ISOLATED EXECUTIVE IMPAIRMENT AND COGNITIVE DECLINE

孤立的执行力障碍和认知能力下降

• 批准号: 7234365
• 负责人: JULENE K JOHNSON
• 金额: $ 24.62万
• 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/7234365
• 关键词: Activities of Daily Living; Alzheimer' s Disease; Atrophic; Awareness; Brain; Clinical; Cognition; Cognitive; Cognitive aging; Cognitive deficits; Data; Dementia; Development; Differential Diagnosis; Elderly; Frontotemporal Dementia; Future; Goals; Impaired cognition; Impairment; Individual; Magnetic Resonance Imaging; Measurement; Measures; Memory; Performance; Prefrontal Cortex; Primary Prevention; Rate; Research Personnel; Risk; Score; Staging; Structure; Testing; Vascular Dementia; cerebral atrophy; entorhinal cortex; executive function; follow-up; frontal lobe; functional decline; functional disability; gray matter; mild neurocognitive impairment; neuroimaging; pre-clinical; programs; tool; treatment trial

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)：大多数关于认知老化的研究集中在记忆衰退和阿尔茨海默病(AD)上。然而，阿尔茨海默病和其他痴呆的临床前阶段也可能始于非记忆认知领域的损害。我们有初步的临床和神经病理数据表明，孤立的执行障碍，一种非记忆认知缺陷，可能是发展为功能衰退和/或痴呆症的风险。该项目的总体目标是检验这样一种假设，即非痴呆老年人额叶执行功能的孤立损害将预测未来的认知衰退/痴呆、功能障碍和脑萎缩。为了验证这一假设，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、功能和神经成像测量，并与48名遗忘性轻度认知障碍受试者和匹配的对照组进行比较。具体地说，我们预测，在执行功能测试中较低的基线表现将与1)在两年和四年的随访间隔中功能测量(即日常生活能力)的较低表现以及2)与匹配的对照组相比在两年和四年的随访间隔中的认知表现的下降有关。我们还假设，在基线时，患有单纯性执行障碍的受试者在MRI上会有更严重的前额叶皮质萎缩，并在两年的随访间隔中表现出更快的前额叶皮质萎缩速度。我们预测，在所有受试者中，执行功能测试的分数与额叶皮质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/或痴呆症的重大风险的认识，2)提供临床和神经成像工具，以识别可能被纳入未来初级预防和治疗试验的非记忆性认知障碍个人，以及3)扩大与单独存在执行障碍的个人的鉴别诊断，以包括阿尔茨海默病和额颞痴呆、血管性痴呆症等。