Objectives: The aim was to investigate the prevalence of probable depression and probable anxiety and to investigate the determinants of depressive symptoms and anxiety symptoms among transgender people. Methods: In this “Transgender Survey” (n = 104) we included transgender people who had joined self-help groups to obtain and share information about the gender-affirming surgeries performed at the Division of Plastic, Reconstructive and Aesthetic Surgery at the University Medical Center Hamburg-Eppendorf. Data collection took place between April and October 2022. To measure probable depression, the patient health questionnaire-9 was used. The generalized anxiety disorder-7 was used to quantify probable anxiety. Results: The prevalence of probable depression was 33.3% and it was 29.6% for probable anxiety. Multiple linear regressions showed that both more depressive symptoms and anxiety symptoms were significantly associated with younger age (β = −0.16, p < 0.01; β = −0.14, p < 0.01), being unemployed (e.g., full-time employed compared to unemployment: β = −3.05, p < 0.05; β = −2.69, p < 0.05), worse self-rated health (β = −3.31, p < 0.001; β = −1.88, p < 0.05), and having at least one chronic disease (β = 3.71, p < 0.01; β = 2.61, p < 0.05). Conclusions: Remarkably high prevalence rates were identified among transgender people. Furthermore, risk factors of poor mental health (e.g., unemployment or younger age) were identified—which can help to address transgender people at risk for poor mental health.

Aim: The aim of the study was to investigate the effect of the onset of Parkinson's disease (PD) on life satisfaction. Method: Data from 2008, 2011, and 2014 were used from a population-based prospective cohort (German Ageing Survey; 8,982 observations in FE regression analysis) of community-residing individuals in the second half of life (≥40 years) in Germany. Satisfaction with life was quantified using the established Satisfaction with Life Scale. Physician-diagnosed PD was reported. Results: In total, 48.9% were female. The mean age was 63.8 years (±11.3 years). Average life satisfaction equaled 3.8 (±0.7). Linear fixed effects regressions revealed that the onset of PD was associated with a considerable decline in life satisfaction (β = −0.37, 95% CI −0.69 to −0.05, p < 0.05). This effect was significantly more pronounced in men. Moreover, a decrease in life satisfaction was associated with younger age, changes from “employed” to “not employed,” worsening self-rated health, the onset of depression, and an increase in the number of physical illnesses. Conclusions: The onset of PD is associated with a marked reduction of life satisfaction among individuals in the second half of life in the total sample and in men, but not in women. For example, this effect was about twice as large as the effect of depression on life satisfaction. Moreover, the effect of PD on life satisfaction was more pronounced than the effect of a strong decrease in self-rated health (from “very good” to “very bad”) on life satisfaction. Effective treatment of symptoms might contribute to maintaining life satisfaction.

Objective: The aim of this study was to investigate the longitudinal impact of depressive symptoms on utilization of healthcare in terms of GP visits as well as specialist visits and hospital admission in late life among community-dwelling individuals.Methods: Longitudinal data (baseline and follow-up) were derived from the German multicentre, prospective cohort study “Late-life depression in primary care: needs, health care utilization and costs” study (AgeMooDe). At baseline, n = 1,230 patients aged 75 years and older were recruited from primary care practices. Main outcomes of interest were use of health care services: the number of GP visits, the number of medical specialist visits, and hospital admission. We used the Geriatric Depression Scale (GDS-15) to measure depression. Outcomes were analyzed with multilevel random intercept negative binominal regression and logistic random-effects models.Results: At baseline (n = 1,191), mean age was 80.7 (SD 4.6) years, 62.9% were female, and 196 individuals (16.5%) had depression (GDS-15 ≥6). Our longitudinal analyses indicated that older individuals with more depressive symptoms visited their GP more often (IRR=1.03; CI [1.01-1.04], p < 0.001), were visiting medical specialists more frequently (IRR=1.03; CI [1.01-1.04], p < 0.01), and had higher odds of being hospitalized (OR=1.08; CI [1.02-1.13], p < 0.01).Conclusions: Based on this large longitudinal study we showed that, after adjustment for important covariates, older individuals with more depressive symptoms had higher health care utilization over time. They visited their GP and specialists more frequently and they had higher odds of being hospitalized. This may suggest that higher utilization of specialist care and increased likelihood of being hospitalized may be also attributable to unspecific symptoms or symptoms that are elevated through depressive symptoms.

Background and Objectives: The aim of our study was to fill the gap in knowledge regarding the association between sexual orientation and psychosocial outcomes (loneliness and subjective well-being) based on nationally representative samples.Research Design and Methods: Cross-sectional data collected in 2017 were taken from a nationally representative sample of individuals in the second half of life (>40 years) in Germany (n = 4,785, average age 66.4 years, standard deviation [SD]: 10.5 years). Outcomes were assessed using well-established tools (life satisfaction: Satisfaction with Life Scale; positive and negative affect: Positive and Negative Affect Schedule; loneliness: De Jong Gierveld Loneliness Scale). Sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual, and other). Analyses were adjusted for socioeconomic factors, lifestyle-related factors, and health-related factors.Results: In total, around 7.8% of respondents belonged to sexual minorities. Adjusted for various several socioeconomic, lifestyle-related and health-related covariates, linear regressions showed that sexual minority older adults reported higher loneliness scores (β = 0.07, p < .05), whereas sexual orientation was not associated with subjective well-being (life satisfaction, as well as positive and negative affect). Furthermore, our analysis showed that gender, age, marital status, and depressive symptoms were consistently associated with loneliness and subjective well-being.Discussion and Implications: In accordance with minority stress theory, our study showed that sexual minority older adults report higher loneliness scores. This finding is important as loneliness has become widely acknowledged as a new geriatric giant, which could increase, for example, the risk of morbidity and mortality. Moreover, reducing loneliness is important for successful aging.

Qualitative studies showed that community-dwelling Lesbian, Gay, Bisexual and Transgender (LGBT) individuals perceive that LGBT individuals are discriminated against in nursing homes (NHs) due to their sexual orientation. Therefore, the objective of this quantitative, population-based study was to investigate the link between sexual orientation and planning to move into a NH in old age. Cross-sectional data from the most recent sixth wave of the nationally representative German Ageing Survey (n = 4,645) were used. The sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual and other). Planning to move into a NH in the future (yes/no) was our outcome measure. Multiple logistic regressions were performed (adjusting for various socioeconomic, psychosocial and health-related covariates). Regressions showed that sexual orientation was not significantly associated with plans to move to a NH. Preference to move into NH were consistently positively associated with age (OR: 1.04 (1.02–1.07), not having at least one child (OR: 2.17 (1.41–3.36)), high education (OR: 3.82 (1.32–11.11)), greater loneliness (OR: 1.44 (1.05–1.96)) and worse physical functioning (OR: 0.99 (0.98–1.00)). Unexpectedly, our results showed that plans to move to a NH did not differ significantly between heterosexual individuals and sexual minorities. This indicates that sexual orientation does not play a significant role in shaping preferences around moving into a NH ‘in general’. In contrast, other factors like age, greater loneliness and worse physical functioning were important. Those factors should be taken into account when shaping and updating policies on nursing homes.