Validation of the DCTclock drawing task as a cognitive screening tool for prodromal Alzheimers disease in the Framingham Heart Study

抽象的。可能的阿尔茨海默病（AD）的诊断传统上依赖于流体生物标志物 和神经成像。然而，这些测试通常是侵入性的，昂贵的，并且通常仅在专业领域可用。 诊所。用于筛查痴呆症的常见神经心理学测试（例如，简易精神状态检查（Mini-mental State Examination） 不足以敏感地检测到可以预测前驱AD出现的早期认知变化。的 DCTclockTM是FDA批准的数字神经心理学测试，有可能用于初级保健 和临床试验研究作为一种非侵入性和具有成本效益的筛查工具，用于检测早期阶段 的AD。DCT clockTM可由任何医疗保健专业人员轻松管理， 捕捉细微神经心理行为的方法。初步研究表明，DCT clockTM具有高 在神经影像学上预测皮质淀粉样蛋白（A β）沉积和顶叶低代谢的敏感性，提示 它可以作为更具侵入性或昂贵的生物标志物检测的替代品。该项目将验证 DCTclockTM在来自心脏病研究（FHS）的老年人大样本中，使用横断面 和纵向方法，其目标是确定：（1）DCT时钟区分轻度 相对于现有的认知筛查措施，正常老化的认知障碍（MCI），（2）其 与AD遗传生物标志物和AD病理学神经影像学指标（包括MRI指标）的相关性 和脑内的肾上腺素水平自2011年以来，FHS已收集了DCTclockTM图纸数据， 超过1，600名无痴呆症的老年人，使其成为这项验证研究的理想数据库。

Abstract. The diagnosis of probable Alzheimer’s disease (AD) has traditionally depended on fluid biomarkers and neuroimaging. However, these tests are often invasive, expensive, and generally available only in specialty clinics. Common neuropsychological tests used to screen for dementia (e.g., Mini-Mental State Examination) are not sensitive enough to detect early cognitive changes that can predict the emergence of prodromal AD. The DCTclockTM is an FDA approved digital neuropsychological test with the potential to be deployed in primary care and clinical trials research as a non-invasive and cost-effective screening tool for detecting the earliest stages of AD. The DCTclockTM can be easily administered by any healthcare professional and uses cutting-edge methods to capture nuanced neuropsychological behavior. Initial studies suggest that the DCTclockTM has high sensitivity to predict cortical amyloid (Aß) deposition and parietal hypometabolism on neuroimaging, suggesting that it could serve as a surrogate for more invasive or costly biomarker testing. This project will validate the DCTclockTM in a large sample of older adults from the Framingham Heart Study (FHS), using cross sectional and longitudinal approaches with the goals of determining: (1) the DCTclock’s ability to distinguishing mild cognitive impairment (MCI) from normal aging relative to existing cognitive screening measures, (2) its associations with genetic biomarkers of AD and neuroimaging measures of AD pathology, including MRI metrics and brain Aß levels on a PET scan. DCTclockTM drawing data has been collected in the FHS since 2011 from over 1,600 older adults without dementia, making it an ideal database for this validation study.