| Principal Investigator |
Principal Investigator's Name: |
Aaron Bonner-Jackson |
E-mail: |
abonnerjackson@lifespan.org
|
Institution: |
Brown Medical School, Rhode Island Hospital |
Department: |
Neuropsychology |
Country: |
|
Proposed Analysis: |
Prediction of Functional Decline in Alzheimer???s disease and Mild Cognitive Impairment using Cognitive Reserve, Neurocognitive Performance,
and Brain Volume
Background
Alzheimer???s disease (AD) is the most common classification of dementia. It is a debilitating neurodegenerative disease that affects more than 5 million individuals in the United States and millions more worldwide. The prevalence of AD increases substantially with age, such that individuals over age 80 have approximately a 40% chance of developing the illness. As such, AD represents a vital public health issue and an enormous burden in terms of care and medical expenses, particularly as the general population becomes older. Therefore, identification of factors that may influence the likelihood of developing AD is an essential activity.
A diagnosis of dementia is based, in part, on cognitively impaired performance on standardized neuropsychological measures. However, premorbid intellectual abilities that are present prior to the onset of cognitive decline may play a role in determining the likelihood of developing dementia and the course of decline. Dementia is also diagnosed based on the observation of functional decline in an individual, typically measured as performance of Activities of Daily Living. Maintaining functional abilities in daily life is crucial for individuals to remain independent and able to care for themselves as they age.
The concept of cognitive reserve (CR) refers to the theory that individuals vary in inherent cognitive capacities, and it is thought that this difference underlies observed variability in clinical manifestation of AD (Stern, 2009). For example, an individual with a higher level of CR may not show clinical signs of the disease, while a second individual with less CR will show such signs, even though both have the same amount of disease burden in the brain. Such a phenomenon could be due to intellectual characteristics, integrity of brain tissue, or a combination of both factors.
Previous literature has demonstrated the relationship between CR (as measured by single word reading ability) and development of dementia. Performance in certain neuropsychological domains (such as executive function, visuospatial abilities, and processing speed) has also been associated with rate of decline in a group of probably AD patients (Atchison et al., 2007). However, the association between CR and functional decline (after controlling for baseline neurocognitive ability) has not been investigated. Furthermore, we are aware of only one study (Mori et al., 1997) that has examined the relationship between brain volume, cognitive reserve, and intellectual decline, although this study used only patients with AD (not MCI) and did not utilize an age-matched control group.
The purpose of the present study is to examine the relationship between CR and functional outcome, as well as the interaction between these variables, brain volume, and neuropsychological performance in individuals with AD, MCI, and healthy controls. Specifically, we plan to investigate the association between baseline CR and functional outcome at later follow-ups, and we will examine the ways in which this association interacts with whole-brain volume, ventricular size, and performance on neurocognitive measures.
Methods
Participants and measures:
Participants for the proposed study consist of the healthy control, MCI, and AD subjects enrolled in ADNI. Upon approval of the present proposal by the ADNI committee, relevant data will be extracted from the ADNI website. The measures of interest that will be used in the proposed study include: demographics, Functional Activities Questionnaire, current diagnosis, neuropsychological test data (including MMSE), and structural neuroimaging brain volume data.
Data analyses:
Regression analyses will be used to examine the association between CR and functional decline in all three groups (AD, MCI, controls). CR will be estimated using performance on a measure of single word reading ability, and functional decline will be measured using change on the FAQ. We will also include volumes of selected brain regions and performance on neurocognitive measures in regression analyses to model potential interactive effects of these variables.
Investigators
Aaron Bonner-Jackson, Ph.D.
Post-Doctoral Fellow, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Geoffrey Tremont, Ph.D., ABPP
Assistant Professor of Psychiatry, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Ozioma Okonkwo, Ph.D.
Post-Doctoral Fellow, Department of Neurology, Johns Hopkins University
Baltimore, Maryland
References:
Atchison TB, Massman PJ, Doody RS (2007). Baseline cognitive function predicts rate
of decline in basic-care abilities of individuals with dementia of the Alzheimer???s type. Archives of Clinical Neuropsychology, 22, 99-107.
Mori E, Hirono N, Yamashita H, Imamura T, Ikejiri Y, Ikeda M, Kitagaki H, Shimomura
T, Yoneda Y (1997). Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer???s disease. American Journal of Psychiatry, 154, 18-24.
