Practice effects of daily functioning across the Alzheimer’s disease spectrum

练习日常功能对阿尔茨海默病谱系的影响

基本信息

批准号：
10276723
负责人：
KEVIN M DUFF
金额：
$ 47.84万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10276723
关键词：
Address Adult Alzheimer&apos s Disease Alzheimer’s disease biomarker Amyloid deposition Biological Markers Brain Pathology Clinic Clinical Clinical Research Clinical Trials Cognition Cognition Disorders Cognitive Data Dementia Diagnosis Disease Elderly Enrollment Exposure to Financial cost Future Goals Heterogeneity Hippocampus (Brain)Impaired cognition Impairment Individual Intervention Link Literature Magnetic Resonance Imaging Materials Testing Measures Memory Methodology Mission Monitor National Institute on Aging Outcome Outcome Measure Participant Performance Positron-Emission Tomography Prognosis Proxy Research Research Personnel Resources Risk Sampling Savings Screening procedure Severity of illness Target Populations Testing Time Work amyloid imaging apolipoprotein E-4 base clinical trial participant cognitive function cognitive testing daily functioning experience follow-up functional decline innovation mild cognitive impairment normal aging novel performance based measurement performance tests predictive tools response screening tau Proteins tool treatment response

项目摘要

Project Summary The main objective of this new application is to demonstrate that individuals with low practice effects on measures of daily functioning repeated across one week are more likely to cognitively progress over the following year. This project would also examine if practice effects on these performance-based functional scales differ across the disease spectrum in late adulthood by comparing older individuals who are cognitively intact to those with Mild Cognitive Impairment and Alzheimer's disease. In an exploratory aim, the relationship between practice effects on these functional scales and various biomarkers of Alzheimer's disease (e.g., hippocampal volumes via MRI, amyloid deposition via PET, APOE e4) will be studied. These findings would add to the supporting evidence of practice effects as a marker of diagnosis, prognosis, and treatment response in normal aging, Mild Cognitive Impairment, and dementing illnesses. However, it will extend our prior work by focusing on practice effects on functional measures (whereas our prior work looked at practice effects on cognitive tests). By realizing the aims of this pragmatic project, we would be able to offer more efficient screening of potential participants for clinical trials, which would reduce participant burden and financial costs associated with these trials. Practice effects could also be used to enrich trials with those more likely to progress and to monitor treatment benefit as a proximal outcome measure. Practice effects also have considerable clinical benefits for diagnosis and prognosis of cognitive disorders in late life. This project is consistent with the mission of the National Institute on Aging. Relevance. Current clinical trials in Mild Cognitive Impairment and Alzheimer's disease require participants to progress/decline across the trial to accurately evaluate the experimental intervention. Although existing biomarkers (e.g., tau and amyloid imaging) are being used to identify those most likely to progress, these biomarkers are expensive and invasive. Cheaper, less invasive, and more sensitive biomarkers are clearly needed to make these trials more efficient. We propose that practice effects on performance-based functional measures might fill this important gap in the literature. In the current pragmatic project, we expect to provide clinicians and researchers with a new tool (i.e., practice effects on functional scales) for predicting cognitive decline in seniors with and without cognitive impairments. We expect to provide supporting evidence to include practice effects in future clinical trials in normal aging, Mild Cognitive Impairment, and Alzheimer's disease.

项目摘要该新应用的主要目的是证明练习率低的个人对一周重复的每日功能的度量更有可能在认知上进展第二年。该项目还将检查练习是否对这些基于绩效的影响在成年后期，在整个疾病范围内的功能量表通过比较老年人对于患有轻度认知障碍和阿尔茨海默氏病的人的认知完整的人。在探索目的，实践对这些功能量表的影响与各种阿尔茨海默氏病的生物标志物（例如，通过MRI的海马体积，通过PET淀粉样蛋白沉积， APOE E4）将被研究。这些发现将增加实践影响的支持证据正常衰老，轻度认知障碍的诊断，预后和治疗反应的标志，和痴呆疾病。但是，它将通过专注于实践影响来扩展我们的先前工作功能度量（而我们先前的工作研究了对认知测试的实践影响）。通过实现这个务实项目的目的是，我们能够提供更有效的潜力筛查临床试验的参与者，这将减轻与参与者的负担和财务成本这些试验。练习效果也可以用来丰富试验，而这些试验更有可能进步和监测治疗益处作为近端结果度量。练习效果也有相当大的后期认知障碍的诊断和预后的临床益处。这个项目是一致的随着国家老化研究所的任务。关联。当前的轻度认知障碍和阿尔茨海默氏病的临床试验需要参与者在整个试验中进行/下降，以准确评估实验干预措施。尽管现有的生物标志物（例如Tau和淀粉样蛋白成像）被用来识别最多的生物标志物这些生物标志物可能会进展，既昂贵又具有侵入性。便宜，侵入性较小，更多显然需要敏感的生物标志物才能使这些试验更有效。我们提出了这种做法对基于绩效的功能措施的影响可能会填补文献中的这一重要空白。在当前的务实项目，我们希望为临床医生和研究人员提供一种新工具（即实践对功能尺度的影响）预测有或没有认知能力的老年人认知能力下降障碍。我们希望提供支持证据，以在以后的临床试验中包括实践效果在正常衰老，轻度认知障碍和阿尔茨海默氏病。