Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Dementia is a public health priority that affects 47.5 million people worldwide.¹ The rapidly growing number of people with dementia presents a challenge to the health care systems. People with dementia need comprehensive medical, nursing, psychological, and social support to delay the progression of disease and sustain autonomy and social inclusion. Primary care has been identified as the first point of contact for people with dementia and is thus a promising setting for identification, comprehensive needs assessment, and initiating dementia-specific treatment and care.² However, primary care systems worldwide are insufficiently prepared for these tasks.^3-6

The provision of appropriate medical and nursing care for people with dementia is a major challenge for the healthcare system in Germany. New models of healthcare provision need to be developed, tested and implemented on the population level. Trials in which collaborative care for dementia in the primary care setting were studied have demonstrated its effectiveness. These studies have been conducted in different healthcare systems, however, so it is unclear whether these results extend to the specific context of the German healthcare system.

Weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The goal was to analyze overweight and obesity depending on smoking status and number of cigarettes per day (cpd) among former and current smokers. The sample included 7124 residents of Germany aged 18–79 y from a national health examination survey (participation rate: 61.4%). Body weight and height were objectively measured; smoking status and cpd were assessed by a questionnaire administered in a health examination center. The number of cpd was positively related to being overweight and more so to obesity among former smoking men, but not women. The results were adjusted for age, school education, exercise and alcohol consumption. Men who formerly had smoked more than 30 cpd had an adjusted odds ratio (OR) of 5.0 for obesity compared to men who had never smoked. With an increasing number of cpd more psychological and physiological processes of compensation of nicotine supply after smoking cessation may be expected. Male smokers should be provided with information on how to prevent weight gain after smoking cessation. To foster smoking cessation, female smokers should be informed that women who stop smoking manage to have no increase in the rates of overweight or obesity when considered at the general population level.