Delaying Cognitive Decline in Alzheimer's Disease

描述（由申请人提供）：本研究的目的是延缓阿尔茨海默病（AD）患者发现单词问题的进展。试图恢复已经开始衰退的阿尔茨海默氏症的矛盾之处在于，阿尔茨海默氏症患者——根据定义——外显记忆受损，使新学习成为问题。目前的方法是新颖的，因为它试图加强尚未丢失的连接，使它们在疾病进展时更能抵抗丢失。这项研究利用了一项发现，即阿尔茨海默病患者通过加强物体与其书面名称之间的联系，在疾病过程中继续很好地阅读单词。虽然这项研究是专门针对找字问题的，但一个成功的结果将预示着其他旨在预防而不是逆转痴呆症患者认知功能下降的研究。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，他们将观看照片并重复自己的名字；在另一种情况下，他们将看到写有自己名字的图片，然后阅读并抄写这些名字。在这些条件下训练的图片命名将在训练后的三个时间间隔内与研究前测试但从未训练过的图片命名进行比较。据预测，将图片与文字名称配对，再加上抄写图片名称的动作任务，将比简单地练习观看图片并重复图片名称更能提高日后为图片命名的能力。这种更好地保留命名能力的推广到新的例子，上下文和任务，也预测。在阿尔茨海默病的早期阶段，当患者仍然住在家里并在正常的家庭环境中运作时，正常生活面临的最大挑战之一是沟通困难，部分原因是无法使用适当的词语。这项研究的目标是成功地延缓这种发现单词的问题，这将对早期AD患者的生活质量以及他们的家人和照顾者产生重大影响。

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.