Krems an der Donau, Austria.
¹⁴ Department of Geriatrics and Neurology, Elisabeth Hospital Recklinghausen, Recklinghausen, Germany.
¹⁵ Department of Neurology, Segeberger Kliniken, Bad Segeberg, Germany.
¹⁶ Department of Therapeutic Sciences, MSH Medical School Hamburg, Hamburg, Germany.
¹⁷ Department of Geriatrics, University Witten/Herdecke, Schwelm, Germany.
¹⁸ Helios Clinic Schwelm, Schwelm, Germany.
¹⁹ Geriatric Center Neumünster and Bad Bramstedt, Friedrich-Ebert-Hospital Neumünster, Neumünster, Germany.
²⁰ Schön Klinik Bad Aibling, Bad Aibling, Germany.
²¹ German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University of Munich, Munich, Germany.
²² Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany.
²³ Research Group Digital Health Pathways, Fraunhofer IIS, Erlangen, Germany.
²⁴ Neurological Practice Roland Kurth, Kiel, Germany.
²⁵ Institute for Social Work, University of Kassel, Kassel, Germany.
²⁶ Department of Neurology, Technical University of Munich, Munich, Germany.
²⁷ Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.
²⁸ Agaplesion Bethesda Clinic, Competence Centre of Geriatrics and Aging Research, University of Ulm, Ulm, Germany.
²⁹ Malteser Hospital Bonn, Geriatric Centre, Academic Teaching Hospital, University of Bonn, Bonn, Germany.
³⁰ Department of Neurology and Early Neurological Rehabilitation, MediClin Hedon Klinik Lingen, Lingen, Germany.
³¹ Paracelsus-Elena-Klinik Kassel, Kassel, Germany.
³² Ageing Clinical Research, Dpt. II Internal Medicine, University Hospital of Cologne, and Cologne Cluster of Excellence in Cellular Stress Responses in Aging-associated Diseases, Cologne, Germany.
³³ Department of Neurology, Jena University Hospital, Jena, Germany.
³⁴ Departments of Neurology and Neurogeriatry, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany.
³⁵ Department of Endocrinology and Metabolism, Charité-University Medical Center, Berlin, Germany.
³⁶ Department of Neuropediatrics, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
³⁷ Gerontopsychiatry, Department of Psychiatry and Psychotherapy, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Kiel, Germany.
³⁸ Clinic of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany.
³⁹ Paracelsus-Elena Klinik, Kassel, Germany.
⁴⁰ Department of Geriatrics and Early Rehabilitation, Evangelical Hospital Kalk Cologne, Cologne, Germany.
⁴¹ Department of Neurology, Asklepios Klinik Barmbek, Hamburg, Germany.
⁴² Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany.
⁴³ Department of Neurology, University of Münster, Münster, Germany.
⁴⁴ Clinic for Neurology and Clinical Neurophysiology, Schön Klinik Neustadt, Neustadt, Germany.
⁴⁵ Department of Urology, Evangelical Hospital Witten, Witten, Germany.
⁴⁶ Department of Geriatrics, Witten-Herdecke University, Witten, Germany.
⁴⁷ Department of Geriatric Medicine, Marien Hospital Herne, University Hospital Ruhr University Bochum, Bochum, Germany.
⁴⁸ Department of Neurology, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.
⁴⁹ Chair of Geriatrics, University Hospital Essen and Geriatriezentrum Haus Berge, Contilia Group, Essen, Germany.
⁵⁰ Department of Neurology, University Hospital Schleswig-Holstein Campus Kiel, Kiel University, Arnold-Heller-Str. 3, House D, 24105, Kiel, Germany. w.maetzler@neurologie.uni-kiel.de.

PMID: 32430766
PMCID: PMC7311516
DOI: 10.1007/s00391-020-01734-1

Abstract
in English, German

Geriatric medicine is a rapidly evolving field that addresses diagnostic, therapeutic and care aspects of older adults. Some disabilities and disorders affecting cognition (e.g. dementia), motor function (e.g. stroke, Parkinson's disease, neuropathies), mood (e.g. depression), behavior (e.g. delirium) and chronic pain disorders are particularly frequent in old subjects. As knowledge about these age-associated conditions and disabilities is steadily increasing, the integral implementation of neurogeriatric knowledge in geriatric medicine and specific neurogeriatric research is essential to develop the field. This article discusses how neurological know-how could be integrated in academic geriatric medicine to improve care of neurogeriatric patients, to foster neurogeriatric research and training concepts and to provide innovative care concepts for geriatric patients with predominant neurological conditions and disabilities.

