ISOLATED EXECUTIVE IMPAIRMENT AND COGNITIVE DECLINE

孤立的执行力障碍和认知能力下降

• 批准号: 7069992
• 负责人: JULENE K JOHNSON
• 金额: $ 25.36万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-06-01 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7069992
• 关键词: atrophy; behavioral /social science research tag; brain disorders; brain imaging /visualization /scanning; brain morphology; clinical research; cognition disorders; dementia; disease /disorder proneness /risk; entorhinal cortex; frontal lobe /cortex; functional ability; human middle age (35-64); human old age (65+); human subject; longitudinal human study; magnetic resonance imaging; memory

DESCRIPTION (provided by applicant): The majority of studies of cognitive aging focus on memory decline and Alzheimer's disease (AD). However, the preclinical stage of AD and other dementias may also begin with impairment in non-memory cognitive domains. We have preliminary clinical and neuropathological data suggesting that isolated executive impairment, a non-memory cognitive deficit, may be a risk for the development of functional decline and/or dementia. The overall goal of this project is to test the hypothesis that an isolated impairment of frontalexecutive function in non-demented elderly will predict future cognitive decline / dementia, functional impairment, and brain atrophy. To test this hypothesis, we will obtain longitudinal cognitive, functional, and neuroimaging measurements of 48 elderly subjects with isolated executive impairment and compare with 48 subjects with amnestic mild cognitive impairment (MCI) and matched controls. Specifically, we predict that lower baseline performance on tests of executive function will be associated with 1) lower performance on functional measures (i.e., activities of daily living) at two- and four-year follow-up intervals and 2) a decline in cognitive performance at two- and four-year follow-up intervals when compared with matched controls. We also hypothesize that subjects with isolated executive impairment will have a greater degree of prefrontal cortex atrophy on MRI at baseline and show a faster rate of prefrontal cortex atrophy at the two-year follow-up interval. Across all subjects, we predict that there will a relationship between scores on tests of executive function and the degree of frontal cortex atrophy. This project will increase awareness of non-memory cognitive impairment as a significant risk for functional and cognitive decline and/or dementia, 2) provide clinical and neuroimaging tools for the identification of individuals with non-memory cognitive impairment for possible inclusion in future primary prevention and treatment trials, and 3) expand differential diagnosis with individuals who present with isolated executive impairment to include AD in addition to frontotemporal dementia, vascular dementia, etc.

描述（由申请人提供）：大多数认知衰老研究都集中在记忆力衰退和阿尔茨海默病（AD）上。然而，AD 和其他痴呆症的临床前阶段也可能始于非记忆认知领域的损伤。我们的初步临床和神经病理学数据表明，孤立的执行障碍（一种非记忆性认知缺陷）可能会导致功能下降和/或痴呆的风险。该项目的总体目标是检验以下假设：非痴呆老年人额叶执行功能的孤立损伤将预测未来的认知能力下降/痴呆、功能障碍和脑萎缩。为了检验这一假设，我们将获得 48 名患有孤立性执行障碍的老年受试者的纵向认知、功能和神经影像测量，并与 48 名患有遗忘性轻度认知障碍 (MCI) 的受试者和匹配的对照组进行比较。具体来说，我们预测执行功能测试的基线表现较低将与以下因素相关：1）两年和四年的随访时间间隔内功能测量（即日常生活活动）的较低表现；2）与匹配对照相比，两年和四年的随访时间间隔认知表现下降。我们还假设，患有孤立性执行障碍的受试者在基线时的 MRI 上会出现更严重的前额皮质萎缩，并且在两年的随访间隔中表现出更快的前额皮质萎缩速度。在所有科目中，我们预测执行功能测试的分数与额叶皮层萎缩的程度之间存在关系。该项目将提高人们对非记忆性认知障碍作为功能和认知衰退和/或痴呆的重大风险的认识，2) 提供临床和神经影像学工具，用于识别非记忆性认知障碍患者，以便可能纳入未来的一级预防和治疗试验，3) 扩大对患有孤立性执行障碍的个体的鉴别诊断，除了额颞叶痴呆、血管性痴呆之外，还包括 AD 痴呆症等