Measurement & Prediction of Everyday Function Dementia

这个为期五年的职业发展计划旨在进一步完善候选人的研究技能，使她成为一名独立和富有成效的研究人员，专注于评估老年人的日常功能障碍。培训计划强调三个内容领域：1）测试开发用于老年人的生态有效措施; 2）将结构成像技术整合到神经心理学研究中; 3）研究设计和统计分析。将利用多种培训方式来实现学习目标：a）定期安排与赞助商、导师和顾问的结构化会议; B）正式课程; c）参加定期现场研究座谈会和年度科学会议;和d）直接研究经验。该项目的目的是开发一种概念化和测量日常功能的方法，该方法：1）以神经解剖学和神经心理学为基础，2）对广泛的功能变化敏感; 3）有助于理解多种因素如何有助于和/或调解日常功能。 研究参与者将包括被诊断患有轻度认知障碍或痴呆的个体，以及认知正常的老年人样本。与痴呆症相关的功能变化的拟议模型改编自世界卫生组织（WHO）提出的分类系统，[96]该系统描述了三个级别的疾病后果：损伤，残疾和障碍。这些级别可以按等级排列，其中“损伤”（可观察到的疾病的外在神经学表现）是“残疾”（进行正常生活所必需的活动的能力下降）的前兆，而残疾又是“残疾”（疾病的社会后果）的前兆。在该项目中，将评估所有三个水平的功能变化，特别强调评估功能变化的损害水平，以增加与痴呆症的临床前和早期阶段相关的早期功能变化的敏感性。将开发一个新的量表来评估功能障碍，将这些障碍组织到神经心理学和神经解剖学相关的领域。残疾的措施和初步评估的障碍也将包括审查之间的关系，不同层次的功能变化所提出的模式。

DESCRIPTION (provided by applicant): This five-year career development plan is designed to further refine the candidate's research skills, enabling her to become an independent and productive researcher focused on the assessment of everyday functional impairments in older adults. The training plan emphasizes three content areas: 1) test development of ecologically valid measures for use with older adults; 2) the integration of structural imaging techniques into neuropsychological research; and 3) research design and statistical analysis. Learning objectives will be met utilizing several training modalities: a) regularly scheduled structured meetings with Sponsors, Mentors, and Consultants; b) formal coursework; c) attendance at regular on-site research colloquia and annual scientific conferences; and d) direct research experience. The aim of this project is to develop a method of conceptualizing and measuring everyday function that is: 1) grounded in neuroanatomy and neuropsychology, 2) sensitive to a wide spectrum of functional change and; 3) useful in understanding how a multitude of factors can contribute to, and/or mediate everyday function. Study participants will include individuals diagnosed with mild cognitive impairment or dementia, and a sample of cognitively normal older adults. The proposed model of the functional changes associated with dementia has been adapted from the classification system set forth by the World Health Organization (WHO), [96] which describe the consequence of disease at three levels: impairment, disability, and handicap. These levels can be hierarchically arranged wherein 'impairments' (observable, externalized neurological manifestations of disease) are precursors to 'disability' (declines in the ability to carry out activities essential to normal life), which in turn is a precursor to 'handicap' (the social consequence of disease). In this project, all three levels of functional change will be assessed, with a particularly emphasis on assessing functional change at the level of impairment in order to increase the sensitivity to early functional changes associated with the preclinical and early stages of dementia. A new scale will be developed to assess functional impairments, which organizes these impairments into neuropsychologically and neuroanatomically-relevant domains. Measures of disability and preliminary assessment of handicap will also be included to examine the relationship between the different levels functional change set forth in the model.