Stern Y (2009). Cognitive reserve. Neuropsychologia, 47, 2015-2028. |
| Additional Investigators |
Investigator's Name: |
Geoffrey Tremont |
E-mail: |
gtremont@lifespan.org
|
Proposed Analysis: |
Prediction of Functional Decline in Alzheimer?s disease and Mild Cognitive Impairment using Cognitive Reserve, Neurocognitive Performance,
and Brain Volume
Background
Alzheimer?s disease (AD) is the most common classification of dementia. It is a debilitating neurodegenerative disease that affects more than 5 million individuals in the United States and millions more worldwide. The prevalence of AD increases substantially with age, such that individuals over age 80 have approximately a 40% chance of developing the illness. As such, AD represents a vital public health issue and an enormous burden in terms of care and medical expenses, particularly as the general population becomes older. Therefore, identification of factors that may influence the likelihood of developing AD is an essential activity.
A diagnosis of dementia is based, in part, on cognitively impaired performance on standardized neuropsychological measures. However, premorbid intellectual abilities that are present prior to the onset of cognitive decline may play a role in determining the likelihood of developing dementia and the course of decline. Dementia is also diagnosed based on the observation of functional decline in an individual, typically measured as performance of Activities of Daily Living. Maintaining functional abilities in daily life is crucial for individuals to remain independent and able to care for themselves as they age.
The concept of cognitive reserve (CR) refers to the theory that individuals vary in inherent cognitive capacities, and it is thought that this difference underlies observed variability in clinical manifestation of AD (Stern, 2009). For example, an individual with a higher level of CR may not show clinical signs of the disease, while a second individual with less CR will show such signs, even though both have the same amount of disease burden in the brain. Such a phenomenon could be due to intellectual characteristics, integrity of brain tissue, or a combination of both factors.
Previous literature has demonstrated the relationship between CR (as measured by single word reading ability) and development of dementia. Performance in certain neuropsychological domains (such as executive function, visuospatial abilities, and processing speed) has also been associated with rate of decline in a group of probably AD patients (Atchison et al., 2007). However, the association between CR and functional decline (after controlling for baseline neurocognitive ability) has not been investigated. Furthermore, we are aware of only one study (Mori et al., 1997) that has examined the relationship between brain volume, cognitive reserve, and intellectual decline, although this study used only patients with AD (not MCI) and did not utilize an age-matched control group.
The purpose of the present study is to examine the relationship between CR and functional outcome, as well as the interaction between these variables, brain volume, and neuropsychological performance in individuals with AD, MCI, and healthy controls. Specifically, we plan to investigate the association between baseline CR and functional outcome at later follow-ups, and we will examine the ways in which this association interacts with whole-brain volume, ventricular size, and performance on neurocognitive measures.
Methods
Participants and measures:
Participants for the proposed study consist of the healthy control, MCI, and AD subjects enrolled in ADNI. Upon approval of the present proposal by the ADNI committee, relevant data will be extracted from the ADNI website. The measures of interest that will be used in the proposed study include: demographics, Functional Activities Questionnaire, current diagnosis, neuropsychological test data (including MMSE), and structural neuroimaging brain volume data.
Data analyses:
Regression analyses will be used to examine the association between CR and functional decline in all three groups (AD, MCI, controls). CR will be estimated using performance on a measure of single word reading ability, and functional decline will be measured using change on the FAQ. We will also include volumes of selected brain regions and performance on neurocognitive measures in regression analyses to model potential interactive effects of these variables.
Investigators
Aaron Bonner-Jackson, Ph.D.
Post-Doctoral Fellow, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Geoffrey Tremont, Ph.D., ABPP
Assistant Professor of Psychiatry, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Ozioma Okonkwo, Ph.D.
Post-Doctoral Fellow, Department of Neurology, Johns Hopkins University
Baltimore, Maryland
References:
Atchison TB, Massman PJ, Doody RS (2007). Baseline cognitive function predicts rate
of decline in basic-care abilities of individuals with dementia of the Alzheimer?s type. Archives of Clinical Neuropsychology, 22, 99-107.
Mori E, Hirono N, Yamashita H, Imamura T, Ikejiri Y, Ikeda M, Kitagaki H, Shimomura
T, Yoneda Y (1997). Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer?s disease. American Journal of Psychiatry, 154, 18-24.
