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Ian McDowell

Bio: Ian McDowell is an academic researcher from University of Ottawa. The author has contributed to research in topics: Dementia & Population. The author has an hindex of 51, co-authored 100 publications receiving 21811 citations.


Papers
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Journal ArticleDOI
TL;DR: The ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools are determined.
Abstract: Background: There is no single generally accepted clinical definition of frailty. Previously developed tools to assess frailty that have been shown to be predictive of death or need for entry into an institutional facility have not gained acceptance among practising clinicians. We aimed to develop a tool that would be both predictive and easy to use. Methods: We developed the 7-point Clinical Frailty Scale and applied it and other established tools that measure frailty to 2305 elderly patients who participated in the second stage of the Canadian Study of Health and Aging (CSHA). We followed this cohort prospectively; after 5 years, we determined the ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools. Results: The CSHA Clinical Frailty Scale was highly correlated ( r = 0.80) with the Frailty Index. Each 1-category increment of our scale significantly increased the medium-term risks of death (21.2% within about 70 mo, 95% confidence interval [CI] 12.5%–30.6%) and entry into an institution (23.9%, 95% CI 8.8%–41.2%) in multivariable models that adjusted for age, sex and education. Analyses of receiver operating characteristic curves showed that our Clinical Frailty Scale performed better than measures of cognition, function or comorbidity in assessing risk for death (area under the curve 0.77 for 18-month and 0.70 for 70-month mortality). Interpretation: Frailty is a valid and clinically important construct that is recognizable by physicians. Clinical judgments about frailty can yield useful predictive information.

5,189 citations

Book
21 May 1987
TL;DR: The theory and the leading methods of measurement, all of which rely on subjective judgments in questionnaires and rating scales are described, showing readers how to select the most suitable one, apply it, and score the results.
Abstract: This is a convenient guide to the health measurement methods used in health and social surveys, epidemiological studies, and clinical trials. It describes the theory and the leading methods of measurement, all of which rely on subjective judgments in questionnaires and rating scales. The authors discuss the validity and reliability of each method, showing readers how to select the most suitable one, apply it, and score the results. Epidemiologists and health care researchers; social scientists; health care planners and analysts.

4,798 citations

MonographDOI
01 Jan 2006
TL;DR: A convenient guide to the health measurement methods used in health and social surveys, epidemiological studies, and clinical trials can be found in this paper, where the authors discuss the validity and reliability of each method, showing readers how to select the most suitable one, apply it, and score the results.
Abstract: This is a convenient guide to the health measurement methods used in health and social surveys, epidemiological studies, and clinical trials. It describes the theory and the leading methods of measurement, all of which rely on subjective judgments in questionnaires and rating scales. The authors discuss the validity and reliability of each method, showing readers how to select the most suitable one, apply it, and score the results. Epidemiologists and health care researchers; social scientists; health care planners and analysts.

1,838 citations

Journal ArticleDOI
TL;DR: Regular physical activity could be an important component of a preventive strategy against Alzheimer's disease and many other conditions, and use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were associated with a reduced risk of Alzheimer's Disease.
Abstract: A prospective analysis of risk factors for Alzheimer's disease was a major objective of the Canadian Study of Health and Aging, a nationwide, population-based study. Of 6,434 eligible subjects aged 65 years or older in 1991, 4,615 were alive in 1996 and participated in the follow-up study. All participants were cognitively normal in 1991 when they completed a risk factor questionnaire. Their cognitive status was reassessed 5 years later by using a similar two-phase procedure, including a screening interview, followed by a clinical examination when indicated. The analysis included 194 Alzheimer's disease cases and 3,894 cognitively normal controls. Increasing age, fewer years of education, and the apolipoprotein E epsilon4 allele were significantly associated with increased risk of Alzheimer's disease. Use of nonsteroidal anti-inflammatory drugs, wine consumption, coffee consumption, and regular physical activity were associated with a reduced risk of Alzheimer's disease. No statistically significant association was found for family history of dementia, sex, history of depression, estrogen replacement therapy, head trauma, antiperspirant or antacid use, smoking, high blood pressure, heart disease, or stroke. The protective associations warrant further study. In particular, regular physical activity could be an important component of a preventive strategy against Alzheimer's disease and many other conditions.

1,240 citations

Journal ArticleDOI
TL;DR: A comprehensive estimate of the prevalence of "cognitive impairment, no dementia" (CIND) in an elderly population of elderly Canadians and this diagnostic category includes a costly group of disorders that merit further study.

950 citations


Cited by
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Journal ArticleDOI
TL;DR: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity, which makes it a useful clinical and research tool.
Abstract: OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.

26,004 citations

Posted Content
TL;DR: The Satisfaction With Life Scale is narrowly focused to assess global life satisfaction and does not tap related constructs such as positive affect or loneliness, but is shown to have favorable psychometric properties, including high internal consistency and high temporal reliability.
Abstract: This article reports the development and validation of a scale to measure global life satisfaction, the Satisfaction With Life Scale (SWLS). Among the various components of subjective well-being, the SWLS is narrowly focused to assess global life satisfaction and does not tap related constructs such as positive affect or loneliness. The SWLS is shown to have favorable psychometric properties, including high internal consistency and high temporal reliability. Scores on the SWLS correlate moderately to highly with other measures of subjective well-being, and correlate predictably with specific personality characteristics. It is noted that the SWLS is suited for use with different age groups, and other potential uses of the scale are discussed.

21,449 citations

Journal ArticleDOI
TL;DR: The criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies.

7,439 citations

Journal ArticleDOI
Ronald C. Petersen1
TL;DR: It is suggested that the diagnosis of mild cognitive impairment can be made in a fashion similar to the clinical diagnoses of dementia and AD, and an algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI.
Abstract: The concept of cognitive impairment intervening between normal ageing and very early dementia has been in the literature for many years. Recently, the construct of mild cognitive impairment (MCI) has been proposed to designate an early, but abnormal, state of cognitive impairment. MCI has generated a great deal of research from both clinical and research perspectives. Numerous epidemiological studies have documented the accelerated rate of progression to dementia and Alzheimer's disease (AD) in MCI subjects and certain predictor variables appear valid. However, there has been controversy regarding the precise definition of the concept and its implementation in various clinical settings. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. It is suggested that the diagnosis of MCI can be made in a fashion similar to the clinical diagnoses of dementia and AD. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. By refining the criteria for MCI, clinical trials can be designed with appropriate inclusion and exclusion restrictions to allow for the investigation of therapeutics tailored for specific targets and populations.

6,382 citations