Subjective Cognitive Decline in OIder Adults

随着人口的不断老龄化，阿尔茨海默病（AD）和AD相关痴呆的发病率 （ADRD）正在急剧增加，导致迫切需要识别有风险的老年人。有效的早期 识别将发生在疾病的临床前阶段，在临床上明显的症状发作之前。 主观认知下降（SCD）可以代表临床前和早期疾病状态，在临床试验中很容易捕获。 临床和研究环境。SCD由多种病理途径驱动，包括AD， 神经变性和脑小血管疾病，所有这些都是临床痴呆的基础。神经精神 症状也会导致SCD，并代表早期症状和痴呆风险。当前SCD 评估方法缺乏区分SCD潜在病因的特异性。工具开发具有 重点是问题的内容，而不是确定与具体的基本问题有关的问题。 贡献者。此外，存在最少的调查了解这些机制的相互作用， SCD的存在。迄今为止，大多数研究都集中在SCD与一种单一的病理性疾病的关系上。 过程这些评估定义和工具开发的方法限制了SCD的特异性。本研究 将利用范德比尔特记忆与衰老项目的遗留数据，这是一项纵向研究， 认知未受损且SCD最小的个体。为了补充这一群体， 扩大范围的SCD和神经精神症状，这项建议将招募一个前瞻性的纵向 一组认知未受损的老年人，患有一系列SCD。参与者将接受详细的 认知、神经影像学和腰椎穿刺评估，以获取多个临床和病理 标记。利用这些丰富的信息，该研究将改变SCD项目的选择方式和使用功能 选择方法将确定与每个SCD贡献者相关的问题，以创建SCD贡献者的配置文件。 将检查这些特征的修饰因素，包括年龄、性别和伴随病理。提供 这些新的SCD谱将增强这种成本有效且易于测量的早期疾病的效用 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.