Trial Designs and Outcomes in Dementia Therapeutic Research.

Abstract

This book was compiled to aid the interpretation of previously done dementia trials and provide assistance in creating meaningful future ones. The volume starts with a brief history of work done to date and proceeds through various clinical trial designs. A considerable amount of time is spent on different potential outcome variables, including a discussion of the representation of these outcomes via scale. Ethical considerations in treatment of dementia as well as in conducting dementia research are also discussed. Trial Designs and Outcomes in Dementia Therapeutic Research, which was edited by 2 Canadian experts on Alzheimer's disease and geriatric medicine, is well organized and indexed. Topics of interest can be easily located. It has useful discussions of different study designs that can be employed in dementia research and the types of bias that can be introduced. Chapters concerning the currently available treatments for dementia, both pharmacologic and psychosocial, are useful reviews now but will very likely rapidly become out of date and contribute little to the overall purpose of the book. The book concludes with the recognition that, while progress has been made in the treatment of dementia, the outcomes wanted by patients—a return to former functioning—are, for the most part, unavailable. Included is an impassioned discussion of what the goals of dementia research should be and how to measure them and consideration of the different aims of different stakeholders. The complexity of dementia and its impact on the elements of personhood, family, caregivers, and the health care system are stressed.