martes, 29 de noviembre de 2011

National Guideline Clearinghouse | NIH Consensus Development Conference statement on preventing Alzheimer's disease and cognitive decline.

Guideline Title

NIH Consensus Development Conference statement on preventing Alzheimer's disease and cognitive decline.

Bibliographic Source(s)

Daviglus ML, Bell CC, Berrettini W, Bowen PE, Connolly ES, Cox NJ, Dunbar-Jacob JM, Granieri EC, Hunt G, McGarry K, Patel D, Potosky AL, Sanders-Bush E, Silberberg D, Trevisan M. NIH state-of-the-science conference statement: preventing Alzheimer's disease and cognitive decline. NIH Consens State Sci Statements 2010 Apr 28;27(4):1-30. PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.

full-text:
National Guideline Clearinghouse NIH Consensus Development Conference statement on preventing Alzheimer's disease and cognitive decline.

NIH Consens State Sci Statements. 2010 Apr 28;27(4). [Epub ahead of print]

NIH State-of-the-Science Conference Statement: Preventing Alzheimer's Disease and Cognitive Decline.

Daviglus ML, Bell CC, Berrettini W, Bowen PE, Connolly ES, Cox NJ, Dunbar-Jacob JM, Granieri EC, Hunt G, McGarry K, Patel D, Potosky AL, Sanders-Bush E, Silberberg D, Trevisan M.

Abstract

OBJECTIVE:

To provide health care providers, patients, and the general public with a responsible assessment of currently available data on prevention of Alzheimer's disease and cognitive decline.

PARTICIPANTS:

A non-Department of Health and Human Services, nonadvocate 15-member panel representing the fields of preventive medicine, geriatrics, internal medicine, neurology, neurological surgery, psychiatry, mental health, human nutrition, pharmacology, genetic medicine, nursing, health economics, health services research, family caregiving, and a public representative. In addition, 20 experts from pertinent fields presented data to the panel and conference audience.

EVIDENCE:

Presentations by experts and a systematic review of the literature prepared by the Duke University Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience.

CONFERENCE PROCESS:

The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.

CONCLUSIONS:

(1) Extensive research over the past 20 years has provided important insights on the nature of Alzheimer's disease and cognitive decline and the magnitude of the problem. Nevertheless, there remain important and formidable challenges in conducting research on these diseases, particularly in the area of prevention. There are numerous ongoing or planned investigations which may offer promising new insights regarding the causes and prevention of these diseases. (2) Cognitive decline and Alzheimer's disease are major sources of morbidity and mortality worldwide. They pose a significant burden not only on affected individuals, but also on their caregivers and society in general. (3) Firm conclusions cannot be drawn about the association of modifiable risk factors with cognitive decline or Alzheimer's disease. (4) There is an absence of highly reliable consensus-based diagnostic criteria for cognitive decline, mild cognitive impairment, and Alzheimer's disease, and the available criteria have not been uniformly applied. (5) There is insufficient evidence to support the use of pharmaceutical agents or dietary supplements to prevent cognitive decline or Alzheimer's disease. However, ongoing additional studies including (but not limited to) antihypertensive medications, omega-3 fatty acid, physical activity, and cognitive engagement may provide new insight into the prevention or delay of cognitive decline or Alzheimer's disease. (6) Large-scale population-based studies and RCTs are critically needed to investigate strategies to maintain cognitive function in individuals at risk for decline, to identify factors that may delay the onset of Alzheimer's disease among individuals at risk, and to identify factors that may slow the progression of Alzheimer's disease among individuals already diagnosed with the disease.