Cognitive Assessment and Adjudication Core

糖尿病预防的认知评估与判断核心(认知核心)的目标 项目成果研究(DPPOS)阿尔茨海默病(AD)和AD相关痴呆(ADRD)项目将 执行与认知相关的所有培训、认证、质量保证(QA)和质量控制(QC)活动 测试和收集测量认知衰退和定义轻度认知综合征所需的数据 认知障碍(MCI)和痴呆。此外，认知核心将与神经成像和 血浆生物标记物核心(Biomarkers Core)和DPPOS临床操作和程序核心(临床 核心)进一步将认知减退、MCI和痴呆症归类为AD连续体、非AD病理性 或血管对认知损害和痴呆的贡献(VCID)，以及与生物统计和 数据基础架构核心(Data Core)，用于分析认知数据及其解释。DPPOS已包括 西班牙英语口语学习测试(SEVLT)，数字符号替换测试(DSST)，自2009年开始。和 自2015年起修订的简易精神状态检查(3MS)。我们建议继续使用SEVLT、DSST和 3MS在两个拟议的评估波中，增加了使用 第三版国家阿尔茨海默病协调中心(NACC)统一数据集(UDS)表格。这个 认知核心将通过以下目标实现其目标：(1)开发、维护、更新和实施 与认知和功能测试相关的培训、认证和质量保证程序，包括培训手册； 视频，以及SEVLT、DSST和3MS NACC版本3的认证和重新认证流程- UDS认知、医生和功能评估；(2)制定和实施与以下相关的质量控制程序 认知和功能测试，包括10%起的测试表格和录音的集中检查 在每季度进行的所有测试中，DPPOS现场人员的再培训和重新认证为 通过具有专用核心的电子邮件进行实时查询，实现必要且持续的质量改进 经理；(3)对MCI、痴呆症及其亚型的诊断执行裁决程序， 包括由经验丰富的认知裁判员评估的认知和功能数据的汇总表， 一个网站，用于分发摘要表格和审判员的认知诊断条目，以及 解决裁判员之间分歧的程序；(4)将MCI和痴呆症进一步判定为AD 在所有参与者中使用血浆ptau-181和淀粉样正电子发射的连续或非AD病理 体层摄影术(PET)在那些接受脑成像的人中，探索使用脑血管数据来判断VCID 从MRI、临床脑成像和中风病史，探索神经退行性变的生物标记物的使用 和tau来定义tau和具有和不具有淀粉样阳性的神经退行性变；(5)协助数据核心 分析所有项目的认知数据；(6)协助临床核心返回认知诊断研究 参与者。

The goal of the Cognitive Assessment and Adjudication Core (Cognition Core) of the Diabetes Prevention Program Outcomes Study (DPPOS) Alzheimer’s disease (AD) and AD related dementias (ADRD) project is to conduct all training, certification, quality assurance (QA) and quality control (QC) activities related to cognitive testing and collection of data necessary to measure cognitive decline and define the cognitive syndromes of mild cognitive impairment (MCI) and dementia. In addition, the Cognition Core will work with the Neuroimaging and Plasma Biomarkers core (Biomarkers Core) and the DPPOS Clinical Operations and Procedures Core (Clinical Core) to further classify cognitive decline, MCI, and dementia as due to AD continuum, non-AD pathologic change, or vascular contributions to cognitive impairment and dementia (VCID), and with the Biostatistics and Data Infrastructure Core (Data Core) in analyses of cognitive data and their interpretation. DPPOS has included the Spanish English Verbal Learning Test (SEVLT), the Digit Symbol Substitution Test (DSST), since 2009. And the Modified Mini-Mental Status Exam (3MS) since 2015. We propose to continue using the SEVLT, DSST, and 3MS in the two proposed assessment waves, adding comprehensive cognitive and functional testing using the third version of the National Alzheimer’s Coordinating Center (NACC) uniform dataset (UDS) forms. The cognition core will achieve its goal through the following aims: (1) To develop, maintain, update, and implement training, certification, and QA procedures related to cognitive and functional testing including training manuals, videos, and certification and recertification processes for the SEVLT, DSST, and 3MS, version 3 of the NACC- UDS cognitive, physician, and functional assessments; (2) To develop and implement QC procedures related to cognitive and functional testing including, central examination of testing forms and audio recordings from 10% of all tests administered on a quarterly basis, retraining and recertification of DPPOS site personnel as necessary, and continuous quality improvement through real time queries via email with a dedicated core manager; (3) To implement an adjudication procedure for the diagnoses of MCI, dementia, and their subtypes, including summary forms of cognitive and functional data to be evaluated by experienced cognitive adjudicators, a website for the distribution of the summary forms and entry of cognitive diagnoses by adjudicators, and a process for resolution of disagreements among adjudicators; (4) Further adjudicate MCI and dementia as AD continuum or non-AD pathology using plasma ptau-181 in all participants and amyloid positron emission tomography (PET) in those undergoing brain imaging, explore adjudicating VCID using cerebrovascular data from MRI, clinical brain imaging, and history of stroke, and explore the use of biomarkers of neurodegeneration and tau to define tau and neurodegeneration with and without amyloid positivity; (5) Assist the data core in the analyses of cognitive data for all projects; (6) Assist the Clinical Core in the return of cognitive diagnoses to study participants.