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Riepe, M.W.* ; Mittendorf, T.* ; Förstl, H.* ; Frölich, L.* ; Haupt, M.* ; Leidl, R. ; Vauth, C.* ; von der Schulenburg, M.G.*

Quality of life as an outcome in Alzheimer's disease and other dementias - obstacles and goals.

BMC Neurology 9, 47:47 (2009)
Publ. Version/Full Text Volltext DOI PMC
Open Access Gold
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.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords FRONTOTEMPORAL DEMENTIA; COST-EFFECTIVENESS; MILD DEMENTIA; COGNITIVE IMPAIRMENT; SPATIAL COGNITION; PREFRONTAL CORTEX; DECISION-MAKING; SELF-AWARENESS; DEFICITS; ANOSOGNOSIA
e-ISSN 1471-2377
Journal BMC Neurology
Quellenangaben Volume: 9, Issue: , Pages: 47 Article Number: 47 Supplement: ,
Publisher BioMed Central
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Health Economics and Health Care Management (IGM)