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

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Discussion</p> <p>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.</p> <p>Summary</p> <p>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.</p

VALIDITY OF EQUATIONS FOR ESTIMATING (V) over dotO(2)PEAK FROM THE 20-M SHUTTLE RUN TEST IN ADOLESCENTS AGED 11-13 YEARS

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Batista, MB, Cyrino, ES, Arruda, M, Dourado, AC, Coelho-E-Silva, MJ, Ohara, D, Romanzini, M, and Ronque, ERV. Validity of equations for estimating V.o(2)peak from the 20-m shuttle run test in adolescents aged 11-13 years. J Strength Cond Res 27(10): 2774-2781, 2013The aim of this study was to analyze the validity of 4 regression equations to estimate the peak oxygen consumption (V.o(2)peak) from the 20-m shuttle run test in adolescents aged 11-13 years. One hundred and fifteen adolescents, 61 boys (mean +/- SD: age = 12.3 +/- 0.9 years) and 54 girls (age = 12.1 +/- 0.7 years) performed the 20-m shuttle run test and an incremental progressive maximal test for direct V.o(2)peak analysis. Four linear regression equations were used to estimate the V.o(2)peak: Barnett et al. (equation 1), Leger et al. (equation 2), Mahar et al. (equation 3), and Matsuzaka et al. (equation 4). For boys, only the V.o(2)peak estimated by EQ3 did not differ from the value directly measured (p > 0.05). The EQ1, EQ2, and EQ4 underestimated the V.o(2)peak, whereas the EQ3 overestimated, particularly in girls (p < 0.05). Large limits of agreement were found between the reference method and the 4 equations, with higher estimated values by EQ2 for boys (8.36 +/- 15.24 mLkg(-1)min(-1)) and girls (2.45 +/- 12.63 mLkg(-1)min(-1)). The highest correlation values were observed by EQ4 for boys (r = 0.80), EQ1 for girls (r = 0.72), and EQ3 for total sample (r = 0.80). The equations analyzed were not precise for individual V.o(2)peak prediction; however, the EQ3 revealed better agreement, particularly for boys. Considering the data obtained in the boys and total sample, our results suggest that the EQ3 may provide the best predictive measure of V.o(2)peak from the 20-m shuttle run test in adolescents aged 11-13 years.271027742781Foundation for the Support of Scientific and Technological Development of Parana (FAADCT/Brazil)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq