Semantic Interference and Early Detection of Dementia

描述（由申请人提供）：记忆障碍的患病率随着年龄的增长而增加，这对临床医生提出了挑战，他们必须区分良性疾病和严重的进行性疾病。考虑到新型药理学试剂的持续开发，其在降低记忆障碍的进展速率方面显示出希望，退行性疾病如阿尔茨海默病（AD）的早期诊断尤其重要。未来的药物可能是最有效的，当在疾病发展的早期给药时，限制脑损伤的程度，使早期诊断至关重要。 拟议的调查的目的是评估效用，西班牙裔和非西班牙裔老年人谁是在认知能力下降的风险，两个新开发的神经心理测试：语义干扰测试（SIT）和前瞻性记忆测试（PMT）。SIT评估主动和追溯语义干扰，而PMT评估基于事件和时间的前瞻性记忆。在我们的实验室中使用英语和西班牙语的老年人的试点工作表明，语义干扰的脆弱性所测量的SIT是一个更敏感的指标，在AD的早期阶段的认知障碍比传统的神经心理学测试，评估延迟记忆或遗忘率。我们的数据还表明，PMT在区分轻度受损的AD患者和正常老年人对照方面具有良好的敏感性和特异性。 这项研究的一个独特的方面是，语义干扰和前瞻性记忆措施的预测效用将进行比较，传统的神经心理学测试在预测认知能力下降和进展为老年痴呆症的西班牙裔和非西班牙裔患者谁是正常的或谁有轻度认知障碍（MCI）。遗传风险因素，如载脂蛋白E（ApoE）状态也将评估其预测能力，单独和与SIT和PMT措施相结合，哪些人将发展认知能力下降和进展为痴呆症。对语义干扰的脆弱性增加和前瞻性记忆下降的研究可能会增强对MCI的检测和对高危人群进展为痴呆的预测，从而具有重要的临床、启发式和治疗意义。

DESCRIPTION (provided by applicant): The prevalence of memory disorders increases with advancing age, presenting a challenge for clinicians who must differentiate a benign condition from a serious and progressive disorder. The early diagnosis of degenerative conditions such as Alzheimer's Disease (AD) is particularly important given the continuing development of novel pharmacological agents that show promise in decreasing the rate of progression of memory impairment. Future agents will likely be most effective by limiting the extent of brain impairment when administered early in the development of the disease, making early diagnosis critical. The purpose of the proposed investigation is to assess the utility, among Hispanic and non-Hispanic elderly who are at risk for cognitive decline, of two newly developed neuropsychological tests: the Semantic Interference Test (SIT) and the Prospective Memory Test (PMT). The SIT assesses proactive and retroactive semantic interference, whereas the PMT assesses event- and time-based prospective memory. Pilot work in our laboratories using English- and Spanish-speaking elderly indicates that vulnerability to semantic interference as measured by the SIT is a more sensitive indicator of cognitive impairment in the early stages of AD than traditional neuropsychological tests that assess delayed memory or rate of forgetting. Our data also indicate that the PMT has good sensitivity and specificity in differentiating mildly impaired AD patients from normal elderly controls. A unique aspect of this study is that the predictive utility of semantic interference and prospective memory measures will be compared to traditional neuropsychological tests in predicting cognitive decline and progression to dementia among elderly Hispanic and non-Hispanic patients who are normal or who have mild cognitive impairment (MCI). Genetic risk factors such as apolipoprotein E (ApoE) status will also be assessed with regards to its ability to predict, alone and in combination with SIT and PMT measures, which individuals will develop cognitive decline and progression to dementia. The study of increased vulnerability to semantic interference and decline in prospective memory may enhance the detection of MCI and the prediction of progression to dementia in at risk populations, thus having important clinical, heuristic, and treatment implications.