Jpad-Journal of Prevention of Alzheimers Disease最新文献

{"title":"Posters","authors":"N. Falgàs, R. Sánchez-Valle, Mircea, Balasa, S. Borrego, Magdalena Castellví, -. AdriàTort, Merino, J. Olives, B. Bosch, Guadalupe Fernández, F. Lomeña, N. Bargalló, Albert Lladó, Itziar, D. Rojas, J. Romero, O. Rodríguez‐Gomez, P. Pesini, Á. Sanabria, A. Pérez-Cordón, Carla, Abdelnour, M. Rosende-Roca, Ana, Mauléon, Liliana Vargas, Montserrat Alegret, A. Espinosa, G. Ortega, Silvia Gil, M. Guitart, Anna Gailhajane, M. Santos-Santos, S. Moreno-Grau, Oscar, Sotolongo-Grau, S. Ruiz, L. Montrreal, Elvira, Martín, E. Pelejà, F. Lomeña, F. Campos, A. Vivas, M. Gómez-Chiari, M. A. Tejero, J. Giménez, V. Pérez-Grijalba, Marta Marquié, G. Monté-Rubio, Sergi Valero, A. Orellana, Lluís., Tárraga, Manuel E. Sarasa, A. Ruiz, Mercè Boada","doi":"10.14283/jpad.2018.40","DOIUrl":"https://doi.org/10.14283/jpad.2018.40","url":null,"abstract":"P21: PATTERNS OF MMSE SUBTEST SCORES IN AMYLOID-POSITIVE AND -NEGATIVE PARTICIPANTS IN J-ADNI. Ryoko Ihara1, Kazushi Suzuki1, Atsushi Iwata2, Takeshi Iwatsubo1,3, the Japanese Alzheimer’s Disease Neuroimaging Initiative ((1) The Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Tokyo Japan; (2) Department of Neurology, The University of Tokyo, Tokyo Japan; (3) Department of Neuropathology, The University of Tokyo, Tokyo – Japan)","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"5 1","pages":"46-196"},"PeriodicalIF":6.4,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14283/jpad.2018.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66893032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Vascular Neuropathology on Late-life Cognition: Results from the SMART Project.","authors":"R. Kryscio, E. Abner, Peter T. Nelson, David A. Bennett, J. Schneider, Lei Yu, L. Hemmy, K. Lim, Kamal Masaki, N. Cairns, C. Xiong, R. Woltjer, H. Dodge, S. Tyas, D. Fardo, W. Lou, L. Wan, F. Schmitt","doi":"10.14283/JPAD.2016.95","DOIUrl":"https://doi.org/10.14283/JPAD.2016.95","url":null,"abstract":"BACKGROUND\u0000Cerebral vascular pathology may contribute to cognitive decline experienced by some elderly near death. Given evidence for mixed neuropathologies in advanced age, preventing or reducing cerebrovascular burden in late life may be beneficial.\u0000\u0000\u0000OBJECTIVE\u0000To correlate measures of cerebral vascular pathology with cognitive trajectories.\u0000\u0000\u0000SETTING\u0000Observational study.\u0000\u0000\u0000PARTICIPANTS\u0000A cohort of 2,274 individuals who came to autopsy at a mean age of 89.3 years and 82 percent of whom had at least two cognitive assessments within the last six years of life was compiled from six centers conducting longitudinal studies.\u0000\u0000\u0000MEASUREMENTS\u0000For each cognitive domain: immediate and delayed memory, language, and naming, three trajectories were examined: good, intermediate, and poor cognition. The probability of a participant belonging to each trajectory was associated with measures of cerebral vascular pathology after adjustment for demographics, APOE, and Alzheimer neuropathology.\u0000\u0000\u0000RESULTS\u0000A large proportion of the cohort (72-94%) experienced good or intermediate cognition in the four domains examined. The presence of arteriolosclerosis and the presence of lacunar infarcts doubled the odds of belonging to the poor cognitive trajectory for language when compared to the good trajectory. The presence of lacunar infarcts increased the odds of an intermediate or poor trajectory for immediate and delayed recall while the presence of large artery infarcts increased the odds of poor trajectories for all four cognitive domains examined. Microinfarcts and cerebral amyloid angiopathy had little effect on the trajectories.\u0000\u0000\u0000CONCLUSION\u0000Indicators of cerebral vascular pathology act differently on late life cognition.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"82 1","pages":"85-91"},"PeriodicalIF":6.4,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility of At-Home iPad Cognitive Testing For Use in Clinical Trials.","authors":"D. Rentz, M. Dekhtyar, J. Sherman, S. Burnham, D. Blacker, Sarah L. Aghjayan, K. Papp, R. Amariglio, A. Schembri, Tanya Chenhall, P. Maruff, P. Aisen, B. Hyman, R. Sperling","doi":"10.14283/JPAD.2015.78","DOIUrl":"https://doi.org/10.14283/JPAD.2015.78","url":null,"abstract":"BACKGROUND\u0000Technological advances now make it feasible to administer cognitive assessments at-home on mobile and touch-screen devices such as an iPad or tablet computer. Validation of these techniques is necessary to assess their utility in clinical trials.