Validation of the DCTclock drawing task as a cognitive screening tool for prodromal Alzheimers disease in the Framingham Heart Study

抽象的。疑似阿尔茨海默病(AD)的诊断传统上依赖于液体生物标志物 和神经成像。然而，这些检查通常是侵入性的，费用昂贵，而且通常只有专科医生才能使用 诊所。用于筛查痴呆症的常见神经心理测试(例如，简易精神状态检查)有 不够敏感，不能检测到可以预测前驱AD出现的早期认知变化。这个 DCTclockTM是FDA批准的数字神经心理测试，有可能部署在初级保健中 和临床试验研究作为检测早期阶段的非侵入性和成本效益的筛查工具 公元一代的。DCTclockTM可以由任何医疗保健专业人员轻松管理，并使用最先进的 方法捕捉细微差别的神经心理行为。初步研究表明，DCTclockTM具有较高的 神经影像对皮质淀粉样蛋白沉积和顶叶低代谢的敏感性，提示 它可以作为更具侵入性或成本更高的生物标记物检测的替代品。该项目将验证 来自弗雷明翰心脏研究(FHS)的大样本老年人的DCTclockTM，使用横断面 和纵向方法，目标是确定：(1)DCT时钟区分轻度 相对于现有认知筛查措施的正常老龄化的认知障碍(MCI)，(2)ITS 阿尔茨海默病的遗传生物标记物与包括MRI指标在内的阿尔茨海默病病理神经影像指标的相关性 以及正电子发射计算机断层扫描上的脑A？水平。DCTclockTM绘图数据自2011年以来一直在FHS中收集，从 超过1600名没有痴呆症的老年人，使其成为这项验证性研究的理想数据库。

Abstract. The diagnosis of probable Alzheimer’s disease (AD) has traditionally depended on fluid biomarkers and neuroimaging. However, these tests are often invasive, expensive, and generally available only in specialty clinics. Common neuropsychological tests used to screen for dementia (e.g., Mini-Mental State Examination) are not sensitive enough to detect early cognitive changes that can predict the emergence of prodromal AD. The DCTclockTM is an FDA approved digital neuropsychological test with the potential to be deployed in primary care and clinical trials research as a non-invasive and cost-effective screening tool for detecting the earliest stages of AD. The DCTclockTM can be easily administered by any healthcare professional and uses cutting-edge methods to capture nuanced neuropsychological behavior. Initial studies suggest that the DCTclockTM has high sensitivity to predict cortical amyloid (Aß) deposition and parietal hypometabolism on neuroimaging, suggesting that it could serve as a surrogate for more invasive or costly biomarker testing. This project will validate the DCTclockTM in a large sample of older adults from the Framingham Heart Study (FHS), using cross sectional and longitudinal approaches with the goals of determining: (1) the DCTclock’s ability to distinguishing mild cognitive impairment (MCI) from normal aging relative to existing cognitive screening measures, (2) its associations with genetic biomarkers of AD and neuroimaging measures of AD pathology, including MRI metrics and brain Aß levels on a PET scan. DCTclockTM drawing data has been collected in the FHS since 2011 from over 1,600 older adults without dementia, making it an ideal database for this validation study.