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Disease Staging and Milestones

Published online by Cambridge University Press:  02 December 2014

Kiran Rabheru
Kiran Rabheru*
Affiliation:
The Vancouver General, UBC and Riverview Hospitals, Vancouver B.C., Canada
*
Vancouver General, UBC and Riverview Hospitals, 855 West 12th Avenue Centennial Pavilion, 5W, Vancouver, B.C. V5Z 1M9, Canada
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Abstract

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This new section to the guidelines was added due to the recognition that clinical milestones are useful indices of the progression of dementia in patients with Alzheimer's disease and could help in the development of stage-specific targeted therapy. This review specifically looks at clinical milestones that could be used in clinical trials, such as global function, function, behaviour, caregiver burden, and quality of life milestones. It also addresses the possible use of biological and surrogate markers for use as milestones - which may eventually replace clinical milestones. It concludes that current definitions of dementia must be broadened beyond cognition alone to include some of the domains listed.

Résumé:

RÉSUMÉ:

Cette nouvelle section a été ajoutée aux lignes directrices parce qu'on reconnaît que les étapes cliniques sont des indices utiles de la progression de la démence chez les patients atteints de la maladie d'Alzheimer et peuvent aider à développer un traitement approprié à chaque étape de la maladie. Cette revue examine les étapes cliniques qui pourraient être utilisées dans les essais cliniques comme la fonction globale, la fonction, le comportement, le fardeau pour les soignants et les étapes de la qualité de vie, de même que la possibilité d'utiliser des marqueurs biologiques et des marqueurs de substitution comme critères d'étapes qui pourraient éventuellement remplacer les étapes cliniques. En conclusion, les définitions actuelles de la démence doivent être élargies au-delà de la cognition seule afin d'inclure certains autres domaines.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue S1 , March 2007 , pp. S62 - S66
Copyright
Copyright © The Canadian Journal of Neurological 2007

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