\u0000\u0000\u0000OBJECTIVES\u0000We used a Computerized Cognitive Composite for Preclinical Alzheimer's Disease (C3-PAD) developed for iPad 1) to determine the feasibility of performing the C3-PAD at home by older individuals without the presence of a trained psychometrician; 2) to explore the reliability of in-clinic compared to at-home C3-PAD performance and 3) to examine the comparability of C3-PAD performance to standardized neuropsychological tests.\u0000\u0000\u0000DESIGN SETTING PARTICIPANTS\u0000Forty-nine cognitively normal older individuals (mean age, 71.467.7 years; 20% non-Caucasian) were recruited from research centers at the Massachusetts General Hospital and Brigham and Women's Hospital. Participants made two in-clinic visits one-week apart and took five 30-minute alternate versions of the C3-PAD at-home measuring episodic memory, reaction time and working memory.\u0000\u0000\u0000MEASUREMENTS\u0000A reliability analysis explored equivalence of the six alternate C3-PAD test versions. A feasibility assessment calculated the percentage of individuals who completed all at-home tests correctly, in contrast to incomplete assessments. Correlational analyses examined the association between C3-PAD-clinic compared to C3-PAD-home assessments and between C3-PAD performance and standardized paper and pencil tests.\u0000\u0000\u0000RESULTS\u0000Excellent reliability was observed among the 6 C3-PAD alternate versions (Cronbach alpha coefficient=0.93). A total of 28 of 49 participants completed all at-home sessions correctly and 48 of 49 completed four out of five correctly. There were no significant differences in participant age, sex or education between complete and incomplete at-home assessments. A single in-clinic C3-PAD assessment and the at-home C3-PAD assessments were highly associated with each other (r2=0.508, p<0.0001), suggesting that at-home tests provide reliable data as in-clinic assessments. There was also a moderate association between the at-home C3-PAD assessments and the in-clinic standardized paper and pencil tests covering similar cognitive domains (r2= 0.168, p< 0.003).\u0000\u0000\u0000CONCLUSIONS\u0000Reliable and valid cognitive data can be obtained from the C3-PAD assessments in the home environment. With initial in-clinic training, a high percentage of older individuals completed at-home assessments correctly. At-home cognitive testing shows promise for inclusion into clinical trial designs.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"3 1 1","pages":"8-12"},"PeriodicalIF":6.4,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Factors and Cognitive Decline.","authors":"P J Smith, J A Blumenthal","doi":"10.14283/jpad.2015.71","DOIUrl":"10.14283/jpad.2015.71","url":null,"abstract":"<p><p>Cognitive decline is an increasingly important public health problem, with more than 100 million adults worldwide projected to develop dementia by 2050. Accordingly, there has been an increased interest in preventive strategies that diminish this risk. It has been recognized that lifestyle factors including dietary patterns, may be important in the prevention of cognitive decline and dementia in later life. Several dietary components have been examined, including antioxidants, fatty acids, and B vitamins. In addition, whole dietary eating plans, including the Mediterranean diet (MeDi), and the Dietary Approaches to Stop Hypertension (DASH) diet, with and without weight loss, have become areas of increasing interest. Although prospective epidemiological studies have observed that antioxidants, fatty acids, and B vitamins are associated with better cognitive functioning, randomized clinical trials have generally failed to confirm the value of any specific dietary component in improving neurocognition. Several randomized trials have examined the impact of changing 'whole' diets on cognitive outcomes. The MeDi and DASH diets offer promising preliminary results, but data are limited and more research in this area is needed.