Delaying Cognitive Decline in Alzheimer's Disease

描述（由申请人提供）：本研究的目的是延迟阿尔茨海默病（AD）患者的单词查找问题的进展。试图恢复AD中已经开始下降的自相矛盾的是，AD患者-根据定义-在外显记忆中有障碍，使新的学习成为问题。目前的方法是新颖的，因为它试图加强尚未失去的连接，使它们随着疾病的进展而更能抵抗损失。这项研究利用了这一发现，即AD患者通过加强物体与其书面名称之间的联系，在疾病过程中继续阅读单词。虽然这项研究针对的是单词查找问题，但成功的结果对其他旨在预防而不是逆转痴呆症认知功能下降的研究来说是个好兆头。轻度认知障碍（MCI）和轻度AD患者的图片命名能力刚刚开始出现下降的迹象，他们将在两种情况下练习命名图片。在一种情况下，他们会看到图片，并重复他们的名字;在另一种情况下，他们会看到他们写的名字的图片，然后阅读和抄写的名字。在训练后的三个时间间隔，将在这些条件中的每一个中训练的图片的命名与在研究之前测试但从未训练的图片的命名进行比较。据预测，图片与其书面名称的配对，结合转录名称的运动任务，将导致在以后的日期命名图片的能力比简单的实践观看图片和重复的名称。这种更好地保存命名能力的新范例，上下文和任务的推广，也预测。在AD的早期阶段，当患者仍然生活在家中并在正常的家庭环境中运作时，正常生活的最大挑战之一是部分由于无法获得适当的词语而导致的沟通困难。成功延迟这种单词查找问题-拟议研究的目标-将对早期AD患者及其家人和护理人员的生活质量产生重大影响。

DESCRIPTION (provided by applicant): The goal of this study is to delay the progression of word-finding problems in patients with Alzheimer's Disease (AD). The paradox of attempting to restore that which has begun to decline in AD is that patients with AD - by definition - have impairments in explicit memory, making new learning problematic. The current approach is novel in that it attempts to strengthen connections that have not yet been lost, making them more resistant to loss as the disease progresses. This study capitalizes on the finding that patients with AD continue to read words well into the course of the disease by strengthening the connections between objects and their written names. While the study is specific in its targeting of word-finding problems, a successful outcome would bode well for other studies aimed at prevention, rather than reversal, of declining cognitive functions in dementia. Patients with mild cognitive impairment (MCI) and mild AD whose naming of pictures has just begun to show signs of decline will practice naming pictures in two conditions. In one condition, they will view the pictures and repeat their names; in the other condition they will view the pictures with their written names, then read and transcribe the names. Naming of pictures trained in each of these conditions will be compared, at three time intervals post-training, with naming of pictures tested before the study but never trained. It is predicted that the pairing of the picture with its written name, combined with the motor task of transcribing the name, will result in a greater ability to name the picture at a later date than simple practice viewing the picture and repeating the name. Generalization of this better preserved naming ability to novel exemplars, contexts and tasks, is also predicted. PUBLIC HEALTH RELEVANCE During the early stages of AD, when patients are still living at home and functioning within the normal family setting, one of the greatest challenges to normal living is difficulty communicating caused in part by the inability to access the appropriate words. The successful delay of such word finding problems - the goal of the proposed study - would have significant consequences for the quality of life of patients with early AD, and for their families and caregivers.