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Reference: Webster, L, Groskreutz, D, Grinbergs-Saull, A et al., Quinn, TJ ed., (2017). Core outcome measures for interventions to prevent or slow the progress of dementia for people living with mild to moderate dementia: Systematic review and consensus recommendations. PLoS One, 12 (6), e0179521.Citable link to this page:

 

Core outcome measures for interventions to prevent or slow the progress of dementia for people living with mild to moderate dementia: Systematic review and consensus recommendations.

Abstract: BACKGROUND: There are no disease-modifying treatments for dementia. There is also no consensus on disease modifying outcomes. We aimed to produce the first evidence-based consensus on core outcome measures for trials of disease modification in mild-to-moderate dementia. METHODS AND FINDINGS: We defined disease-modification interventions as those aiming to change the underlying pathology. We systematically searched electronic databases and previous systematic reviews for published and ongoing trials of disease-modifying treatments in mild-to-moderate dementia. We included 149/22,918 of the references found; with 81 outcome measures from 125 trials. Trials involved participants with Alzheimer's disease (AD) alone (n = 111), or AD and mild cognitive impairment (n = 8) and three vascular dementia. We divided outcomes by the domain measured (cognition, activities of daily living, biological markers, neuropsychiatric symptoms, quality of life, global). We calculated the number of trials and of participants using each outcome. We detailed psychometric properties of each outcome. We sought the views of people living with dementia and family carers in three cities through Alzheimer's society focus groups. Attendees at a consensus conference (experts in dementia research, disease-modification and harmonisation measures) decided on the core set of outcomes using these results. Recommended core outcomes were cognition as the fundamental deficit in dementia and to indicate disease modification, serial structural MRIs. Cognition should be measured by Mini Mental State Examination or Alzheimer's Disease Assessment Scale-Cognitive Subscale. MRIs would be optional for patients. We also made recommendations for measuring important, but non-core domains which may not change despite disease modification. LIMITATIONS: Most trials were about AD. Specific instruments may be superseded. We searched one database for psychometric properties. INTERPRETATION: This is the first review to identify the 81 outcome measures the research community uses for disease-modifying trials in mild-to-moderate dementia. Our recommendations will facilitate designing, comparing and meta-analysing disease modification trials in mild-to-moderate dementia, increasing their value. TRIAL REGISTRATION: PROSPERO no. CRD42015027346.

Publication status:PublishedPeer Review status:Peer reviewedVersion:Publisher's versionDate of acceptance:2017-05-31 Funder: National Institute for Health Research   Notes:© 2017 Webster et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.

Contributors

Quinn, TJMore by this contributor

RoleEditor

 Bibliographic Details

Publisher: Public Library of Science

Publisher Website: http://www.plos.org/

Journal: PLoS Onesee more from them

Publication Website: http://journals.plos.org/plosone/

Volume: 12

Issue: 6

Extent: e0179521

Issue Date: 2017-06-29

pages:e0179521Identifiers

Doi: https://doi.org/10.1371/journal.pone.0179521

Eissn: 1932-6203

Uuid: uuid:6559a7d1-cea3-4ec8-890d-7d1719de1627

Urn: uri:6559a7d1-cea3-4ec8-890d-7d1719de1627

Pubs-id: pubs:705520 Item Description

Type: journal-article;

Language: eng

Version: Publisher's versionKeywords: Dementia Alzheimer disease Cognitive impairment Biomarkers Magnetic resonance imaging Systematic reviews Database searching Quality of life

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Autor: Webster, L - - - Groskreutz, D - - - Grinbergs-Saull, A - - - Howard, R - - - O'Brien, JT - - - Mountain, G - - - Banerjee, S

Fuente: https://ora.ox.ac.uk/objects/uuid:6559a7d1-cea3-4ec8-890d-7d1719de1627



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