Task-specific and person-specific factors related to Subjective Cognitive Decline

在认知老化领域，迫切需要确定临床前的标志物 阿尔茨海默病(AD)，以便在疾病的早期进行药物干预 光谱到它可以最有效的时候。人们对主观方面的兴趣与日俱增 认知功能减退(SCD)是临床前AD的潜在标志。SCD，或者认为 一个人的认知能力下降了，尽管在标准诊断测试中表现正常，是一种 许多老年人关心的重要健康后果，并导致一些人寻求 医疗救治。确定SCD可在多大程度上作为临床前标记物 AD是非常有价值的，因为SCD是非侵入性的，价格低廉，而且很容易获得。然而， SCD是一个复杂的、多因素的结构。为了确定它作为一种标记的真正用途 临床前AD，关键是全面描述影响SCD的因素，以及 这会影响SCD反映“真实”或实际认知功能的程度。事实上，SCD 肯定不仅反映了一个人的实际认知功能，而且还反映了特定于任务的因素 (例如，SCD是如何测量的)和特定于人的因素(例如，一个人的自我评价有多好 评估；一个人感觉多老；一个人对衰老有什么看法)。这个纵向项目的目标是 建议是检查新的特定于任务和特定于人的因素，这些因素可能会 200名老年人SCD及其与实际(客观测量)认知的关系 成年人。拟议研究的一个关键方面是纳入敏感的、客观的认知 结果将使能够更准确地检查SCD和 比到目前为止所进行的更客观的认识。第一个客观认知结果是 视觉短时记忆(STM)绑定任务的表现高度敏感 当标准的神经心理测试在正常范围内时，具体到AD病理。 我们还将考察注意力控制作为一种测量非记忆变化的方法，这种变化可能会 在记忆变化之前的早期AD在一些个体中是明显的。最后一个关键结果是 随着时间的推移，认知发生变化，从而能够检查可能发生的认知细微下降 当个体在横断面测试中的表现仍在正常范围内时。已被占用 这些目标共同体现了可持续发展工作组最近确定的关键问题(2014年) 对于推进SCD的当前知识状态至关重要，并将有助于一种新的 SCD模型。拟议研究的结果将提供具体的指导方针，指导如何 评估和解释老年人的SCD，并将为确定如何以及何时进行奠定基础 SCD可作为临床前阿尔茨海默病的指标。

In the field of cognitive aging, there is an urgent push to identify the markers of pre-clinical Alzheimer’s disease (AD) in order to move pharmacologic intervention earlier in the disease spectrum to a time when it can be most effective. There is growing interest in subjective cognitive decline (SCD) as a potential marker of pre-clinical AD. SCD, or the perception that one’s cognition has declined despite “normal” performance on standard diagnostic testing, is an important health outcome that is concerning to many older adults, and leads some to seek medical attention. Determining the extent to which SCD may serve as a pre-clinical marker of AD is of great value, as SCD is non-invasive, inexpensive, and easily obtainable. However, SCD is a complex, multi-factorial construct. In order to determine its true utility as a marker of pre-clinical AD, it is critical to comprehensively characterize the factors that influence SCD, and that affect the degree to which SCD reflects “true” or actual cognitive functioning. Indeed, SCD is certain to reflect not only a person’s actual cognitive functioning, but also task-specific factors (i.e., how SCD is measured) and person-specific factors (e.g., how good one is at self- evaluation; how old one feels; what one believes about aging). The goals of this longitudinal proposal are to examine novel task-specific and person-specific factors that are likely to influence SCD and/or its association with actual (objectively measured) cognition in 200 older adults. A key aspect of the proposed study is the inclusion of sensitive, objective cognitive outcomes that will enable a more precise examination of the association between SCD and objective cognition than has been conducted thus far. The first objective cognitive outcome is performance on a visual short term memory (STM) binding task shown to be highly sensitive and specific to AD pathology when standard neuropsychological testing is within normal limits. We will also examine attentional control as a measure of non-memory changes that may signal early AD before memory changes are apparent in some individuals. A final critical outcome is cognitive change over time, enabling examination of subtle decline in cognition that may occur when individuals still perform within the normal range on cross-sectional testing. Taken together, these aims embody key issues recently identified by the SCD Working Group (2014) as critical for advancing the current state of knowledge on SCD, and will contribute to a novel model of SCD. Results from the proposed study will provide specific guidelines for how to assess and interpret SCD in older adults, and will set the stage for determining how and when SCD may be used as an indicator of preclinical Alzheimer’s disease.