Semantic Interference and Early Detection of Dementia

描述(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一个挑战，他们必须将良性疾病与严重的进行性疾病区分开来。阿尔茨海默病(AD)等退行性疾病的早期诊断尤为重要，因为新的药理药物的不断开发在降低记忆障碍的进展速度方面显示出希望。未来的药物可能是最有效的，当在疾病发展的早期使用时，限制大脑损伤的程度，使得早期诊断至关重要。 这项拟议的调查的目的是评估两种新开发的神经心理学测试：语义干扰测试(SIT)和前瞻记忆测试(PMT)在有认知能力下降风险的西班牙裔和非西班牙裔老年人中的效用。SIT评估的是主动性和回溯性语义干扰，而PMT评估的是基于事件和时间的前瞻记忆。我们实验室对讲英语和西班牙语的老年人进行的试点工作表明，与评估延迟记忆或健忘率的传统神经心理学测试相比，SIT测量的语义干扰易感性是AD早期认知障碍的更敏感指标。我们的数据还表明，PMT在区分轻度AD患者和正常老年对照组方面具有良好的敏感性和特异性。 这项研究的一个独特之处在于，语义干扰和前瞻性记忆测量的预测效用将与传统的神经心理学测试相比较，以预测正常或有轻度认知障碍(MCI)的西班牙裔和非西班牙裔老年患者的认知能力下降和进展为痴呆。还将评估诸如载脂蛋白E(ApoE)状态等遗传风险因素是否能够单独以及与SIT和PMT测量一起预测哪些人将发展为认知能力下降和发展为痴呆症。对语义干扰易感性增加和前瞻记忆下降的研究可能会加强对MCI的检测和对高危人群进展为痴呆的预测，因此具有重要的临床、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.