Die Geriatrie ist ein sich rasch entwickelnder Fachbereich, der sich mit der Diagnose, Therapie und Pflege von älteren Erwachsenen befasst. Einige Erkrankungen und Störungen, die Kognition (z. B. Demenz), Motorik (z. B. Schlaganfall, ParkinsonSyndrome, Neuropathien), Emotionen (z. B. Depression), Verhalten (z. B. Delirium) und chronische Schmerzerkrankungen betreffen, sind bei alten Menschen besonders häufig. Da unser Wissen über diese altersbedingten Erkrankungen stetig zunimmt, ist die Umsetzung von neurogeriatrischem Wissen in der geriatrischen Medizin und die spezifische neurogeriatrische Forschung für die Entwicklung des Fachgebietes unerlässlich. Dieser Artikel stellt Szenarien vor, wie neurologisches Wissen in die akademische Geriatrie integriert werden kann, um die Versorgung neurogeriatrischer Patienten zu verbessern, neurogeriatrische Forschungs- und Ausbildungskonzepte zu fördern und innovative Versorgungskonzepte für geriatrische Patienten mit führend neurologischen Erkrankungen und Störungen umzusetzen.

Keywords: Centers for Aging Medicine; Cognitive decline; Interdisciplinarity; Movement disorder; Multidisciplinary team; Neurogeriatric assessment; Neurology.

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Conflict of interest statement

A.H. Jacobs, K. Emmert, R. Baron, T. Bartsch, J. Bauer, C. Becker, D. Berg, P. Bergmann, K. Boetzel, C. Bollheimer, G. Deuschl, M. Djukic, M. Drey, H. Durwen, G. Ebersbach, M. Elshehabi, J. Geritz, C. Gisinger, T. Guennewig, B. Hauptmann, H.-J. Heppner, M.A. Hobert, W. Hofmann, P. Huellemann, K. Jahn, J. Klucken, R. Kurth, R. Lindner, P. Lingor, A. Lukas, S. Maetzold, T. Mokrusch, B. Mollenhauer, R. Nau, A. Plate, M.C. Polidori, T. Prell, P. Schellinger, D. Spira, U. Stephani, S. Studt, C. Trenkwalder, H.L. Unger, P. Urban, C.A.F. von Arnim, T. Warnecke, M. Weiss, A. Wiedemann, R. Wirth, K. Witt, R. Dodel and W. Maetzler declare that they have no competing interests.

Figures

**Fig. 1**
The field of geriatrics with its high expertise in interdisciplinary teamwork can fuel into the mostly organ-oriented medical fields for the formation of various dedicated specialties (e.g. oncogeriatrics, urogeriatrics, orthogeriatrics, geriatric psychiatry, neurogeriatrics). This may lead to the formation of centres for aging medicine

**Fig. 2**
Prevalence of health disabilities in patients ≥75 years old referred to the general emergency room at the University Hospital Bern from 2009–2012. From [6] with courtesy. ED emergency department, *ADL* activity of daily living

**Fig. 3**
Axial sections showning signs of subcortical hypodensities (CCT, a) or hyperintensities (MRI, b) as manifestation of atherosclerotic encephalopathy (SAE) leading to impairment of motor function and cognition in a 78-year-old patient with diabetes mellitus and hypertension. Signs of normal pressure hydrocephalus (NPH) with dilatation of ventricles (c) and tight sulci in the high frontoparietal regions (d) as a typical geriatric syndrome with gait disturbances, falls, impaired cognition and urinary incontinence

See this image and copyright information in PMC

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Neurogeriatrics-a vision for improved care and research for geriatric patients with predominating neurological disabilities

Affiliations

Neurogeriatrics-a vision for improved care and research for geriatric patients with predominating neurological disabilities

Authors

Affiliations

Abstract
in English, German

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Abstract in English, German

Conflict of interest statement

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References

Publication types

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Full Text Sources

Medical

Research Materials

Abstract
in English, German