Delaying Cognitive Decline in Alzheimer's Disease

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DESCRIPTION (provided by applicant): The goal of this study is to delay the progression of word-finding problems in patients with Alzheimer's Disease (AD). The paradox of attempting to restore that which has begun to decline in AD is that patients with AD - by definition - have impairments in explicit memory, making new learning problematic. The current approach is novel in that it attempts to strengthen connections that have not yet been lost, making them more resistant to loss as the disease progresses. This study capitalizes on the finding that patients with AD continue to read words well into the course of the disease by strengthening the connections between objects and their written names. While the study is specific in its targeting of word-finding problems, a successful outcome would bode well for other studies aimed at prevention, rather than reversal, of declining cognitive functions in dementia. Patients with mild cognitive impairment (MCI) and mild AD whose naming of pictures has just begun to show signs of decline will practice naming pictures in two conditions. In one condition, they will view the pictures and repeat their names; in the other condition they will view the pictures with their written names, then read and transcribe the names. Naming of pictures trained in each of these conditions will be compared, at three time intervals post-training, with naming of pictures tested before the study but never trained. It is predicted that the pairing of the picture with its written name, combined with the motor task of transcribing the name, will result in a greater ability to name the picture at a later date than simple practice viewing the picture and repeating the name. Generalization of this better preserved naming ability to novel exemplars, contexts and tasks, is also predicted. PUBLIC HEALTH RELEVANCE During the early stages of AD, when patients are still living at home and functioning within the normal family setting, one of the greatest challenges to normal living is difficulty communicating caused in part by the inability to access the appropriate words. The successful delay of such word finding problems - the goal of the proposed study - would have significant consequences for the quality of life of patients with early AD, and for their families and caregivers.