Calidad de vida en la enfermedad de Alzheimer / Quality of life in Alzheimer´s disease

Introducción. La calidad de vida es un concepto de creciente interés cuya evaluación complementa la valoración clínica tradicional, de interés fundamentalmente en ámbitos de organización de la asistencia. Presentamos un estudio de calidad de vida en la enfermedad de Alzheimer y su relación con medidas cognitivas y funcionales. Pacientes y métodos. Se evalúa la calidad de vida mediante la escala EQ-5D en una muestra de casos de enfermedad de Alzheimer diagnosticados con criterios del National Institute of Neurologic, Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association que han donado muestra de sangre para el Banco Nacional de ADN, en los que se ha determinado también el estadio de la escala de deterioro global, y se ha efectuado un test de fluencia verbal y el test minimental de Folstein. Se realizó un análisis clásico, contraste de variables mediante chi al cuadrado para las proporciones y t de Student para las medias,y estimación de r para los modelos de regresión en las variables cuantitativas. Se determinó la tarifa social mediante el programa SPSS v. 11. Resultados. Se analizan 141 casos, con una relación de 2 a 1 entre mujer y varón, y una edad media de 76,2 años. Los aspectos de cuidado personal, actividad y, en menor medida, motilidad se ven afectados en la enfermedad de Alzheimer, pero no parecen hacerlo los aspectos de dolor y ansiedad. Existe relación entre calidad de vida, escalas funcionales y escalas cognitivas. Los aspectos funcionales se correlacionan mejor que los cognitivos con la calidad de vida. Conclusiones. La calidad de vida se evalúa en la enfermedad de Alzheimer mediante escalas generales, como EQ-5D. Los aspectos cognitivos no parecen aportar información relevante en relación con la calidad de vida que no se aporte ya por los aspectos funcionales (AU)

Introduction. Quality of life is a concept that is receiving increasing amounts of attention; its assessment complements the traditional clinical evaluation, which is of special interest in areas related with healthcare organisation. Here, we present a study on quality of life in Alzheimer’s disease and its relationship with cognitive and functional measures. Patients and methods. Quality of life was evaluated by means of the EQ-5D scale in a sample of cases of Alzheimer’s disease (diagnosed according to criteria established by the National Institute of Neurologic, Communicative Disorders and Stroke-Alzheimer’s Disease and Related Disorders Association) that donated blood samples for the National DNA Bank. The status of the global deterioration scale was determined and a verbal fluency test and the Folstein minimental test were also carried out. A classic analysis, variable contrast by means of chi-square for proportions and Student’s t test for measurements were conducted, as well as estimation of r for the regression models in the quantitative variables. The social rate was determined using the software application SPSS v. 11. Results. Altogether 141 cases were analysed, with a male to female ratio of 2:1, and a mean age of 76.2 years. Aspects such as personal hygiene, activity and, to a lesser extent, motility are affected in Alzheimer’s disease, but pain and anxiety aspects do not seem to be affected. There is a relationship between quality of life, functional scales and cognitive scales. Functional aspects correlate with quality of life better than cognitive ones. Conclusions. Quality of life is evaluated in Alzheimer’s disease using general scales, such as EQ-5D. Cognitive aspects do not appear to provide relevant information about quality of life that is not already provided by the functional aspects (AU)

[Quality of life in Alzheimer's disease]. / Calidad de vida en la enfermedad de Alzheimer.

INTRODUCTION: Quality of life is a concept that is receiving increasing amounts of attention; its assessment complements the traditional clinical evaluation, which is of special interest in areas related with healthcare organisation. Here, we present a study on quality of life in Alzheimer's disease and its relationship with cognitive and functional measures. PATIENTS AND METHODS: Quality of life was evaluated by means of the EQ-5D scale in a sample of cases of Alzheimer's disease (diagnosed according to criteria established by the National Institute of Neurologic, Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association) that donated blood samples for the National DNA Bank. The status of the global deterioration scale was determined and a verbal fluency test and the Folstein minimental test were also carried out. A classic analysis, variable contrast by means of chi-square for proportions and Student's t test for measurements were conducted, as well as estimation of r for the regression models in the quantitative variables. The social rate was determined using the software application SPSS v. 11. RESULTS: Altogether 141 cases were analysed, with a male to female ratio of 2:1, and a mean age of 76.2 years. Aspects such as personal hygiene, activity and, to a lesser extent, motility are affected in Alzheimer's disease, but pain and anxiety aspects do not seem to be affected. There is a relationship between quality of life, functional scales and cognitive scales. Functional aspects correlate with quality of life better than cognitive ones. CONCLUSIONS: Quality of life is evaluated in Alzheimer's disease using general scales, such as EQ-5D. Cognitive aspects do not appear to provide relevant information about quality of life that is not already provided by the functional aspects.

[Relationship between managers and clinicians]. / Relación entre los gestores y los clínicos.

The relationship between managers and physicians has acquired a new importance. The evolution of different aspects of the medical practice such as technological advances, a society with a greater level of maturity and the restriction of sanitary resources show the need for a correct administration coordinates by both the managers and the physicians (who actually prescribe the use of these resources). The meeting point between physicians and managers is what we know as clinical management. The concept of clinical management is based on the figure of the patient without diminishing the role of the physician, whose cooperation in the elaboration of the programs with the managers is vital so as to achieve excellence in different aspects such as clinical assistance, investigation and medical education.