</p>","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"3 1 1","pages":"53-64"},"PeriodicalIF":6.4,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4758517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHORT-TERM IMPACT OF A COMBINED NUTRACEUTICAL ON COGNITIVE FUNCTION, PERCEIVED STRESS AND DEPRESSION IN YOUNG ELDERLY WITH COGNITIVE IMPAIRMENT: A PILOT, DOUBLE-BLIND, RANDOMIZED CLINICAL TRIAL","authors":"A. Cicero, M. Bove, A. Colletti, M. Rizzo, F. Fogacci, M. Giovannini, C. Borghi","doi":"10.14283/jpad.2016.110","DOIUrl":"https://doi.org/10.14283/jpad.2016.110","url":null,"abstract":"Background: The prevalence of senile dementia is increasing worldwide, especially in the developed countries. Nevertheless, drug therapy isn’t often enough to treat this condition. Researchers are evaluating the possible impact of a preventive approach, based on an improvement of lifestyle and the intake of micronutrients. Moreover, there is an increasing interest for combined nutraceuticals that can act as memory and learning enhancers, with a significant and beneficial potential on the cognitive disorders. Objective: To evaluate the effects of a rational assemblage of nutraceuticals on cognitive functions in a sample of 30 elderly subjects. Design: Double bind, cross-over designed trial versus placebo Setting: outpatient clinical practice Participants: 30 elderly subjects with basal Mini-Mental State Examination score between 20 and 27 and self-perceived cognitive decline. Intervention: Treatment with a combination of nutraceuticals based on Bacopa monnieri, L-theanine, Crocus sativus, copper, folate and vitamins of B and D group. After2 months of treatment or placebo. Measurements: Patients were evaluated with Mini-Mental State Examination (MMSE), Perceived Stress Questionnaire (PSQ) and Index and Self-Rating Depression Scale (SRDS). Results: MMSE and PSQ Index significantly improved in the active treatment arm, both versus baseline and versus the parallel arm. Both groups experienced a significant improving in the SRDS scores. Conclusions: We obtained a good and significant improvement of the cognitive functions tested with the MMSE, PSQ-Index and SRDS score, after 2 months of combined therapy of nutraceuticals. Further confirmation will be needed to verify these observations on the middle and long term in a larger number of subjects.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"1 1","pages":""},"PeriodicalIF":6.4,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Harvard Automated Phone Task: new performance-based activities of daily living tests for early Alzheimer's disease.","authors":"G. Marshall, M. Dekhtyar, Jonathan Bruno, K. Jethwani, R. Amariglio, Keith A. Johnson, R. Sperling, D. Rentz","doi":"10.14283/JPAD.2015.72","DOIUrl":"https://doi.org/10.14283/JPAD.2015.72","url":null,"abstract":"BACKGROUND\u0000Impairment in activities of daily living is a major burden for Alzheimer's disease dementia patients and caregivers. Multiple subjective scales and a few performance-based instruments have been validated and proven to be reliable in measuring instrumental activities of daily living in Alzheimer's disease dementia but less so in amnestic mild cognitive impairment and preclinical Alzheimer's disease.\u0000\u0000\u0000OBJECTIVE\u0000To validate the Harvard Automated Phone Task, a new performance-based activities of daily living test for early Alzheimer's disease, which assesses high level tasks that challenge seniors in daily life.\u0000\u0000\u0000DESIGN\u0000In a cross-sectional study, the Harvard Automated Phone Task was associated with demographics and cognitive measures through univariate and multivariate analyses; ability to discriminate across diagnostic groups was assessed; test-retest reliability with the same and alternate versions was assessed in a subset of participants; and the relationship with regional cortical thickness was assessed in a subset of participants.\u0000\u0000\u0000SETTING\u0000Academic clinical research center.\u0000\u0000\u0000PARTICIPANTS\u0000One hundred and eighty two participants were recruited from the community (127 clinically normal elderly and 45 young normal participants) and memory disorders clinics at Brigham and Women's Hospital and Massachusetts General Hospital (10 participants with mild cognitive impairment).\u0000\u0000\u0000MEASUREMENTS\u0000As part of the Harvard Automated Phone Task, participants navigated an interactive voice response system to refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and make a bank account transfer and payment (APT-Bank). The 3 tasks were scored based on time, errors, and repetitions from which composite z-scores were derived, as well as a separate report of correct completion of the task.