The Alzheimer's Disease and Memory Disorders Center
Research Studies On Brain Health, Mild Cognitive Impairment and Alzheimer Prevention
Telephone Screening for Mild Cognitive Impairment
Principal Investigators: Brian R. Ott, MD and Geoffrey Tremont, PhD
Mild cognitive impairment (MCI) is a significant risk factor for the subsequent development of dementia. The best method for detecting MCI is through comprehensive evaluation, which can be costly and time consuming. Cost effective cognitive screening measures are needed to identify early cognitive decline in older adults. The Minnesota Cognitive Acuity Screen (MCAS) has been developed to assess a wide range of functions known to be impaired in dementia. It also has the unique feature of telephone administration. A preliminary study shows that the MCAS can very effectively distinguish between healthy elderly and individuals with mild to moderate dementia.
The proposed study will recruit 200 older adult individuals (aged 60-79) who are cognitively healthy (n = 50), have mild cognitive impairment (MCI; n = 100), or have mild Alzheimer’s disease (AD; n = 50). They will undergo a comprehensive in-office diagnostic work-up and will be administered the MCAS over the telephone within two weeks of the in-office exam. We will define the sensitivity and specificity, and positive and negative predictive values of the Minnesota Cognitive Acuity Screen (MCAS) for MCI compared to cognitively-normal older controls and persons with mild AD. We will also identify whether other factors (psychiatric history, repetitious behaviors, practice effects, awareness of deficit) can distinguish between the groups.
Funded by Long Term Care Group, 2006-16
Pilot Trial of a Mind-Body Intervention for Mild Cognitive Impairment
Principal Investigator: Geoffrey Tremont, PhD
Mild cognitive impairment (MCI) is a condition that causes slight, but noticeable declines in cognitive abilities including memory and thinking skills. MCI often precedes Alzheimer’s disease but there are currently no treatments that prevent the progression of MCI to dementia. Interventions that could delay the progression of MCI and improve cognition and daily living skills would greatly benefit affected individuals and their families.
Yoga is a low risk, mind-body intervention that is widely accessible and easily incorporated into daily life. In addition, initial studies have shown that yoga can positively impact several risk factors for MCI and Alzheimer’s disease including stress, depression and cardiovascular health. Research is needed to determine if yoga is an effective strategy for improving cognition and quality of life in people with MCI.
Geoffrey Tremont, Ph.D., and colleagues have developed a yoga manual and plan to conduct a pilot study to determine the effects of a 12-week yoga program in people with MCI. Participants in the study will either receive a twice-weekly yoga intervention or healthy living education (e.g. the control group). The researchers will determine if the participants in the yoga intervention group show greater benefits in cognitive, emotional and daily functioning. They will also measure changes in blood pressure and stress levels to determine if yoga positively impacts these risk factors.
The results of this work will provide valuable information on implementing a yoga program in individuals with MCI. The researchers will use this data to support future funding of a large-scale clinical trial to explore the underlying mechanisms and long-term effects of yoga on brain health. If successful, this effort could reveal a new, non-drug strategy for delaying the progression of MCI.
Funded by the National Alzheimer's Association, 2015-19
Blood -brain Barrier Disruption As a Biomarker For Perioperative Neurocognitive Disorder: Cognitive Recovery After Elective Surgery
Principal Investigator: Lori A. Daiello, PharmD, ScM
Despite decades of research, little is known about how to effectively prevent postoperative delirium or postoperative cognitive dysfunction; however, emerging perspectives on the role of the blood-brain barrier (BBB) in health and disease suggest that increased permeability (BBB dysfunction) may be associated with the development of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD). Up to half of all older adults develop POD, and POCD is reported in 5-20% of surgical patients over 65 years; at present, neither condition can be effectively prevented nor treated and both are associated with decreased quality of life and survival, as well as numerous other negative outcomes. Our long-term goal is to advance knowledge of the effects of surgical stress on the aging brain, ultimately leading to effective strategies to improve the cognitive safety of surgery. The objective of this research is to investigate the extent to which an innovative brain imaging technique, water exchange index MRI (WEI-MRI) evidence of BBB dysfunction predicts the incidence of POD and POCD, in a longitudinal study of older adults undergoing major elective non-cardiac surgeries. Our central hypothesis is that in the aging brain, BBB dysfunction is a biomarker for brain vulnerability that predicts increased risk for POD, POCD, and progressive cognitive decline. We will test this hypothesis by accomplishing the following specific aims: 1) Evaluate associations between BBB permeability and the incidence of POD; 2) Evaluate associations between BBB permeability and the incidence of POCD; and 3) Identify changes in markers of endothelial injury and inflammation in peripheral blood that predict POD and POCD. This approach is innovative because it employs a noninvasive technology to precisely measure BBB permeability and pinpoint the area(s) of the brain in which it occurs. The proposed research is significant in that it will lay essential groundwork for development of future interventions to improve the cognitive safety of major elective surgeries in the aging population. Recognition of BBB dysfunction may be of critical prognostic importance in determining brain susceptibility to surgical stress.
Funded by NIH/NIA # R01AG058648, 2019-2024