Cognitive, Motor, and Emotional Markers of Self-reported Cognitive Concerns

 描述(申请人提供)：阿尔茨海默氏型痴呆症(DAT)是一种晚期和不可治愈的神经退行性疾病，对社会造成非常高的成本。对早期发现DAT的研究对于解决迫在眉睫的公共卫生危机至关重要。在没有明显认知损害的情况下，自我报告的认知担忧(SCCs)的存在可能代表了DAT发展的临床前阶段。然而，研究结果并不一致，与鳞状细胞癌相关的神经和行为特征还没有完全了解。本研究的目标是确定SCC的认知、运动和情绪标记物的特征。这些标志物将使用美国国立卫生研究院神经和行为功能评估工具箱(NIHTB)的子测试进行量化，NIHTB是一套简短但全面的计算机测量方法。具体目标1将使用NIHTB认知电池来表征SCC的认知标记物，该电池具有有利的心理测量学特性，可能对检测标准纸笔神经心理测试无法测量的细微认知变化很敏感。NIHTB认知成套测验的分数将在假设DAT之前的三个认知老年组中进行比较：没有SCC的心理测量正常认知(SCC-)，有SCC+的正常认知(SCC+)，以及轻度认知障碍(MCI)。预计性能将遵循一个连续体，SCC-组得分最好，SCC+组次之，MCI组最差。此外，还将比较SCC+组和SCC-组在三周时间间隔内的重复评估中各自表现出实践效果的程度。以前的研究表明，在MCI中，练习效果会降低，因此，SCC+组的练习效果预计会比SCC-组的小。具体目标2将使用NIHTB情感电池和NIHTB机动电池的三个分测试来表征SCC的非认知标记。SCC+和SCC-组将在一系列积极和消极的情绪结构以及步态稳定性、平衡性和精细运动协调性方面进行比较。根据先前的发现，这些运动功能在MCI中降低，SCC+组预计会表现出比SCC-组更慢的步速，平衡能力降低，以及更差的精细运动协调能力。在情绪方面，SCC+组比SCC-组表现出更大的压力和拒绝，以及更少的自我效能感和情绪支持。这项拟议的研究将是第一次在老龄化和痴呆的背景下使用NIHTB措施。研究结果将确定DAT高危人群的神经学和行为特征。研究结果也可能为未来早期发现DAT的策略提供参考，这与长期的职业目标是一致的 研究非侵入性的早期检测方法，在服务不足的地区广泛使用。

 DESCRIPTION (provided by applicant): Dementia of the Alzheimer's type (DAT) is a terminal and incurable neurodegenerative disorder with a very high cost to society. Research in the early detection of DAT is critical to address a looming public health crisis. The presence of self-reported cognitive concerns (SCCs) in the absence of overt cognitive impairment may represent a preclinical stage in the development of DAT. However, research findings are inconsistent and the neurological and behavioral features associated with SCCs are not fully understood. The goal of the proposed study is to characterize cognitive, motor, and emotional markers of SCCs. These markers will be quantified using subtests from the U.S. NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIHTB), a brief but comprehensive set of computer-based measures. Specific Aim 1 will characterize the cognitive markers of SCCs using the NIHTB Cognition Battery, which has advantageous psychometric properties and may be sensitive to detecting subtle cognitive changes not measurable by standard paper-and- pencil neuropsychological tests. Scores on the NIHTB Cognition Battery will be compared across three cognitive aging groups hypothesized to precede DAT: psychometrically normal cognition without SCCs (SCC-), normal cognition with SCCs (SCC+), and mild cognitive impairment (MCI). Performance is expected to follow a continuum with scores best for SCC- group, next best for the SCC+ group, and worst for the MCI group. Additionally, the SCC+ and SCC- groups will be compared regarding the extent to which each demonstrates a practice effect on a repeated evaluation within a three-week interval of time. Previous research shows that practice effects are reduced in MCI, and therefore the SCC+ group is expected to show less of a practice effect than the SCC- group. Specific Aim 2 will characterize non-cognitive markers of SCCs using the NIHTB Emotion Battery and three subtests of the NIHTB Motor Battery. The SCC+ and SCC- groups will be compared on a wide range of positive and negative emotional constructs as well as on gait stability, balance, and fine motor coordination. Based on previous findings that these motor functions are reduced in MCI, the SCC+ group is expected to show slower gait speed, decreased balance, and poorer fine motor coordination than the SCC- group. On the Emotion Battery, the SCC+ group is expected to show greater perceived stress and rejection as well as less self-efficacy and emotional support than the SCC- group. The proposed study will be the first to use NIHTB measures in the context of aging and dementia. Findings will define neurological and behavioral signatures in a group at-risk for DAT. Results may also inform future strategies in the early detection of DAT, which is consistent with the long-term career goal to investigate noninvasive methods for early detection widely accessible for use in underserved areas.