Cognitive Complaints in Aging Adults

 描述（由申请人提供）：随着人口持续老龄化，痴呆症和阿尔茨海默病（AD）的发病率急剧增加，导致迫切需要识别那些有不健康大脑老化和痴呆风险的老年人。轻度认知功能障碍（MCI）是公认的AD前驱期。由于多达60%的MCI患者在三年内转化为AD，因此MCI的早期识别变得越来越重要。不幸的是，估计至少有一半的MCI患者在社区中未被诊断出来。初级保健水平的许多障碍与MCI的诊断不足有关，包括没有足够的时间评估认知和缺乏有效的筛查工具可用于初级保健。为了克服这些障碍，目前的研究将探讨社区内的认知投诉的性质，以制定一个有效的和可靠的认知投诉措施，以社区为基础的老年人。拟议研究中的信息将提供一个具有成本效益和时间效益的工具， 评估和转诊决策的初级保健病人需要一个更全面的记忆工作了。使用病例对照队列，我们将验证一组问题，这些问题可以可靠地测量认知主诉的鉴别诊断以及与客观认知表现、神经解剖学变化和生物标志物水平的关系。指导培训活动将侧重于潜在变量建模，老龄化研究中的神经影像学原理，社区内心理工具的临床实施以及专业发展。拟议的研究和培训将利用一个跨学科的团队（包括神经心理学，老年医学，神经学，神经放射学和生物统计学）以及与范德比尔特记忆和阿尔茨海默氏症中心，范德比尔特大学成像科学研究所和范德比尔特大学生物统计学系相关的资源，以实现概述的目标。

 DESCRIPTION (provided by applicant): As the population continues to age, the incidence of dementia and Alzheimer's disease (AD) is dramatically increasing, resulting in an urgent need to identify those older adults at risk for unhealthy brain aging and dementia. Mild cognitive impairment (MCI) is a well-accepted prodromal phase of AD. Because as many as 60% of individuals with MCI convert to AD within a three-year period, early identification of MCI is becoming increasingly important. Unfortunately, estimates suggest that at least half of individuals with MCI go undiagnosed in the community. Many barriers at the primary care level are associated with under-diagnosis of MCI, including insufficient time to assess cognition and lack of efficient screening tools available for use in primary care. To overcome these barriers, the current study will examine the nature of cognitive complaints within the community in order to develop a valid and reliable cognitive complaint measure for community-based older adults. Information from the proposed study will provide a cost-effective and time-efficient tool to aid in assessment and referral decisions for primary care patients in need of a more comprehensive memory work-up. Using a case-control cohort, we will validate a set of questions that reliably measure cognitive complaint with respect to differential diagnosis and in relation to objective cognitive performance, neuroanatomical changes, and biomarker levels. Mentored training activities will focus on latent variable modeling, neuroimaging principles in aging research, clinical implementation of psychological tools within the community, and professional development. The proposed study and training will leverage an interdisciplinary team (including neuropsychology, geriatrics, neurology, neuroradiology, and biostatistics) as well as resources associated with the Vanderbilt Memory & Alzheimer's Center, the Vanderbilt University Institute of Imaging Science, and the Vanderbilt University Department of Biostatistics to fulfill the aims outlined.