Predictors of Functional Ability in MCI

描述（由申请人提供）：正在做出相当大的努力来检测痴呆症（特别是阿尔茨海默病）的早期阶段。轻度认知障碍（MCI）被描述为正常衰老和痴呆之间的中间阶段。这种疾病的诊断标准目前还没有很好的定义，在过去的十年中已经重新定义。MCI定义的两个主要变化是纳入了轻度日常活动， 生活（ADL）障碍（不干扰工作和开展生活活动的能力）和MCI亚型（遗忘型和多领域MCI）。日常功能障碍的类型和程度还不清楚，如果我们要找到更好的诊断标准和早期治疗MCI，这种损害的预测因素需要进一步研究。生物医学标志物，如脑区萎缩，在MCI和痴呆的早期阶段的检测受到了广泛的关注。然而，这些生物标志物单独提供有限的临床效用。目前的项目有三个主要目标：1）检查MCI不同亚型的功能下降率（例如，遗忘-MCI，多域MCI）在4年的时间内使用基于观察的ADL任务。此外，为了检查每个ADL子任务如何最好地预测不同MCI亚型中从MCI到痴呆的转化，2）检查生物标志物和特定类型的ADL损伤之间的关系，以及3）确定最佳预测因子（即，在基线和MCI患者中随时间推移的ADL功能障碍的生物标志物或神经心理学表现）。总共有55名MCI参与者将从阿尔茨海默病研究中心（ADRC）入组本研究，并将接受总共4年的随访。所有参与者都已经完成了神经心理学测试，并将在ADRC接受神经成像。参与者将接受基于观察的ADL任务。将检查特定CNS生物标志物与日常功能能力之间的关系。还将分析CNS生物标志物测量、神经心理学表现缺陷和日常功能损害预测转化为特定类型MCI的比率的程度;此外，将在基线和4年期间检查MCI亚型中特定生物标志物和神经心理学表现如何预测功能障碍。这些结果将更好地表征MCI亚型中的功能障碍，并更好地提供对异常生物标志物的更好的临床理解，因为它们与ADL功能有关。

DESCRIPTION (provided by applicant): Considerable effort is being made to detect dementia (particularly Alzheimer's disease) at its very early stages. Mild cognitive impairment (MCI) is described as the intermediate stage between normal aging and dementia. The diagnostic criteria for this disorder are currently not well defined and have been redefined over the past decade. Two of the major changes in definition of MCI are the inclusion of mild activities of daily living (ADL) impairments (that do not interfere with the ability to work and carry out life activites) and subtypes of MCI (those with amnestic and multiple-domain MCI). The types and degree of daily functional impairment are not well understood and predictors of such impairment need to be further investigated if we are to find better diagnostic criteria and early treatments for MCI. Biomedical markers, such as brain region atrophy has received much attention for the detection MCI and dementia in its earliest stages. These biomarkers alone, however, provide limited clinical utility. The current project has three major goals: 1) to examine the rate of functional decline in different subtypes of MCI (e.g., amnestic-MCI, multiple-domain MCI) over a 4-year period using an observation-based ADL task. Additionally, to examine how each ADL sub-task best predicts conversion from MCI to dementia in the different MCI subtypes, 2) to examine the relationship between biomarkers and specific types of ADL impairments, and 3) to determine the best predictors (i.e., biomarkers or neuropsychological performance) of ADL dysfunction at baseline and over time in MCI patients. A total of 55 MCI participants will be enrolled into this study from an Alzheimer's Disease Research Center (ADRC) and will be followed for a total 4 years. All participants will have already completed a neuropsychological test battery and will have undergone neuroimaging at the ADRC. Participants will be administered an observation-based ADL task. The relationship between specific CNS biomarkers and daily functional ability will be examined. How well the CNS biomarker measures, deficits in neuropsychological performance and daily functional impairment predict the rate of conversion to a specific type of MCI will also be analyzed; additionally, how specific biomarkers and neuropsychological performance predict functional disabilities will be examined in MCI subtypes at baseline as well as over a 4 year period. The results will better characterize functional impairment in the sub-types of MCI as well as better provide a better clinical understanding of abnormal biomarkers as they relate to ADL functioning.