Practical guidelines for the diagnosis and management of weight loss in Alzheimer's disease: a consensus from appropriateness ratings of a large expert panel.

ABSTRACT

BACKGROUND: Weight loss is a frequent condition in Alzheimer's disease patients and is responsible for complications and impaired quality of life. Practical guidelines for the diagnosis and management of weight loss in Alzheimer's disease are lacking. AIM: To elaborate practical guidelines for the diagnosis and management of weight loss in Alzheimer's disease. METHODS: Following a literature review, a set of statements about weight loss in Alzheimer's disease were proposed to a 23-member nationwide expert panel drawn from French geriatricians selected by the organisation committee. Statements were discussed and modified with the experts during a meeting and modified according to their remarks. By the means of a postal questionnaire each expert was then asked to rate each statement on a 9-point appropriateness scale, 1 being highly inappropriate and 9 highly appropriate. Analysis was based on the median and the range of the ratings. To avoid the influence of extreme or atypical opinions, the two ratings the furthest from the median were excluded from analysis for each statement. Agreement/disagreement about the statements was determined using the RAND/UCLA methodology. RESULTS: Of the 23 statements selected by the expert panel and submitted for rating, 17 obtained the agreement of the expert panel. Practical guidelines were produced from these 17 statements. CONCLUSION: These expert panel ratings, based on the best evidence currently available, provide comprehensive guidelines to appropriately diagnose, manage and prevent weight loss in Alzheimer's disease.