Detect: A novel device to assess how HIV affects neurocognitive decline and postural instability in older adults at risk for Alzheimer's Disease
检测:一种新型装置,用于评估艾滋病毒如何影响有阿尔茨海默病风险的老年人的神经认知衰退和姿势不稳定
基本信息
- 批准号:10538617
- 负责人:
- 金额:$ 78.31万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-02-15 至 2024-11-30
- 项目状态:已结题
- 来源:
- 关键词:3D virtual realityAccelerationAcquired Immunodeficiency SyndromeAdoptionAdultAffectAgeAgingAlzheimer&aposs DiseaseAlzheimer&aposs disease riskAssessment toolCaliforniaClassificationClinicClinicalCognitionCognitiveDataDedicationsDementiaDetectionDevicesDiagnosisEarly DiagnosisElderlyEnvironmentEpidemicEquilibriumEvaluationFrequenciesFrightFutureGeneral PopulationGeriatric AssessmentGoalsHIVHIV-associated neurocognitive disorderHIV/AIDSHearing problemHomeHome environmentImpaired cognitionImpairmentIndividualInstitutionInvestigationLiteratureLongitudinal StudiesMeasuresMemoryMethodsMonitorMotorMusculoskeletal EquilibriumNeurocognitive DeficitNeuropsychologyParticipantPathway interactionsPatientsPatternPerformancePersonsPopulationPopulations at RiskPostureProspective StudiesReaction TimeResearchResearch DesignResourcesRiskRisk FactorsScreening procedureSelf AdministrationSensorySignal TransductionSiteSystemTechniquesTestingTimeTraumatic Brain InjuryTriageUniversitiesWorkacceptability and feasibilityaccurate diagnosisamnestic mild cognitive impairmentauditory processingclinical careclinical phenotypeclinical practicecognitive changecognitive functioncognitive testingcohortdesigndiagnostic strategydigital healthepidemiology studyexperiencefrailtygeriatric neuroHIVhearing impairmentimprovedindividual patientmemory recallmemory recognitionmild cognitive impairmentmotor deficitmultimodalityneuroAIDSneurobehavioralnovelportabilityposture instabilityprimary care settingprogramsprogression riskresponsescreeningsensory integrationtoolvirtualvirtual reality
项目摘要
Project Summary/Abstract
This application is in response to the NIA’s Strategic Directions Goal D-3, which calls for better tools to assess
cognitive function in the clinic, primary care setting, and home environment in order to distinguish persons at risk
for developing Alzheimer’s disease (AD) from persons not at risk. Persons living with HIV (PLHIV) are now living
well into the age demographic in which they are at increasing risk for developing AD. Because up to 50% of
PLHIV experience cognitive impairment from HIV or related factors that often include memory problems, AD may
go unidentified in a significant proportion of older PLHIV. There is a pressing need in geriatric neuroHIV for the
ability to accurately identify and disentangle HIV- and AD-associated cognitive impairment and predict individuals
who are at risk for further cognitive decline. Evidence from epidemiological studies suggests that sensory (e.g.,
auditory processing) and motor (e.g., balance) impairments are observed more frequently in PLHIV compared
to the general population of a similar age and that these impairment may impact the progression of cognitive
impairment in PLHIV and in AD. Building on substantial evidence demonstrating that virtual reality is widely
accepted among older adults, we propose to use a novel and portable 3-D virtual reality automated tool, called
DETECT, to accurately measure cognition decline and changes in postural stability over time in older PLHIV with
and without amnestic mild cognitive impairment (aMCI), a precursor to AD. DETECT was developed for rapid
and brief cognitive testing in diverse settings, such as busy geriatric HIV clinics or the home, and can accurately
discriminate between normal cognition, MCI, and dementia. Additionally, our pilot work indicates that DETECT
is a sensitive screening tool for differentiating between normal cognition and HIV-associated neurocognitive
disorder (HAND) in PLHIV. The system is also accurate for diagnosing postural instability using a novel technique
that obviates the need for standing and ambulation. To expand on this work, we propose a two site (UCSD and
Emory) prospective study of 120 older individuals representing three different clinical phenotypes: PLHIV with
HAND and aMCI (HAND+/aMCI+), PLHIV with HAND but without aMCI (HAND+/aMCI-), and HIV-uninfected
persons with aMCI (HIV-/aMCI+). An empirically-based neuropsychological diagnostic approach will be used to
identify aMCI among PLHIV. We will use DETECT to: (Aim 1) compare the determinants of cognitive decline in
these groups, and (Aims 2 and 3) understand how non-cognitive functional changes such as postural instability,
hearing loss, and central auditory processing dynamically influence cognitive decline in these groups. Our
longitudinal study design will allow us to better understand how cognitive change differs over time between these
groups of individuals. The long-term goal of this work is to bring rapid, accurate tools that can identify those at
increased risk for progression to AD dementia into clinical practice. The eventual adoption of such tools into
clinical practice could provide clarity to patients and clinicians, alleviate fears among PLHIV who do not have
aMCI, improve efficiency, and guide the triage of individual patients into specific treatment pathways.
