ETHNICITY & PREDICTORS OF FUNCTIONAL DECLINE IN DEMENTIA

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Alzheimer's Disease (AD) remains a relentlessly progressive disorder with therapy restricted to management of the patient, alleviation of family distress and the treatment of comorbid psychiatric and medical disease. Therapy at any stage of AD is aimed at achieving improvements in or optimizing the patient's functional ability. Since the rate and type of functional deterioration among AD patients is quite variable, the patient and family often are unable to establish realistic expectations and can not adequately plan for the future. Data from our laboratories indicate that factors such as ethnicity and specific constellations of neuropsychological deficits observed at baseline may be useful in predicting certain patterns of functional decline longitudinally. This is of potential importance since any method that allows for the prediction of subsequent functional deterioration in the early stages of AD would assist in planning effective psychosocial interventions. The proposed study Will investigate the extent to which initial patterns of cognitive/neuropsychological test performance among Hispanic and Non-Hispanic Alzheimer's Disease (AD) patients can be used to predict different patterns and rates of functional deterioration over time. Employment of a comprehensive cognitive/neuropsychological battery, will enable us to examine the extent to which impairment in specific neuropsychological domains (i.e. memory, attention, language, visuoperceptive abilities/praxis, and higher-order problem-solving abilities) predicts observed functional competence and the course of deterioration within different functional domains. Factors such as comorbid medical and psychiatric disease and demographic variables as they relate to the prediction of functional deterioration will also be examined. A unique aspect of this study is that traditional functional assessment instruments which yield global scores, will be supplemented by an extensive battery of measures which provide direct assessment of a wide array of different functional capacities within the clinical setting. This investigation represents the first attempt to delineate specific cognitive/neuropsychological processes and other factors which may mediate and predict deleterious functional deterioration within both Hispanic and Non-Hispanic populations. Further, the data obtained in the present investigation has the potential to provide useful information that will lead to the development of early psychosocial interventions as well as specific approaches to management.