Neurosessments: Developing a quick, objective motor test to prompt cognitivetesting in primary care

项目总结/摘要 阿尔茨海默病（AD）是美国痴呆症的主要原因，每九个人中就有一个人受到影响。 老年人然而，阿尔茨海默病和相关痴呆（AD/ADRD）可能难以诊断， 医生错过了近一半的可能的痴呆症病例。漏诊率甚至更高， 黑人老年人大多数医生不定期筛查他们的病人与认知测试，由于 主要是因为他们与病人面对面的时间不够。因此，显然需要一种快速、 可以由医务人员在医生与患者接触之前进行的客观测试， 当担心AD/ADRD时，及时进行认知测试或专家转诊进行随访。因为研究 已经表明，大脑中的运动区域在AD进展的早期受到影响，这是AD治疗的长期目标。 Neurosessments LLC将开发一种运动测试，这将有助于改善初级保健中的痴呆症检测， 适合来自不同背景的老年人。Neurosessments LLC团队之前的研究 开发了一种运动测试的实验版本，可以识别痴呆症，预测功能衰退， 检测大脑淀粉样蛋白，无论患者的教育程度，性别或年龄。本报告的总体目标 第一阶段SBIR是将该运动测试的原始版本改编为快速（<2分钟）且易于管理的测试。 一个名为qBEANS（快速行为检查，以促进神经心理筛查）的版本，供医务人员使用， 使用.具体目标是：1）确定简短版运动测试的可靠性和种族公平性， 2)开发用于管理和评分可用于临床环境的运动测试的数字用户界面。 实现这些目标将导致第二阶段SBIR，在初级保健办公室内部署qBEANS， 社区卫生诊所提高认知测试率，改善痴呆症检测。这项建议是 创新地利用运动行为在早期阶段检测可能的痴呆症， 用于初级保健的工具。商业化计划是向医疗机构出售一次性测试试剂盒， 提供者在初级保健环境中使用，每年筛查65岁及以上的成年人。通过常规筛查， 初级保健提供者将能够识别其分数表明可能患有痴呆症的个人， 提供者是否进行额外的认知测试或参考专家进行可能的诊断 AD/ADRD。社会影响是，它将提高早期痴呆症诊断率，使老年人 和他们的家人的礼物的时间作出决定的治疗方案，法律的计划，个人护理计划， 和财务。

PROJECT SUMMARY/ABSTRACT Alzheimer’s disease (AD) is the leading cause of dementia in the United States, affecting one out of every nine older adults. However, Alzheimer’s disease and related dementias (AD/ADRD) can be difficult to diagnose, with physicians missing nearly half of all probable dementia cases. Rates of missed diagnosis are even higher among Black older adults. The majority of physicians do not regularly screen their patients with cognitive tests, due mostly to a lack of time during their face-to-face time with patients. Thus, there is a clear need for a quick, objective test that can be administered by medical staff prior to the physician’s time with the patient, which will prompt cognitive testing or a specialist referral for follow-up when there is concern for AD/ADRD. Since research has shown that motor regions in the brain are affected early in the progression of AD, the long-term goal of Neurosessments LLC is to develop a motor test that will help improve dementia detection in primary care that is appropriate for older adults from diverse backgrounds. Prior research by the Neurosessments LLC team has developed an experimental version of a motor test that can identify dementia, predict functional decline, and detect brain amyloid, regardless of the patient’s educational attainment, sex, or age. The overall objective of this Phase I SBIR is to adapt the original version of this motor test into a quick (<2 minutes) and easy to administer version called qBEANS (quick Behavioral Exam to Advance Neuropsychological Screening) for medical staff to use. The specific aims are to 1) determine the reliability and racial equity of a short version of the motor test and 2) develop a digital user interface for administering and scoring the motor test that is usable in a clinical setting. Achieving these aims will lead to a Phase II SBIR that deploys qBEANS within primary care offices and community health clinics to increase rates of cognitive testing and improve dementia detection. This proposal is innovative in its use of motor behavior to detect probable dementia in its early stages, and its development of tools for intended use in primary care. The commercialization plan is to sell single-use test kits to medical providers for use in primary care settings to annually screen adults ages 65 and older. Through routine screening, primary care providers will be able to identify individuals whose scores indicate possible dementia, informing providers of whether or not to perform additional cognitive testing or refer to specialists for possible diagnosis of AD/ADRD. The societal impact is that it will improve the rates of early dementia diagnosis, giving older adults and their families the gift of time to make decisions about treatment options, legal plans, personal care plans, and finances.