We aim to develop a novel approach for the early detection of pre-clinical signs of mental decay in elderlies.By means of consecutive sessions of testing we will: 1. describe the normal aging slopes of different cognitive skills in healthy elders (HE); 2. identify the variations in aging slopes that suggest anomalous aging, and then the possibility that a neurocognitive disorder is going to onset; 3. verify, in groups of elder participants with minor neurocognitive disorders (ND) or subjective cognitive decline (SCD), if the slopes of the cognitive skills are similar to those identified as anomalous in HE and thus should be considered as a sign of an ongoing onset of ND in HE.
For these aims, we will develop a novel battery of computerized test, to be administered by Android operating tablets. The battery will include tests of episodic long-term verbal and visuo-spatial tests, as well as tests of selective and divided attention, cognitive domains that are well known to be involved since the early stages of neurocognitive disorders (ND), being long-term memory involved in early stages off Alzheimer and attention in that of FTD.
To increase the sensitivity of the assessment we will include in the studies tests tapping cognitive abilities that in the last years have been shown to be impaired in early stages of neurocognitive disorders (for example, prospective memory and topographical orientation). We will also develop parallel forms of tests to be used in the longitudinal studies to reduce the risk of learning effects.
Finally, a neuroimaging study will be performed to test if anomalous slopes correspond to different rate of neural atrophy in respect to that observed in healthy individuals.
Results of present project will provide an advancement in the knowledge of the pre-clinical and early stages of pathological
aging as well as a novel way to monitor aging in healthy population. The parallel batteries of tests we will develop, by
evaluating the rate of aging of different cognitive functions, will allow to detect very early signs of anomalous aging and
conversion to ND not only in SCD but even in HE who have never complained difficulties in daily life. The
opportunity to identify signs of anomalous aging in healthy individuals whose cognitive abilities are still well within the
normal range and who are still living an active, autonomous life, will have important scientific, social and economic
impact. Indeed, from a scientific point of view it will represent a great opportunity to study preclinical stages of ND and
conversion to MCI and dementia in selected population of (at-the-moment) healthy individuals predicting with a high level of
confidence who is going to develop cognitive decline and who is not. The possibility to classify individuals according to the
presence/absence of anomalous, but yet normal, aging together with the possibility to utilize the parallel tests would result
in an important opportunity for developing future multi-centric studies aimed on one side to further understanding the
physio-pathological mechanisms underlining these pathology, and on the other side to develop and test the efficacy and
effectiveness of novel pharmacological and behavioral therapies that would effectively fight ND onset.
Given the known incidence of novel cases of MCI and ND and the annual rate of conversion from SCD in MCI and ND, we
expect that some HE and some SCD may show signs of the onset of ND before the end of the project, so that their
performances will results within the normal range at the 1st evaluation, but defective at the 3rd evaluation. Single case
analyses will be performed on these possible cases to test the hypothesis that the corresponding aging rate differs from that of HE and SCD who will show no sign of pathological decline.
A specific set of analyses will be performed on RMI data for assessing possible differences in VBM and connectivity
between HE and SCD at T1 and for comparing the indexes of brain atrophy in T1 to those recorded in T43 A classificator
(implemented by means of ADOBE SENSEI) will be trained to identify the rates of brain atrophy, to distinguish HE form
SCD (T1) and converter from non-converter.
Finally, correlational studies will be performed in order to identify the neural correlates of anomalous aging of different
cognitive domains.
In summary, the data analyses will provide the following results:
1. cut-offs and convergent validity of each novel test
2. limits of normal aging rate and indexes of anomalous aging rate in novel tests
3. neural correlates of normal and anomalous aging