Computer Assessment of Mild Cognitive Impairment (CAMCI)

描述（由申请人提供）：阿尔茨海默病（AD）影响美国400万人。65岁以上的患病率每五年翻一番。目前，临床前AD的认知特征是通过标准神经心理学评估来确定的，该评估通常涉及一系列测试的管理，通常需要2-3小时。我们建议开发一个简短的（10分钟）计算机化的测试，可以由病人在医生的检查室完成。拟议的轻度认知障碍计算机评估将以标准化的方式收集数据，同时简单、无威胁和方便用户，并将可靠地识别有认知困难的老年人。行为测试将评估工作记忆、偶然记忆和前瞻记忆、执行功能、语言和心理速度。初步试验结果表明，该测试可以在临床环境中进行，并且可以区分有和没有轻度认知障碍的老年人以及有阿尔茨海默氏症风险的老年人。该项目的第一阶段将涉及60名患者和4名护士，以收集有关测试管理有效性和敏感性的数据，作为轻度认知障碍（MCI）和阿尔茨海默氏症的有效初始筛查。CAMCI是基于目前公认的精神状态评估和目前公认的临床前痴呆的识别标准。这将为轻度认知障碍的结局提供有价值的信息，因为患者可以通过定期访视跟踪他们的初级保健医生。最后，也是最重要的一点是，识别出处于痴呆症早期阶段的老年人，将允许在疾病的最早阶段进行治疗干预，这反过来又会减缓甚至阻止疾病的进展。最终目标是改善认知能力下降早期阶段的人们的生活质量，并通过防止进一步下降来降低医疗保健成本。迫切需要和商业上可行的市场来提供更好的MCI和AD诊断仪器。

DESCRIPTION (provided by applicant): Alzheimer's disease (AD) affects 4 million people in the US. The prevalence doubles every five years beyond age 65. At present, the cognitive features of preclinical AD are identified through standard neuropsychological assessment that typically involves the administration of a battery of tests, often taking 2-3 hours. We propose to develop a brief (10 minute) computerized test that can be completed by the patient in a physician's examining room. The proposed Computer-based Assessment of Mild Cognitive Impairment (CAMCI), will collect data in a standardized fashion while being simple, non-threatening and user-friendly and will reliably identify older individuals experiencing cognitive difficulties. The behavioral tests will assess working memory, incidental memory and prospective memory, executive function, language and psychomotor speed. Initial pilot results show that the test can be administered in a clinical setting and can discriminate between older individuals with and without mild cognitive impairment and at risk for Alzheimer's. The Phase I of the project will involve running 60 patients and 4 nurses to collect data on the effectiveness of the test administration and sensitivity as an effective initial screen for mild cognitive impairment (MCI) and Alzheimer's. The CAMCI is based on currently accepted mental status assessments and currently accepted criteria for the identification of preclinical dementia. This will provide valuable information as to the outcome of mild cognitive impairment as patients can be tracked over interval visits to their primary care physician. Finally, and most important, identifying older people who are in the very beginning stages of a dementing illness will allow therapeutic intervention in the earliest stages of the disease, which, in turn, will slow or even prevent the progression of the disease. The ultimate goal is to improve the quality of life of people in the early stages of cognitive decline and to reduce health care costs by preventing further decline. There is a critical need and commercially viable market to provide better diagnostic instruments for MCI and AD.