Enclosure B: Statement of Task10
An ad hoc committee will examine the evidence on preventive factors and/or interventions associated with decreasing the risk of developing Alzheimer’s-type dementia, amnestic mild cognitive impairment, and age-related cognitive impairment (i.e., primary prevention) and make recommendations to inform public health strategies and messaging and recommendations for future research. The committee’s work will be based on a systematic review commissioned by the Agency for Healthcare Research and Quality (AHRQ) and will take place in two phases: in the first phase the committee will provide input into the design of the AHRQ systematic review and in the second phase the committee will use the review to make its recommendations.
Phase 1:
The committee will convene to inform the development of an AHRQ systematic review that will address the following draft key questions (KQs):
- What are the preventive factors and/or interventions associated with decreasing the risk of developing Alzheimer’s-type dementia?
- What are the preventive factors and/or interventions associated with decreasing the risk of developing amnestic mild cognitive impairment?
- What are the preventive factors and/or interventions associated with decreasing the risk of developing age-related cognitive impairment?
Interventions targeting stroke risk factors will be a priority in this study.
Responding to the preliminary KQs and a preliminary study design developed by the National Institutes of Health (NIH), AHRQ, and the Evidence-based Practice Center (EPC) that AHRQ will contract with to conduct the systematic review, the Institute of Medicine committee will provide advisory input to NIH, AHRQ, and the EPC in the form of a short (1-3 page) data request document that describes potential changes and considerations for the KQs and study design that would result in a systematic review that would be most informative for the committee’s work during phase 2.
Phase 2:
After the AHRQ/EPC systematic review is released, the committee will reconvene to consider the evidence found (based on the final KQs addressed in the systematic review). Interventions targeting stroke risk factors will be included. Based on the AHRQ systematic review and additional expert and public input, the committee will assess the quality of existing evidence and develop a short report that makes recommendations to inform the development of
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10 A note about terms: The committee’s original statement of task, shown here, uses terms and draft key questions that existed during the project initiation stage, but no longer exist. During subsequent work by the Evidence-based Practice Center, these terms and questions evolved, as seen in the key questions on which the committee was asked to comment. In consultation with the National Institute on Aging at the first committee meeting, these terms were further refined to clinical Alzheimer’s-type dementia, mild cognitive impairment, and age-related cognitive decline. For clarity, this letter uses these terms; an updated statement of task is currently being formalized.
public health strategies and messaging (i.e., which preventive factors and interventions are supported by sufficient evidence to be incorporated into public health strategies and messages) and recommendations for future research.
The committee will hold an information-gathering workshop open to the public during the course of its work to seek input from stakeholders on the draft AHRQ report. The report will focus on factors and interventions that prevent or reduce the risk of developing Alzheimer’s-type dementia, amnestic mild cognitive impairment, and age-related cognitive impairment; it will not focus on identifying risks for developing Alzheimer’s-type dementia, amnestic mild cognitive impairment, and age-related cognitive impairment, as this has been the topic of significant previous research.