Advertisement

Methodology of clinical trials in dementia. Part II: Future trials— Recommendations

  • J. F. Dartigues

Abstract

In a large review of the 102 clinical trials in dementia (Yesavage et al., 1979) 53 of the clinical trials were considered to be ‘well-designed’ studies (see chapter 14). Of these 53 trials, 48 were positive. It is therefore surprising that, despite these apparently satisfactory figures, the number of controlled trials in dementia has considerably decreased since 1975. Furthermore the medical community at large has not accepted the above-mentioned results as real proof of advancement in the treatment of dementia. The reasons for this have been summarised by Hughes et al. (1976):

Because of the small magnitude of the improvement to be expected and the absence of indications of long-term benefits, it would seem that at present vasodilators are of minor clinical value in the treatment of dementia. Further studies with better methodologies and longer follow-up periods … may lead to more favourable conclusions.

Keywords

Future Trial Ergot Alkaloid Senile Dementia Demented Patient Geriatric Ward 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Blessed, G. and Wilson, D. (1982). The contemporary natural history of mental disorder in old age. Brit. J. Psychiatr., 141, 59–67.CrossRefGoogle Scholar
  2. Cook, P. and James, I. (1981). Cerebral vasodilators. (Two parts): New Engl. J. Med., 305, 1508–13; 305, 1560–4.CrossRefGoogle Scholar
  3. Cox, D. R. (1972). Regression model and life-tables. J. Roy. Stat. Soc. (B), 134, 187–220.Google Scholar
  4. Elandt-Johnson, R. C. and Johnson, N. L. (1979). Survival models and data analysis. In Bradley, R. A., Hunter, J. S., Kendall, D. G. and Watson, G. S. (eds), Wiley Series in Probability and Mathematical Statistics, Wiley Interscience, New York.Google Scholar
  5. Go, R. C. P., Todorov, A. B., Elston, R. C. and Constantinidis, J. (1978). The malignancy of dementia. Ann. Neurol., 3, 559–61.CrossRefGoogle Scholar
  6. Hare, M. (1978). Clinical check list for diagnosis of dementia. Brit. Med. J., 2, 266–7.CrossRefGoogle Scholar
  7. Heston, L. L., Maestri, A. R., Anderson, E. and White, J. (1981). Dementia of the Alzheimer type. Arch. Gen. Psychiatr., 38, 1085–90.CrossRefGoogle Scholar
  8. Hughes, J. R., Williams, J. G. and Currier, R. D. (1976). An ergot alkaloid preparation (hydergine) in the treatment of dementia. Review of the clinical literature. Am. Geriat. Soc., 24, 490–7.CrossRefGoogle Scholar
  9. Kaplan, E. L. and Meyer, P. (1958). Non parametric estimations from incomplete observations. J. Am. Stat. Assoc., 53, 457–81.CrossRefGoogle Scholar
  10. Kay, D. W. K. (1962). Outcome and cause of death in mental disorders of old age: a long-term follow-up of functional and organic psychosis. Acta. Psychiatr. Scand., 38, 249–76.CrossRefGoogle Scholar
  11. Mortimer, J. A. and Schuman, L. M. (1981). Epidemiology of Dementia, Oxford University Press, Oxford.Google Scholar
  12. Naguib, M. and Levy, R. (1980). CT scan in senile dementia. Brit. J. Psychiatr., 141, 618–20.CrossRefGoogle Scholar
  13. Naguib, M. and Levy, R. (1982). Prediction of outcome in senile dementia. A computed tomography study. Brit. J. Psychiatr., 140, 263–7.CrossRefGoogle Scholar
  14. National Institute on Aging Task Force (1980). Senility reconsidered. J. Am. Med. Assoc., 244, 259–63.CrossRefGoogle Scholar
  15. Peto, R. and Peto, J. (1972). Asymptotically efficient rank invariant test procedures. J. Roy. Stat. Soc. (A), 135, 185–206.CrossRefGoogle Scholar
  16. Roth, M. (1955). The natural history of mental disorder in old age. J. Ment. Sci., 102, 281–301.Google Scholar
  17. Shah, K. V., Banks, G. D. and Merskey, M. (1969). Survival in atherosclerotic and senile dementia. Brit. J. Psychiatr., 115, 1283–6.CrossRefGoogle Scholar
  18. Small, G. W. and Jarvik, L. F. (1983). The dementia syndrome. Lancet, 2, 1443–5.Google Scholar
  19. Todorov, A. B., Go, R. C. P., Constantinidis, J. and Elston, R. C. (1975). Specificity of the clinical diagnosis of dementia. J. Neurol. Sci., 26, 81–98.CrossRefGoogle Scholar
  20. Yesavage, J. A., Tinklenberg, J. R., Hollister, L. E. and Berger, P. A. (1979). Vasodilators in senile dementia. Arch. Gen. Psychiatr., 36, 220–3.CrossRefGoogle Scholar

Copyright information

© The contributors 1988

Authors and Affiliations

  • J. F. Dartigues

There are no affiliations available

Personalised recommendations