Subjective Cognitive Decline in OIder Adults

随着人口继续老龄化，阿尔茨海默病(AD)和AD相关痴呆的发病率 (ADRD)急剧增加，因此迫切需要识别高危老年人。提早生效 鉴定将在疾病的临床前阶段进行，即在临床明显症状出现之前。 主观认知下降(SCD)可以代表临床前和早期的疾病状态，很容易在 临床和研究环境。SCD由多种病理途径驱动，包括AD、 神经退行性变和大脑小血管疾病，所有这些都是临床痴呆的基础。神经精神病学 症状也会导致SCD，并代表早期症状和痴呆症的风险。当前SCD 评估方法缺乏特异性来梳理SCD的潜在病因。工具开发有 专注于问题的内容，而不是确定与特定潜在问题相关的问题 贡献者。此外，只有极少的调查了解这些机制对 SCD的存在。到目前为止，大多数研究都集中在SCD与一种单一病理疾病的关系上。 进程。这些评估定义和工具开发的方法限制了SCD的特殊性。本研究 将利用Vanderbilt Memory&Aging Project的遗留数据，该项目是一项纵向研究，包含 认知未受损且SCD程度最低的个体。为了补充这一群体， 扩大SCD和神经精神症状的范围，这项提案将纳入预期的纵向 一组认知正常的老年人，患有一系列SCD。参与者将经历详细的 评估认知、神经影像和腰椎穿刺术以捕捉多个临床和病理 记号笔。利用这些丰富的信息，研究将改变SCD项目的选择和使用功能的方式 选择方法将确定与每个SCD贡献者相关的问题，以创建该SCD的配置文件。 这些特征的修饰者将被检查，包括年龄、性别和伴随的病理。交付的是 这些新颖的SCD图谱将增强这种具有成本效益且易于测量的早期疾病的实用性 临床医生和研究人员可以轻松实现的标记。

As the population continues to age, the incidence of Alzheimer’s disease (AD) and AD-related dementias (ADRD) is dramatically increasing, resulting in an urgent need to identify at-risk older adults. Effective early identification will occur during the preclinical stages of disease, before the onset of clinically overt symptoms. Subjective cognitive decline (SCD) can represent a preclinical and early disease state that is easily captured in clinical and research settings. SCD is driven by multiple pathological pathways, including AD, neurodegeneration, and cerebral small vessel disease, all of which underlie clinical dementia. Neuropsychiatric symptoms also contribute to SCD and represent early symptoms and a risk for dementia. Current SCD assessment methods lack the specificity to tease apart the underlying etiology of SCD. Tool development has focused on the content of the questions, rather than identifying questions that relate to specific underlying contributors. Additionally, minimal investigation exists understanding the interplay of these mechanisms on the presence of SCD. The majority of research has thus far focused on SCD in relation to a singular pathological process. These approaches to assess definition and tool development limit the specificity of SCD. This study will leverage legacy data from the Vanderbilt Memory & Aging Project, a longitudinal study with a subset of individuals who are cognitively unimpaired and have minimal SCD. To supplement this cohort with an expanded range of SCD and neuropsychiatric symptoms, this proposal will enroll a prospective longitudinal cohort of cognitively unimpaired older adults with a range of SCD. Participants will undergo detailed assessments of cognition, neuroimaging, and lumbar puncture to capture multiple clinical and pathological markers. Leveraging this rich information, the study will shift how SCD items are selected and using feature selection methods will identify questions that relate to each SCD contributor to create profiles that SCD. Modifiers of these profiles will be examined, including age, sex, and concomitant pathologies. The delivery of these novel SCD profiles will enhance the utility of this cost effective and easily measurable early disease marker that can be easily implemented by clinicians and researchers.