Testing early markers of cognitive decline and dementia derived from survey response behaviors

7.项目总结/摘要 发现轻度认知障碍和痴呆患者认知和功能下降的临床前标志物 是治疗开发和延迟疾病发作和进展的基础。精细泛函 认知需求活动的缺陷往往预示着痴呆症的发作，但这些早期缺陷， 难以用常规方法进行客观评价。拟议的研究旨在开发和验证 用于测量老年人功能缺陷的基于性能的指数，这些指数具有成本效益，不引人注目， 这可以作为随后认知能力下降和痴呆的早期标志。具体而言，我们建议 制定可以从现有参与者反应行为中得出的功能缺陷指数， 人口代表性调查。完成调查是一项复杂且认知要求高的任务， 被调查者的神经心理学能力通过关注个人如何完成调查，我们的目标是获得 一系列的功能缺陷指数使用两种方法：（1）第一种方法包括指数， 直接从参与者在问卷中的回答模式计算，以捕捉无效的，不连贯的，或 在评定量表上的错误反应（示例包括同意或不同意陈述， 内容，跳过问题，或给出矛盾的回答）。(2)第二种方法考虑指数 从个人的计算机使用行为在网上调查，以衡量效率，速度， 在完成在线调查期间行为的一致性（例如， 校正/改变的答案、平均响应时间和响应时间可变性）。为了评估有效性， 临床效用的指数，我们将系统地研究他们的协会与概念上相关的 结构（同时认知测试分数，日常生活的工具性活动，财务状况，虚弱）， 他们对随年龄变化的敏感性，预测随后认知能力下降的能力，以及 预测随后轻度认知障碍和痴呆的发作。进行的自我报告调查 定期在16个现有的纵向小组研究（> 50，000参与者）将提供丰富的基础， 制定和测试从问卷答复模式中得出的指数。一个持续的人口 一个有代表性的互联网小组将提供机会测试计算机使用行为指数， 不引人注意地记录在在线调查的“背景”中。编组多个数据集并进行聚合 使用相同的数据分析模型进行不同样本和调查措施的结果将大大提高 概括性和测试的适用范围，每个指标。检查预测的准确性， 单独的和一致的指数将使我们能够识别那些对预后有重要影响的指数， 信息和那些提供不相关或冗余信息。这项研究有可能扩大 现有的工具库，可以标志着老年人的认知和功能下降，并允许 痴呆症的高级研究。

7. Project Summary/Abstract Discovering preclinical markers of cognitive and functional decline in mild cognitive impairment and dementia is fundamental for treatment development and to delay disease onset and progression. Subtle functional deficits on cognitively demanding activities often foreshadow dementia onset, but these early deficits are difficult to assess objectively with conventional methods. The proposed studies aspire to develop and validate performance-based indices for measuring functional deficits at older ages that are cost-effective, unobtrusive, and that could serve as early markers of subsequent cognitive decline and dementia. Specifically, we propose to develop indices of functional deficits that can be derived from participant response behaviors in existing population representative surveys. Completing a survey is a complex and cognitively demanding task that taxes a respondent's neuropsychological capacity. By focusing on how individuals complete surveys, we aim to derive a series of indices of functional deficits using two approaches: (1) The first approach consists of indices that are directly computed from participants' response patterns in questionnaires to capture invalid, incoherent, or erroneous responding on rating scales (examples include agreeing or disagreeing with statements regardless of content, skipping questions, or giving contradictory responses). (2) The second approach considers indices derived from individuals' computer use behavior in online surveys to measure the efficiency, speed, and consistency of behaviors during the completion of online surveys (examples include the proportion of corrected/changed answers, average response time, and response time variability). To evaluate the validity and clinical utility of the indices, we will systematically examine their associations with conceptually related constructs (concurrent cognitive test scores, instrumental activities of daily living, financial wellbeing, frailty), their sensitivity to change with age, their ability to predict subsequent cognitive decline, and their ability to predict the subsequent onset of mild cognitive impairment and dementia. Self-report surveys administered regularly in 16 existing longitudinal panel studies (>50,000 participants) will provide a rich basis for developing and testing indices derived from response patterns in questionnaires. An ongoing population representative Internet panel will provide the opportunity to test computer use behavior indices that are unobtrusively recorded “in the background” of online surveys. Marshalling multiple datasets and aggregating results across diverse samples and survey measures using identical data-analytic models will greatly enhance generalizability and test the breadth of applicability of each index. Examining the predictive accuracy of the indices alone and in concert will allow us to identify those indices that contribute substantial prognostic information and those that provide irrelevant or redundant information. This research has potential to broaden the repertoire of available tools that could signal cognitive and functional decline in older ages and allow for advanced study of dementia.