Stern Y (2009). Cognitive reserve. Neuropsychologia, 47, 2015-2028. |
|
|
Investigator's Name: |
Ozioma Okonkwo |
E-mail: |
ozed1404@uab.edu
|
Proposed Analysis: |
Prediction of Functional Decline in Alzheimer?s disease and Mild Cognitive Impairment using Cognitive Reserve, Neurocognitive Performance,
and Brain Volume
Background
Alzheimer?s disease (AD) is the most common classification of dementia. It is a debilitating neurodegenerative disease that affects more than 5 million individuals in the United States and millions more worldwide. The prevalence of AD increases substantially with age, such that individuals over age 80 have approximately a 40% chance of developing the illness. As such, AD represents a vital public health issue and an enormous burden in terms of care and medical expenses, particularly as the general population becomes older. Therefore, identification of factors that may influence the likelihood of developing AD is an essential activity.
A diagnosis of dementia is based, in part, on cognitively impaired performance on standardized neuropsychological measures. However, premorbid intellectual abilities that are present prior to the onset of cognitive decline may play a role in determining the likelihood of developing dementia and the course of decline. Dementia is also diagnosed based on the observation of functional decline in an individual, typically measured as performance of Activities of Daily Living. Maintaining functional abilities in daily life is crucial for individuals to remain independent and able to care for themselves as they age.
The concept of cognitive reserve (CR) refers to the theory that individuals vary in inherent cognitive capacities, and it is thought that this difference underlies observed variability in clinical manifestation of AD (Stern, 2009). For example, an individual with a higher level of CR may not show clinical signs of the disease, while a second individual with less CR will show such signs, even though both have the same amount of disease burden in the brain. Such a phenomenon could be due to intellectual characteristics, integrity of brain tissue, or a combination of both factors.
Previous literature has demonstrated the relationship between CR (as measured by single word reading ability) and development of dementia. Performance in certain neuropsychological domains (such as executive function, visuospatial abilities, and processing speed) has also been associated with rate of decline in a group of probably AD patients (Atchison et al., 2007). However, the association between CR and functional decline (after controlling for baseline neurocognitive ability) has not been investigated. Furthermore, we are aware of only one study (Mori et al., 1997) that has examined the relationship between brain volume, cognitive reserve, and intellectual decline, although this study used only patients with AD (not MCI) and did not utilize an age-matched control group.
The purpose of the present study is to examine the relationship between CR and functional outcome, as well as the interaction between these variables, brain volume, and neuropsychological performance in individuals with AD, MCI, and healthy controls. Specifically, we plan to investigate the association between baseline CR and functional outcome at later follow-ups, and we will examine the ways in which this association interacts with whole-brain volume, ventricular size, and performance on neurocognitive measures.
Methods
Participants and measures:
Participants for the proposed study consist of the healthy control, MCI, and AD subjects enrolled in ADNI. Upon approval of the present proposal by the ADNI committee, relevant data will be extracted from the ADNI website. The measures of interest that will be used in the proposed study include: demographics, Functional Activities Questionnaire, current diagnosis, neuropsychological test data (including MMSE), and structural neuroimaging brain volume data.
Data analyses:
Regression analyses will be used to examine the association between CR and functional decline in all three groups (AD, MCI, controls). CR will be estimated using performance on a measure of single word reading ability, and functional decline will be measured using change on the FAQ. We will also include volumes of selected brain regions and performance on neurocognitive measures in regression analyses to model potential interactive effects of these variables.
Investigators
Aaron Bonner-Jackson, Ph.D.
Post-Doctoral Fellow, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Geoffrey Tremont, Ph.D., ABPP
Assistant Professor of Psychiatry, Brown Medical School & Rhode Island Hospital
Providence, Rhode Island
Ozioma Okonkwo, Ph.D.
Post-Doctoral Fellow, Department of Neurology, Johns Hopkins University
Baltimore, Maryland
References:
Atchison TB, Massman PJ, Doody RS (2007). Baseline cognitive function predicts rate
of decline in basic-care abilities of individuals with dementia of the Alzheimer?s type. Archives of Clinical Neuropsychology, 22, 99-107.
Mori E, Hirono N, Yamashita H, Imamura T, Ikejiri Y, Ikeda M, Kitagaki H, Shimomura
T, Yoneda Y (1997). Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer?s disease. American Journal of Psychiatry, 154, 18-24.
Stern Y (2009). Cognitive reserve. Neuropsychologia, 47, 2015-2028. |
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