\u0000\u0000\u0000RESULTS\u0000We found that the Harvard Automated Phone Task discriminated well between diagnostic groups (APT-Script: p=0.002; APT-PCP: p<0.001; APT-Bank: p=0.02), had an incremental level of difficulty, and had excellent test-retest reliability (Cronbach's α values of 0.81 to 0.87). Within the clinically normal elderly, there were significant associations in multivariate models between performance on the Harvard Automated Phone Task and executive function (APT-PCP: p<0.001), processing speed (APT-Script: p=0.005), and regional cortical atrophy (APT-PCP: p=0.001; no significant association with APT-Script) independent of hearing acuity, motor speed, age, race, education, and premorbid intelligence.\u0000\u0000\u0000CONCLUSIONS\u0000Our initial experience with the Harvard Automated Phone Task, which consists of ecologically valid, easily-administered measures of daily activities, suggests that these tasks could be useful for screening and tracking the earliest functional alterations in preclinical and early prodromal AD.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"2 4 1","pages":"242-253"},"PeriodicalIF":6.4,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Combined Measure of Cognition and Function for Clinical Trials: The Integrated Alzheimer's Disease Rating Scale (iADRS).","authors":"A. Wessels, E. Siemers, P. Yu, S. Andersen, K. Holdridge, J. Sims, K. Sundell, Y. Stern, D. Rentz, B. Dubois, Roy W Jones, J. Cummings, P. Aisen","doi":"10.14283/JPAD.2015.82","DOIUrl":"https://doi.org/10.14283/JPAD.2015.82","url":null,"abstract":"It is generally recognized that more sensitive instruments for the earliest stages of Alzheimer's disease (AD) are needed. The integrated Alzheimer's Disease Rating Scale (iADRS) combines scores from 2 widely accepted measures, the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) and the Alzheimer's Disease Cooperative Study - instrumental Activities of Daily Living (ADCS-iADL). Disease progression and treatment differences as measured by the iADRS were analyzed using data from solanezumab EXPEDITION, EXPEDITION2, and EXPEDITION-EXT Studies; semagacestat IDENTITY Study; and donepezil ADCS - mild cognitive impairment (ADCS-MCI) Study. Psychometric properties of the iADRS were established through principal component analysis (PCA) and estimation of contributions of subscores and individual item scores to the iADRS total score. The iADRS performed better than most composites and scales in detecting disease progression and comparably or better than individual scales in detecting treatment differences. PCA demonstrated the iADRS can be divided into two principal components primarily representing cognitive items and instrumental ADLs. Dynamic ranges of the subscales were similar across all studies, reflecting approximately equal contributions from both subscales to the iADRS total score. In item analyses, every item contributed to the total score, with varying strength of contributions by item and across data sets. The iADRS demonstrated acceptable psychometric properties and was effective in capturing disease progression from MCI through moderate AD and treatment effects across the early disease spectrum. These findings suggest the iADRS can be used in studies of mixed populations, ensuring sensitivity to treatment effects as subjects progress during studies of putative disease-modifying agents.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"2 4 1","pages":"227-241"},"PeriodicalIF":6.4,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14283/JPAD.2015.82","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Symptoms in Dementia: Overview and Measurement Challenges.","authors":"C. Lyketsos","doi":"10.14283/JPAD.2015.60","DOIUrl":"https://doi.org/10.14283/JPAD.2015.60","url":null,"abstract":"Neuropsychiatric symptoms (NPS) are now known to occur almost universally over the course of dementia, Alzheimer’s in particular (1, 2). They also occur with higher-than-expected frequency in the dementia prodrome of mild cognitive impairment (3). Further, NPS in the form of “mild behavioral impairment,” in the absence of cognitive impairment, may constitute a dementia prodrome (4). NPS are associated with a number of adverse outcomes including accelerated