Predictors of Functional Ability in MCI

MCI 功能能力的预测因子

• 批准号: 8740377
• 负责人: Laleh Jill Razani
• 金额: $ 10.88万
• 依托单位: CALIFORNIA STATE UNIVERSITY NORTHRIDGE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8740377
• 关键词: Activities of Daily Living; Address; Alzheimer' s Disease; Atrophic; Attention; Biological Markers; Brain region; Climacteric; Clinical; Cognitive; Cognitive deficits; Dementia; Detection; Diagnostic; Disease; Early treatment; Enrollment; Functional disorder; Goals; Grant; Impaired cognition; Impairment; Individual; Life; Link; Literature; Magnetic Resonance Imaging; Measures; Memory; Neuropsychological Tests; Participant; Patients; Performance; Publishing; Relative (related person); Research; Severities; Staging; Subgroup; Time; Work; base; comparison group; daily functioning; functional decline; functional disability; informant; instrumental activity of daily living; mild cognitive impairment; neuroimaging; neuropsychological; normal aging; public health relevance; skills; treatment planning

DESCRIPTION (provided by applicant): Considerable effort is being made to detect dementia (particularly Alzheimer's disease) at its very early stages. Mild cognitive impairment (MCI) is described as the intermediate stage between normal aging and dementia. The diagnostic criteria for this disorder are currently not well defined and have been redefined over the past decade. Two of the major changes in definition of MCI are the inclusion of mild activities of daily living (ADL) impairments (that do not interfere with the ability to work and carry out life activites) and subtypes of MCI (those with amnestic and multiple-domain MCI). The types and degree of daily functional impairment are not well understood and predictors of such impairment need to be further investigated if we are to find better diagnostic criteria and early treatments for MCI. Biomedical markers, such as brain region atrophy has received much attention for the detection MCI and dementia in its earliest stages. These biomarkers alone, however, provide limited clinical utility. The current project has three major goals: 1) to examine the rate of functional decline in different subtypes of MCI (e.g., amnestic-MCI, multiple-domain MCI) over a 4-year period using an observation-based ADL task. Additionally, to examine how each ADL sub-task best predicts conversion from MCI to dementia in the different MCI subtypes, 2) to examine the relationship between biomarkers and specific types of ADL impairments, and 3) to determine the best predictors (i.e., biomarkers or neuropsychological performance) of ADL dysfunction at baseline and over time in MCI patients. A total of 55 MCI participants will be enrolled into this study from an Alzheimer's Disease Research Center (ADRC) and will be followed for a total 4 years. All participants will have already completed a neuropsychological test battery and will have undergone neuroimaging at the ADRC. Participants will be administered an observation-based ADL task. The relationship between specific CNS biomarkers and daily functional ability will be examined. How well the CNS biomarker measures, deficits in neuropsychological performance and daily functional impairment predict the rate of conversion to a specific type of MCI will also be analyzed; additionally, how specific biomarkers and neuropsychological performance predict functional disabilities will be examined in MCI subtypes at baseline as well as over a 4 year period. The results will better characterize functional impairment in the sub-types of MCI as well as better provide a better clinical understanding of abnormal biomarkers as they relate to ADL functioning.

描述（由申请人提供）：正在做出相当大的努力来在早期阶段检测痴呆症（特别是阿尔茨海默病）。轻度认知障碍（MCI）被描述为正常衰老和痴呆之间的中间阶段。这种疾病的诊断标准目前尚未明确定义，并且在过去十年中已被重新定义。 MCI 定义的两个主要变化是纳入了日常轻度活动 生活 (ADL) 障碍（不影响工作和进行生活活动的能力）和 MCI 亚型（记忆删除和多域 MCI）。日常功能损伤的类型和程度尚不清楚，如果我们要找到更好的 MCI 诊断标准和早期治疗方法，则需要进一步研究此类损伤的预测因素。生物医学标志物，例如大脑区域萎缩，在早期检测 MCI 和痴呆症方面受到了广泛关注。然而，这些生物标志物单独提供的临床效用有限。当前项目有三个主要目标：1）使用基于观察的 ADL 任务检查 4 年期间不同 MCI 亚型（例如遗忘型 MCI、多域 MCI）的功能衰退率。此外，为了检查每个 ADL 子任务如何最好地预测不同 MCI 亚型中从 MCI 向痴呆的转变，2) 检查生物标志物与特定类型的 ADL 损伤之间的关系，3) 确定 MCI 患者基线和随时间变化的 ADL 功能障碍的最佳预测因子（即生物标志物或神经心理学表现）。来自阿尔茨海默病研究中心 (ADRC) 的总共 55 名 MCI 参与者将被纳入这项研究，并将进行为期 4 年的随访。所有参与者都已经完成了神经心理学测试，并将在 ADRC 接受神经影像检查。参与者将接受基于观察的 ADL 任务。将检查特定中枢神经系统生物标志物与日常功能能力之间的关系。还将分析中枢神经系统生物标志物测量、神经心理学表现缺陷和日常功能损伤预测转化为特定类型 MCI 的比率；此外，将在基线以及 4 年多的时间里检查 MCI 亚型的特定生物标志物和神经心理学表现如何预测功能障碍。结果将更好地表征 MCI 亚型的功能障碍，并更好地提供对与 ADL 功能相关的异常生物标志物的更好的临床理解。