Quality of Life as an outcome in Alzheimer's disease and other dementias

obstacles and goals

verfasst von: Matthias W. Riepe, Thomas Mittendorf, Hans Förstl, Lutz Frölich, Martin Haupt, Reiner Leidl, Christoph Vauth, Matthias G. von der Schulenburg
Abstract: Background: The number of individuals at risk for dementia will probably increase in ageing societies as will the array of preventive and therapeutic options, both however within limited economic resources. For economic and medical purposes valid instruments are required to assess disease processes and the efficacy of therapeutic interventions for different forms and stages of illness. In principal, the impact of illness and success of an intervention can be assessed with biomedical variables, e.g. severity of symptoms or frequency of complications of a disease. However, this does not allow clear judgement on clinical relevance or comparison across different diseases. Discussion: Outcome model variables such as quality of life (QoL) or health care resource utilization require the patient to appraise their own well-being or third parties to set preferences. In Alzheimer's disease and other dementias the evaluation process performed by the patient is subject to the disease process itself because over progress of the disease neuroanatomical structures are affected that mediate evaluation processes. Summary: Published research and methodological considerations thus lead to the conclusion that current QoL-instruments, which have been useful in other contexts, are ill-suited and insufficiently validated to play a major role in dementia research, decision making and resource allocation. New models integrating biomedical and outcome variables need to be developed in order to meet the upcoming medical and economic challenges.
Organisationseinheit(en): Center for Health Economics Research Hannover (CHERH)
Externe Organisation(en): Universität Ulm
Technische Universität München (TUM)
Ruprecht-Karls-Universität Heidelberg
Alzheimer Praxis Düsseldorf
Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt
Typ: Artikel
Journal: BMC neurology
Band: 9
Seiten: 47
Anzahl der Seiten: 1
ISSN: 1471-2377
Publikationsdatum: 25.08.2009
Publikationsstatus: Veröffentlicht
Peer-reviewed: Ja
ASJC Scopus Sachgebiete: Klinische Neurologie
Elektronische Version(en): https://doi.org/10.1186/1471-2377-9-47 (Zugang: Offen)

BibTeX

@article{2b56eea4903848e4bc5b9cc264fe76e8,
title = "Quality of Life as an outcome in Alzheimer's disease and other dementias: obstacles and goals",
abstract = "Background: The number of individuals at risk for dementia will probably increase in ageing societies as will the array of preventive and therapeutic options, both however within limited economic resources. For economic and medical purposes valid instruments are required to assess disease processes and the efficacy of therapeutic interventions for different forms and stages of illness. In principal, the impact of illness and success of an intervention can be assessed with biomedical variables, e.g. severity of symptoms or frequency of complications of a disease. However, this does not allow clear judgement on clinical relevance or comparison across different diseases. Discussion: Outcome model variables such as quality of life (QoL) or health care resource utilization require the patient to appraise their own well-being or third parties to set preferences. In Alzheimer's disease and other dementias the evaluation process performed by the patient is subject to the disease process itself because over progress of the disease neuroanatomical structures are affected that mediate evaluation processes. Summary: Published research and methodological considerations thus lead to the conclusion that current QoL-instruments, which have been useful in other contexts, are ill-suited and insufficiently validated to play a major role in dementia research, decision making and resource allocation. New models integrating biomedical and outcome variables need to be developed in order to meet the upcoming medical and economic challenges.",
author = "Riepe, {Matthias W.} and Thomas Mittendorf and Hans F{\"o}rstl and Lutz Fr{\"o}lich and Martin Haupt and Reiner Leidl and Christoph Vauth and {von der Schulenburg}, {Matthias G.}",
year = "2009",
month = aug,
day = "25",
doi = "10.1186/1471-2377-9-47",
language = "English",
volume = "9",
pages = "47",
journal = "BMC neurology",
issn = "1471-2377",
publisher = "BioMed Central Ltd.",
}