Cognitive Complaints in Aging Adults

随着人口继续老龄化，痴呆症和阿尔茨海默病(AD)的发病率急剧上升 增加，导致迫切需要识别那些面临不健康脑老化风险的老年人和 痴呆症。轻度认知障碍(MCI)是公认的AD的前驱阶段。因为有那么多 60%的MCI患者在三年内转变为AD，MCI的早期识别正在成为 变得越来越重要。不幸的是，估计显示至少有一半的MCI患者 在社区中未确诊。初级保健水平的许多障碍与诊断不足有关 MCI，包括没有足够的时间评估认知，以及缺乏有效的筛查工具用于 初级保健。为了克服这些障碍，目前的研究将检查认知投诉的性质 在社区内，以社区为基础制定有效可靠的认知投诉测量方法 上了年纪的人。拟议研究提供的信息将提供一个具有成本效益和时间效益的工具，以帮助 为需要更全面记忆工作的初级保健患者做出评估和转介决定- 向上。使用病例对照队列，我们将验证一组可靠地测量认知投诉的问题 就鉴别诊断和客观认知表现而言，神经解剖学 变化和生物标记物水平。有指导的培训活动将侧重于潜变量建模， 衰老研究中的神经成像原理，社区内心理工具的临床应用， 和职业发展。拟议的研究和培训将利用跨学科团队 (包括神经心理学、老年病学、神经病学、神经放射学和生物统计学)以及资源 与范德比尔特大学成像研究所范德比尔特记忆和阿尔茨海默氏症中心有关 科学，范德比尔特大学生物统计学系，以实现概述的目标。

As the population continues to age, the incidence of dementia and Alzheimer's disease (AD) is dramatically increasing, resulting in an urgent need to identify those older adults at risk for unhealthy brain aging and dementia. Mild cognitive impairment (MCI) is a well-accepted prodromal phase of AD. Because as many as 60% of individuals with MCI convert to AD within a three-year period, early identification of MCI is becoming increasingly important. Unfortunately, estimates suggest that at least half of individuals with MCI go undiagnosed in the community. Many barriers at the primary care level are associated with under-diagnosis of MCI, including insufficient time to assess cognition and lack of efficient screening tools available for use in primary care. To overcome these barriers, the current study will examine the nature of cognitive complaints within the community in order to develop a valid and reliable cognitive complaint measure for community-based older adults. Information from the proposed study will provide a cost-effective and time-efficient tool to aid in assessment and referral decisions for primary care patients in need of a more comprehensive memory work- up. Using a case-control cohort, we will validate a set of questions that reliably measure cognitive complaint with respect to differential diagnosis and in relation to objective cognitive performance, neuroanatomical changes, and biomarker levels. Mentored training activities will focus on latent variable modeling, neuroimaging principles in aging research, clinical implementation of psychological tools within the community, and professional development. The proposed study and training will leverage an interdisciplinary team (including neuropsychology, geriatrics, neurology, neuroradiology, and biostatistics) as well as resources associated with the Vanderbilt Memory & Alzheimer's Center, the Vanderbilt University Institute of Imaging Science, and the Vanderbilt University Department of Biostatistics to fulfill the aims outlined.