Testing Olfaction in Primary care to detect Alzheimer's disease and other Dementias (TOPAD)

在初级保健中测试嗅觉以检测阿尔茨海默病和其他痴呆症 (TOPAD)

• 批准号: 10192624
• 负责人: DAVANGERE P DEVANAND
• 金额: $ 75.02万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-30 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10192624
• 关键词: Address; Advisory Committees; Age; Alzheimer' s Disease; Alzheimer' s disease diagnosis; Area Under Curve; Biological Markers; Biological Specimen Banks; Blood Tests; Brain imaging; Cerebrospinal Fluid; Cognitive; Communities; Dementia; Detection; Diagnosis; Diagnostic; Early Diagnosis; Elderly; Ensure; Evaluation; Family health status; Genomics; Goals; Gold; Health Personnel; Healthcare Systems; Impaired cognition; Impairment; Memory impairment; National Institute on Aging; Nerve Degeneration; Odors; Participant; Pathway interactions; Patients; Pennsylvania; Performance; Persons; Practice Guidelines; Preventive service; Primary Health Care; Proteomics; Protocols documentation; Provider; Receiver Operating Characteristics; Recommendation; Research; Resources; Screening procedure; Smell Perception; Standardization; Testing; Time; United States; Universities; Update; accurate diagnosis; aged; amnestic mild cognitive impairment; base; blood-based biomarker; cognitive testing; community setting; data repository; improved; instrument; mental state; metabolomics; mild cognitive impairment; minimally invasive; multidisciplinary; novel strategies; olfactory bulb; primary care setting; primary outcome; response; screening; secondary analysis; secondary outcome; tool

The goal of our project, called “Testing Olfaction in Primary care to detect Alzheimer’s disease and other Dementias (TOPAD)”, is to test the 12-item BSIT, a short, standardized version of the 40-item University of Pennsylvania Smell Identification Test (UPSIT), for detection of dementia among elderly persons with cognitive concerns in a community-based primary care setting, in response to PAR-15-359 (Novel Approaches to Diagnosing Alzheimer’s Disease and Predicting Progression), and its second aim: “Identifying new biomarkers that are minimally invasive, inexpensive, usable in community settings”. Many elderly persons develop dementia that remains undiagnosed in primary care settings until it is severe, leading to catastrophic consequences for patients, families, and the health care system. Odor identification impairment with the 40-item UPSIT is a well- validated biomarker of dementia, particularly dementia of the Alzheimer’s type (DAT), The shorter version of the UPSIT, the 12-item BSIT, has been shown to be similar to the UPSIT in distinguishing and predicting MCI and DAT. We propose the BSIT for detection of dementia in primary care because it takes 5 minutes to administer, is inexpensive, and can be administered by non-medical personnel. We propose to test the BSIT for detection of dementia among 600 patients with cognitive concerns, without a diagnosis of dementia, age 65 years and older, who attend primary care practices in Northern Manhattan. The term cognitive concerns includes subjective cognitive decline (SCD), and warning signs identified by relatives, significant others, and health care providers. All participants will be tested with the BSIT, the MMSE, and other common dementia screening tools. The performance of tools will be assessed using as a gold standard cognitive diagnosis based using the 2011 National Institute on Aging (NIA)/Alzheimer Association (AA) recommendations for dementia and MCI using the National Alzheimer’s Coordinating Center (NACC) protocol. Our primary outcome will be dementia diagnosis at the initial evaluation. Cognitive assessments will be repeated every 12 months. Our secondary outcomes will be cognitive transitions to dementia (and subtypes), MCI and MCI subtypes. Our primary aim is to compare the accuracy of the BSIT with the MMSE for dementia detection at initial evaluation among persons aged 65 years and older with cognitive concerns in primary care. In secondary analyses, we will examine the secondary outcomes and compare the accuracy of the BSIT for dementia detection with other instruments: Montreal Cognitive Assessment (MOCA), Mini-Cog and Memory Impairment Screen (MIS). Our secondary aim is to compare the BSIT with the MMSE in predicting cognitive transitions at 12 and 24 months. In secondary analyses, we will compare the BSIT with other screening instruments (MOCA, Mini-Cog, MIS). TOPAD will be conducted by a multidisciplinary team of experts in Alzheimer’s research, odor identification testing, dementia diagnosis, and primary care.

我们项目的目标是，在初级保健中测试嗅觉，以检测阿尔茨海默氏症和其他疾病 痴呆症(TOPAD)“，是为了测试12个条目的BSIT，这是40个条目的大学的简短标准化版本 宾夕法尼亚州气味识别测试(UPSIT)，用于检测认知障碍老年人的痴呆症 针对PAR-15-359的要求，在以社区为基础的初级保健环境中关注的问题(新方法 诊断阿尔茨海默病和预测病情进展)，以及它的第二个目标：确定新的生物标记物 它们具有微创、廉价、可在社区环境中使用的特点。许多老年人患上了痴呆症 在初级保健环境中仍未得到诊断，直到病情严重，导致灾难性后果 病人、家庭和医疗保健系统。40件UPSIT的气味识别损害是一个很好的- 经过验证的痴呆症生物标志物，特别是阿尔茨海默氏型痴呆(DAT)，是 UPSIT是由12个项目组成的BSIT，已被证明在区分和预测MCI和 达特。我们建议BSIT用于初级保健中痴呆症的检测，因为它需要5分钟的时间来管理， 价格低廉，可以由非医务人员管理。我们建议测试BSIT以进行检测 在600名有认知障碍、未被诊断为痴呆症的患者中，年龄在65岁和 老年人，他们在曼哈顿北部参加初级保健诊所。认知关注点这个术语包括主观的 认知衰退(SCD)，以及由亲属、重要的其他人和医疗保健提供者识别的警告信号。 所有参与者都将接受BSIT、MMSE和其他常见痴呆症筛查工具的测试。这个 工具的性能将使用作为黄金标准的认知诊断进行评估 国家老龄研究所(NIA)/阿尔茨海默病协会(AA)使用 国家阿尔茨海默氏症协调中心(NACC)方案。我们的主要结果将是痴呆症的诊断 初步评估。认知评估将每12个月重复一次。我们的次要成果将是 认知转变为痴呆症(和亚型)、MCI和MCI亚型。我们的主要目标是比较 BSIT和MMSE在65岁人群初步评估中检测痴呆的准确性 在初级保健中有认知问题的老年人。在二次分析中，我们将研究二次分析 结果并比较BSIT与其他仪器检测痴呆症的准确性：蒙特利尔 认知评估(MOCA)、迷你-Cog和记忆障碍筛查(MIS)。我们的次要目标是 比较BSIT和MMSE在预测12个月和24个月认知转变方面的差异。在二次分析中， 我们将BSIT与其他筛查工具(MOCA、Mini-Cog、MIS)进行比较。将进行TOPAD 由阿尔茨海默氏症研究、气味识别测试、痴呆症诊断、 和初级保健。