项目总结/摘要
此应用程序是为了响应NIA的战略方向目标D-3,该目标要求更好的工具来评估
在临床、初级保健环境和家庭环境中的认知功能,以区分风险人群
从没有风险的人发展阿尔茨海默病(AD)。艾滋病毒感染者目前生活在
进入他们患AD的风险越来越高的年龄段。因为高达50%的
艾滋病毒感染者经历艾滋病毒或相关因素造成的认知障碍,通常包括记忆问题,AD可能
在老年艾滋病毒感染者中有很大一部分未被发现。老年神经HIV迫切需要
准确识别和区分HIV和AD相关认知障碍并预测个体的能力
有进一步认知能力下降的风险。流行病学研究的证据表明,感官(例如,
听觉处理)和运动(例如,平衡)受损在PLHIV中更常见,
这些损害可能会影响认知功能障碍的进展,
在艾滋病病毒感染者和AD中的损伤。基于大量证据表明,虚拟现实广泛应用于
我们建议使用一种新颖的便携式3D虚拟现实自动化工具,称为
DETECT,以准确测量认知能力下降和姿势稳定性随时间的变化,在老年PLHIV患者中,
并且没有遗忘型轻度认知障碍(aMCI),这是AD的前兆。DETECT是为快速
在不同的环境中,如忙碌的老年艾滋病诊所或家庭,
区分正常认知MCI和痴呆此外,我们的试点工作表明,
是区分正常认知和HIV相关神经认知的敏感筛查工具
艾滋病病毒感染者的手(HAND)该系统也是准确的诊断姿势不稳定使用一种新技术
这样就不需要站着和蹲着了。为了扩大这项工作,我们提出了两个网站(UCSD和
Emory)前瞻性研究,120名老年人代表三种不同的临床表型:
HAND和aMCI(HAND+/aMCI+)、伴HAND但不伴aMCI的PLHIV(HAND+/aMCI-)和HIV未感染者
aMCI患者(HIV-/aMCI+)。一种基于神经心理学的诊断方法将被用于
在艾滋病毒感染者中识别aMCI。我们将使用DETECT来:(目的1)比较认知能力下降的决定因素,
这些群体,和(目标2和3)了解如何非认知功能的变化,如姿势不稳定,
听力损失和中枢听觉处理动态地影响这些群体的认知能力下降。我们
纵向研究设计将使我们能够更好地了解认知变化如何随着时间的推移而变化,
个人群体。这项工作的长期目标是带来快速,准确的工具,可以识别那些在
临床实践中进展为AD痴呆的风险增加。这些工具的最终应用,
临床实践可以为患者和临床医生提供清晰的信息,减轻那些没有感染艾滋病毒的人的恐惧。
aMCI,提高效率,并指导个体患者的分诊进入特定的治疗途径。
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
CROI 2021: Neurologic Complications of HIV-1 Infection or COVID-19.
CROI 2021:HIV-1 感染或 COVID-19 的神经系统并发症。
- DOI:
- 发表时间:2021
- 期刊:
- 影响因子:0
- 作者:Ances,BeauM;Anderson,AlbertM;Letendre,ScottL
- 通讯作者:Letendre,ScottL
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Raeanne Cristine Moore其他文献
Raeanne Cristine Moore的其他文献
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{{ truncateString('Raeanne Cristine Moore', 18)}}的其他基金
Cyclical Alterations In Neurocognitive Performance And Mood Over Two Years In Relation To Pesticide Spray Seasons Among Adolescent And Young Adult Participants Of The Espina Study.
Espina 研究的青少年和年轻人参与者两年内与农药喷洒季节相关的神经认知表现和情绪的周期性变化。
- 批准号:
10367408 - 财政年份:2016
- 资助金额:
$ 78.31万 - 项目类别:
Cyclical Alterations In Neurocognitive Performance And Mood Over Two Years In Relation To Pesticide Spray Seasons Among Adolescent And Young Adult Participants Of The Espina Study.
Espina 研究的青少年和年轻人参与者两年内与农药喷洒季节相关的神经认知表现和情绪的周期性变化。
- 批准号:
10624787 - 财政年份:2016
- 资助金额:
$ 78.31万 - 项目类别:
Real-Time Mobile Assessment of Daily Functioning Among Older HIV-Infected Adults
老年艾滋病毒感染者日常功能的实时移动评估
- 批准号:
9063795 - 财政年份:2015
- 资助金额:
$ 78.31万 - 项目类别:
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