Semantic Intereference and Early Detection of Dementia

语义互指和痴呆症的早期检测

• 批准号: 7056068
• 负责人: DAVID LOEWENSTEIN
• 金额: $ 40.64万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7056068
• 关键词: African American; Alzheimer' s disease; Hispanic Americans; apolipoprotein E; brain disorder diagnosis; caucasian American; clinical research; cognition disorders; dementia; diagnosis design /evaluation; early diagnosis; genetic susceptibility; genotype; human old age (65+); human subject; language; longitudinal human study; memory; memory disorders; neuropsychological tests; nonEnglish language; patient oriented research; prognosis; psychological aspect of aging; racial /ethnic difference; semantics

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.

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，他们必须区分良性病症和严重的进行性障碍。鉴于新型药物制剂的不断发展，这些药物有望降低记忆障碍的进展速度，因此对阿尔茨海默病 (AD) 等退行性疾病的早期诊断尤为重要。未来的药物可能会通过在疾病发展的早期施用来限制大脑损伤的程度来最有效，这使得早期诊断至关重要。 拟议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）和前瞻性记忆测试（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。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，与评估延迟记忆或遗忘率的传统神经心理学测试相比，SIT 测量的语义干扰脆弱性是 AD 早期认知障碍的更敏感指标。我们的数据还表明，PMT 在区分轻度受损 AD 患者与正常老年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之处在于，将语义干扰和前瞻性记忆测量的预测效用与传统的神经心理学测试进行比较，以预测正常或患有轻度认知障碍（MCI）的老年西班牙裔和非西班牙裔患者的认知能力下降和进展为痴呆。载脂蛋白 E (ApoE) 状态等遗传风险因素也将根据其单独或与 SIT 和 PMT 测量相结合的预测能力进行评估，哪些个体将出现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高危人群中 MCI 的检测和痴呆进展的预测，从而具有重要的临床、启发和治疗意义。