transition from prodrome to dementia (4), and faster progression from early dementia to severe dementia or death [Peters et al, Am J Psychiatry, in press], as well as serious adverse effects for patients and caregivers such as greater disability, worse quality of life, earlier institutionalization, increased burden, and higher health care costs (2). Given their central importance, NPS are increasingly a focus of study with an eye to the development of effective treatments. \u0000 \u0000The heterogeneity of NPS complicates treatment development; they are heterogeneous in both phenomenology and cause. A wide range of symptoms has been reported although they tend to aggregate into predictable groups, especially in milder disease (5). The most reproducible groupings have been: depression, apathy, psychosis, agitation, and sleep disturbances [6]. Recent treatment development has targeted presumptive or proposed syndromes in these areas (7, 8). From the point of view of cause, NPS likely result from several interacting factors. The brain neurodegenerative process, through disruption of brain circuits involved in affect, behavior, motivation, or perception, is central to their emergence either through direct damage to circuits, or through creating vulnerabilities acted on by the environment. Additionally, NPS may result because of difficulties individuals face adapting to the surroundings as they lose cognitive abilities. Further, NPS may arise because of unmet needs, acute comorbid illnesses causing confusional states akin to delirium, or environments and caregiving that are mismatched with the patient’s current capabilities and skills [Kales et al, BMJ, under review). \u0000 \u0000Treatment development for NPS has to grapple with a number of issues concurrently. Efforts have included the development of nonpharmacologic approaches (9), as well as pharmacologic approaches. The latter initially involved importation of psychopharmaca developed for the treatment of psychiatric disorders into this setting with mixed results (2, 6). Of particular concern has been unexpected serious risks associated with these medications, antipsychotics in particular (6). \u0000 \u0000Central to treatment development for NPS is clinical measurement. As there are no specific “direct” measures of NPS, as with measures of cognitive functioning, measurement relies on reporting of observable behaviors and mental states by patients and others. Measurement is affected by a number of variables. These include aspects of the cognitive disorder that limit patient","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"2 3 1","pages":"155-156"},"PeriodicalIF":6.4,"publicationDate":"2015-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14283/JPAD.2015.60","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Age-Related Differences in Functional Capacity Using the Virtual Reality Functional Capacity Assessment Tool (VRFCAT).","authors":"A. Atkins, I. Stroescu, N. Spagnola, V. Davis, T. Patterson, M. Narasimhan, Philip D. Harvey, R. Keefe","doi":"10.14283/JPAD.2015.61","DOIUrl":"https://doi.org/10.14283/JPAD.2015.61","url":null,"abstract":"Clinical trials for primary prevention and early intervention in preclinical AD require measures of functional capacity with improved sensitivity to deficits in healthier, non-demented individuals. To this end, the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) was developed as a direct performance-based assessment of functional capacity that is sensitive to changes in function across multiple populations. Using a realistic virtual reality environment, the VRFCAT assesses a subject's ability to complete instrumental activities associated with a shopping trip. The present investigation represents an initial evaluation of the VRFCAT as a potential co-primary measure of functional capacity in healthy aging and preclinical MCI/AD by examining test-retest reliability and associations with cognitive performance in healthy young and older adults. The VRFCAT was compared and contrasted with the UPSA-2-VIM, a traditional performance-based assessment utilizing physical props. Results demonstrated strong age-related differences in performance on each VRFCAT outcome measure, including total completion time, total errors, and total forced progressions. VRFCAT performance showed strong correlations with cognitive performance across both age groups. VRFCAT Total