Critical Appraisal

Obesity in middle age and future risk of dementia: a 27 year longitudinal population based study
Rachel A Whitmer, Erica P Gunderson, Elizabeth BarrettConnor, Charles P Quesenberry Jr, Kristine Yaffe

Introduction

Applica bility

validity

Reliability

Faktor ekstrinsik
Siapa yang menulis Di mana ia/mereka bekerja Apa kualifikasinya Apakah anda pernah mendengar namanya Siapa yang menyeponsori Dimana tulisan tsb di muat Apakah ia/mereka pernah membuat tulisan dalam bidang yang sama

 Siapa yg menulis, dimana mereka bekerja dan kualifikasi

Division of Research, Kaiser Permanente, Oakland, CA 94612, USA
Rachel A Whitmer gerontological epidemiologist Erica P Gunderson obesity epidemiologist Charles P QuesenberryJr senior biostatistician

Department of Epidemiology, University of California, La Jolla, CA, USA

Elizabeth Barrett-Connor professor

Department of Psychiatry, University of California, San Francisco, CA, USA

Kristine Yaffe associate professor

Correspondence to: R A Whitmer raw@dor.kaiser.org

Faktor intrinsik
- Desain (penelitian) yang sesuai dengan tujuan/pertanyaan penelitian - Sampel yang sesuai - Metode pengambilan sampel - Metode untuk mendapatkan hasil

 Objective To evaluate any association between obesity in middle age, measured by body mass index and skinfold thickness, and risk of dementia later in life Design Analysis of prospective data from a multiethnic population based cohort

 Participants 10 276 men and women who underwent detailed health evaluations from 1964 to 1973 when they were aged 40-45 and who were still members of the health plan in 1994

Main outcome measures Diagnosis of dementia from January 1994 to April 2003. Time to diagnosis was analysed with Cox proportional hazard models adjusted for age, sex, race, education, smoking, alcohol use, marital status, diabetes, hypertension, hyperlipidaemia, stroke, and ischaemic heart disease

 Conclusion Obesity in middle age increases the risk of future dementia independently of comorbid conditions

Section A Population Appropriateness Is the study population representative of all user, actual & eligible Are inclusion & exclusion criteria well defined Sample size sufficient the estimation Response rate large enough for sufficiently precise estimates The choice of population bias free For Comparative study: - Were participants randomized into group - Were the group comparable at baseline - If group were not comparable at baseline, was incompatibility addresed at analysis Informed consent is obtained

yes no

score 1

1 1 1 1

1 1 1 0

Section Validity = 7/8 x 100% = 87.5%

Section B data collection Data collection methods is clearly described The data instrument is validated The statistics are free from subjectivity (if based on regularly collected statistic) The study measures outcome at a time appropriate for capturing the interventions effect The instrument is included in publication The questions are posed clearly enough to elicit precise answer Those are involved in data collection, are not involved in delivering a service to the target population Section Validity = 6/7 x 100% = 85,714%

Yes Y Y Y

No

Score 1 1 1

Y Y N

1 1 0

Section C Study Design Study design type is utilized appropriately Face validity Research methodology is clearly stated in detail Ethic approval Outcome is clearly stated The outcomes are clearly discussed in relation to data collection

yes

no

score

1 1 1 0 1 1

Section Validity = 5/6 x 100% =100 %

Yes Section D Research Results The results are clearly outlined

No

Score

Account for confounding variables

The conclusions accurately reflect the analysis

Suggestions for further areas of research are addresed

Section Validity = 3/4 x 100% = 75 %

R E L I A B I L I T Y

Applicability