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Alzheimer's Disease: Summary of Results Q&A
The summary of results on the case study of AD provides that AD is still a disease of those primarily age 85 and older, and an expensive, time-consuming process. It is not a disease that is appropriate for "large, epidemiologic studies" thus screening strategies are most sell-suited so cohort studies are feasible. Diagnostic workups assist in making studies manageable and successful in diagnosing sources of AD and number of actual cases of AD in the public.
Diagnosis of AD brings with it many problems including fear and social stigma; thus it is beneficial to examine risk factors and distinguish between cognitive impairments that are minimal and evidenced in the public at large and actual early warning signs and preclinical AD. False positives are a common diagnostic problem as signs are common with advancing age and may include, "poor vision, hearing loss, arthritis" which all affect performance on examination which include mental status examination and neuropsychological examination, as do environmental factors which may contribute to examination errors. False positives may be eliminated with careful cross-sectional analysis or observational studies that take into consideration the unique characteristics of the population at large.
1.Do you agree or disagree with answer Case Study 1 -- Why?
An observational study to examine the association between AD and smoking is the best choice given the information provided in the summary, as there are too many influencing factors (environmental, advancing age, altered mental status) that can affect the results leading to a diagnosis...
Case studies can be beneficial studies in certain circumstances; it may be beneficial in an AD study if the sample size was large enough to accommodate the study. A case study however, typically involves a much smaller sampling of the population (Wang, et al., 1999). Thus, it would more likely provide limited and perhaps biased information regarding the AD population. Observational studies take into consideration a much greater sampling and would take into consideration the errors that may occur due to the aging population that comes with AD (Robert, et al., 2003). Observational studies would also allow the researcher to observe the behaviors and daily lifestyle of the population without interfering with the study subjects.
2.Do you agree or disagree with answer Case Study 4 -- Why?
Cross-sectional studies are most like to provide the best information regarding the linkage between tobacco use and Alzheimer's (Wang, et al. 1999). Alzheimer's is a disease that affects a very large population, but is also very unpredictable in nature to some extent (Robert et al., 2003). In a study testing the hypothesis that smoking provides a protective effect on Alzheimer's disease or dementia (cross-section) on a population-based cohort of just under 700 people, studies suggested that smoking provided a negative effect on Alzheimer's disease. Smoking does not provide a protective effect. Most of the studies related to the link between smoking or tobacco use and AD have been cross-sectional (Jones, Reith, Philpot, 1987; Robert et al., 2003).
Why?
Because cross-sectional analysis provides for…
References:
Jones, GMM., Reith, M., Philpot, MP, et al. 1987. Smoking and dementia of Alzheimer's type. (Letter).
Neurol Neurosurg Psychiatry, 50; 1383.
Macarthur, C., Dougherty, G., and Pless, B. 1997. Reliability and validity of proxy respondent information about childhood injury: An assessment of a Canadian surveillance system. Am. J. Epidemiol. 145(9): 834-841.
Robert, P.H., Schuck, S., Dubois, B., Lepine, J.P., Gallarda, T., Olie, JP, Goni, S., Troy, S. 2003. Validation of the Short Cognitive Battery B2C. Value in screening for Alzheimer's disease and depressive disorders in psychiatric patients. Encephale, 29(2 Pt1). 266-72.
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