Time demonstrated good test-retest reliability (ICC=.80 in young adults; ICC=.64 in older adults) and insignificant practice effects, indicating the measure is suitable for repeated testing in healthy populations. Taken together, these results provide preliminary support for the VRFCAT as a potential measure of functionally relevant change in primary prevention and preclinical AD/MCI trials.","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"2 2 1","pages":"121-127"},"PeriodicalIF":6.4,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14283/JPAD.2015.61","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Aspects of the Phase II Study AFF006 Evaluating Amyloid-beta -Targeting Vaccine AFFITOPE® AD02 in Early Alzheimer's Disease - Prospective Use of Novel Composite Scales.","authors":"S. Hendrix, N. Ellison, S. Stanworth, L. Tierney, F. Mattner, W. Schmidt, B. Dubois, A. Schneeberger","doi":"10.14283/JPAD.2015.67","DOIUrl":"https://doi.org/10.14283/JPAD.2015.67","url":null,"abstract":"BACKGROUND\u0000Optimized scales and composite outcomes have been proposed as a way to more accurately measure Alzheimer's disease related decline. AFFITOPE® AD02, is an amyloid-beta (Aβ)-targeting vaccine to elicit anti-Aβ antibodies. IMM-AD04, commonly known as Alum, originally designated as a control agent, appeared to have disease-modifying activity in a multicenter, parallel group phase II study in early AD patients.\u0000\u0000\u0000OBJECTIVES\u0000To develop adapted outcomes for cognition, function and a composite scale with improved sensitivity to decline and treatment effects in early AD (mild plus prodromal AD) based on historical data and to assess these adapted outcomes in this phase II study.\u0000\u0000\u0000DESIGN\u0000Data from public datasets was analyzed using a partial least squares model in order to identify an optimally weighted cognitive outcome, Adapted ADAS-cog, and an optimally weighted ADL outcome, Adapted ADCS-ADL which were prospectively defined as co-primary endpoints for the study and were also combined into a composite scale. Data from 162 patients in the placebo groups of ADCS studies and 156 mild patients in the ADNI I study were pooled for this analysis. The Adapted ADAS-cog scale considered 13 ADAS-cog items as well as several Neuropsychological test items and CogState items, the Adapted ADCS-ADL considered all ADCS-ADL items. After the pre-specified analyses were complete, additional adapted and composite scales were investigated in a post-hoc manner. Evaluation of the adapted and composite scales was performed on Phase II trial data for AFFITOPE® AD02 (AFF006, Clinical Trial Identifier: NCT01117818) and historic data in early AD. Least square means, standard deviations, and least squares mean to standard deviation ratios were compared among adapted and composite scales and traditional scales for the 5 treatment groups in the phase II study and overall for the historic data. Treatment effect sizes and p-values were also compared for the phase II study.\u0000\u0000\u0000RESULTS\u0000Cognitive items that were selected for the adapted cognitive scale (aADAS-cog) and had the highest weights were Word Recall, Word Recognition, and Orientation. Delayed Word Recall and Digit Cancellation were among the items excluded due to lack of improved sensitivity to decline. Highly weighted ADL items included in the adapted functional scale (aADCS-ADL) were using the telephone, traveling, preparing a meal/snack, selecting clothing, shopping and using appliances. Excluded items were primarily basic ADLs such as eating, walking, toileting and bathing. Comparisons between traditional scales and primary outcome adapted scales show improved sensitivity to group differences with the adapted scales in the phase II trial. Most of the improvement in the sensitivity of the aADAS-cog and the aADCS-ADL is due to a larger treatment difference observed rather than the improved sensitivity to decline in the comparison groups.\u0000\u0000\u0000CONCLUSION\u0000To our knowledge, this is the first study to prospectively use optimi","PeriodicalId":48606,"journal":{"name":"Jpad-Journal of Prevention of Alzheimers Disease","volume":"2 2 1","pages":"91-102"},"PeriodicalIF":6.4,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.14283/JPAD.2015.67","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66892928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}