Predicting dementia with practice effects

描述（由申请人提供）：这份经修订的指导患者导向研究职业发展奖（K23）申请是为了支持Kevin Duff博士进一步开发一种新的认知指数（即练习效果）所需的培训和研究活动，该指数可以帮助预测轻度认知障碍（MCI）的结果。虽然MCI的概念促进了我们对正常衰老和痴呆之间过渡的理解，但它仍然是一个不完美的启发式，以确定哪些患者会发展为痴呆，哪些不会。目前的研究计划将检查练习效果和认知结果之间是否存在反比关系，因此缺乏练习效果会增加遗忘性MCI患者在2年内转化为痴呆的风险；相反，强健的锻炼效果与痴呆症风险的降低有关。具体而言，本研究计划将解决以下研究目标：1)确定练习效果是否预测MCI中痴呆症的转化，以及2)检查练习效果的各种调节因子，并了解它们如何影响转化率。这份申请中详细的培训计划提供了一个多学科项目，利用爱荷华大学的各种可用资源和国家研究人员在记忆障碍方面的专业知识。作为一名神经心理学家，Duff博士设定了以下培训目标：1)发展必要的技能，以进一步发展作为认知衰退预测者的实践效果；2)获得追踪MCI认知衰退和诊断痴呆的额外专业知识；3)获得识别MCI到痴呆转换调节因子的知识；4)扩展回答这些问题所需的统计技术知识。此外，将提供进行伦理研究和拨款写作方面的培训。培训和拟议的项目将为Duffs博士的长期科学目标奠定基础，该目标是创建一个独立的、外部资助的研究项目，研究正常衰老、轻度认知障碍和痴呆的疾病进展标志物。识别从正常衰老到轻度认知障碍再到痴呆的早期标志显然符合国家衰老研究所的使命，因为它提供了更多关于衰老和衰老相关疾病的知识。此外，早期认知障碍的识别可能具有深远的公共卫生意义，因为这些疾病的不准确或延迟识别会导致错过治疗和医疗、法律和计划生育的机会。最后，一种简短、无创、成本有效的疾病进展标记物的可用性将允许更有效和更好地支持临床试验。

DESCRIPTION (provided by applicant): This revised Mentored Patient-Oriented Research Career Development Award ,(K23) application is a request to support the training and research activities necessary for Kevin Duff, Ph.D. to further develop a novel cognitive index (i.e., practice effects), which could assist in the prediction of outcomes in Mild Cognitive Impairment (MCI). Although the concept of MCI has' advanced our understanding of the transition between normal aging and dementia, it remains an imperfect heuristic for identifying which patients will progress to dementia, and which will not.The current research proposal will examine if there is an inverse relationship between practice effects and cognitive outcome, so that an absence of practice effects increases the risk for conversion to dementia in amnestic MCI across 2 years; and, conversely, robust practice effects are associated with a decreased risk for dementia. Specifically, this research plan will address the following research aims: 1) determine if practice effects predict conversion to dementia in MCI, and 2) examine a variety of moderators of practice effects, and see how they affect conversion rates. The training plan detailed in this application offers a multidisciplinary program capitalizing on the diverse resources available at the University of Iowa and on the expertise of national researchers in memory disorders. As a neuropsychologist, Dr. Duff has set the following training goals: 1) develop skills necessary to further develop practice effects as a predictor of cognitive decline, 2) gain additional expertise in tracking cognitive decline in MCI and diagnosing dementia, 3) gain knowledge in identifying moderators of MCI to dementia conversion, and 4) expand knowledge of statistical techniques necessary for answering these questions. Additionally, training will be provided in conducting ethical research and grant writing. The training and proposed project will lay the foundation for Dr. Duffs long-term scientific goal of creating an independent and externally-funded program of research on examining markers of disease progression in normal aging, MCI, and dementia. Identifying early markers of progression from normal aging to MCI to dementia clearly fits with the mission of the National Institute on Aging, in that, it provides greater knowledge about aging and aging- related diseases. Additionally, identification of early cognitive disorders can have profound public health significance with inaccurate or delayed identification of these disorders leading to missed opportunities for treatment and medical, legal, and family planning. Finally, the availability of a brief, non-invasive, and cost effective marker of disease progression would allow for more efficient and better powered clinical trials.