Alzheimer's Disease and Cognitive Decline

Alzheimer's Disease and Cognitive Decline
Full Title: Prevention of Alzheimer's Disease and Cognitive Decline
Expected Release Date: early 2010

Contents
Background and Objectives for the Systematic Review
Key Questions
Analytic Framework
Methods

Background and Objectives for the Systematic Review

As background for a State-of-the-Science Conference scheduled for April 26-28, 2010, the Office of Medical Applications of Research (OMAR) and the National Institute on Aging (NIA), at the National Institutes of Health (NIH) commissioned an evidence report on "Preventing Alzheimer's Disease (AD) and Cognitive Decline" through the Agency for Healthcare Research and Quality (AHRQ). The key research questions were developed by a planning committee. The aim of the report is to summarize the available literature, frame the discussions regarding potential risk factors, highlight the limitations of the evidence base, and identify areas for future research. Through this report, OMAR seeks to increase the scientific rigor of its State-of-the-Science Conference. The focus of the this conference will be on evaluating existing data to determine whether there is sufficient quality of evidence to warrant any specific recommendations at this time for behavioral, lifestyle, or pharmaceutical interventions/modifications targeted at AD and cognitive decline in later life, and to identify needs for additional research.

The findings of our review will clarify what is known about factors that modify the risk of AD or cognitive decline as a means of providing authoritative background information for participants at the State-of-the-Science Conference. More broadly, we expect that our findings will be useful to major stakeholders in this arena, including policymakers, advocacy groups, community organizations, health care providers, and mid- to late-life adults. We also identify future research priorities, which may be useful to government agencies and private sector funding organizations.

This report addresses risk factors and potential therapeutic interventions that may modify the risk of AD or cognitive decline. An NIH OMAR State-of-the Science Conference planning committee developed the key questions and specified the populations and factors to be evaluated. The specific factors and interventions to be reviewed were refined with input from members of the project's technical expert panel (TEP), representatives of NIH OMAR, and staff at the AHRQ. Although a large number of factors are considered, the report is not inclusive of all factors that have been associated with AD or cognitive decline.



Key Questions
.What factors are associated with the reduction of risk of Alzheimer's disease?

..What factors are associated with the reduction of risk of cognitive decline in older adults?

...What are the therapeutic and adverse effects of interventions to delay the onset of Alzheimer's disease? Are there differences in outcomes among identifiable subgroups?

....What are the therapeutic and adverse effects of interventions to improve or maintain cognitive ability or function? Are there differences in outcomes among identifiable subgroups?

.....What are the relationships between the factors that affect Alzheimer's disease and the factors that affect cognitive decline?

If recommendations for interventions cannot be made currently, what studies need to be done that could provide the quality and strength of evidence necessary to make such recommendations to individuals?

For all questions, we are interested in adults, age 50 or older, drawn from general populations. For Key Questions 1 and 2, we examine all the risk factors from an epidemiologic standpoint, limiting our review to observational studies and focusing on factors that are not amenable to randomization (e.g., hypertension). For Key Questions 3 and 4, we prioritize randomized controlled trials (RCTs), but supplement trial data with evidence from observational studies, where necessary. For Key Question 5, we are interested in the consistency of findings for each exposure/intervention on risk of AD and cognitive decline.

open here to see the full-text (large):
http://www.ahrq.gov/clinic/tp/alzcogtp.htm

Current as of April 2010

Internet Citation:

Prevention of Alzheimer's Disease and Cognitive Decline, Review Protocol. April 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/tp/alzcogtp.htm