by Kristina McLinden, Program Director, Division of Neuroscience (DN).
Mounting evidence shows that identifying Alzheimer’s disease and related dementias (AD/ADRD) at the earliest stages is crucial, both to give people diagnosed with AD/ADRD more time to prepare for the future, and to help researchers better identify and characterize clinical trial participants. It’s a tough task, but NIA-supported scientists are making progress toward the goal of highly portable, quick, versatile, and comprehensive measures of neurological and behavioral function.
One recent success grew out of the EXERT trial, a 12-month exercise intervention for older adults with mild cognitive impairment (MCI). EXERT has been a proving ground for the development and validation of a new cognitive composite measure, the Alzheimer’s Disease Assessment Scale Cognitive Subscale Executive Function (ADAS-Cog-Exec). The ADAS-Cog-Exec improves on earlier tests with more sensitivity to changes over time in MCI, by adding measures of executive function — fundamental thinking skills like planning, working memory, time management, and organization — which is enhanced in older adults with increased exercise. Since executive function is important for better quality of life for people living with MCI, this an important innovation for clinicians, researchers, and patients. Other promising detection projects in the pipeline
NIA is already funding exciting research in early detection of AD/ADRD and MCI, including electronic financial indicators of cognitive decline, culturally appropriate dementia screening, and modernization of existing tools. The aim is more sensitive screening tools that can integrate sensory, motor, and emotional changes, all of which may help mark early warning signs of AD/ADRD.
The Consortium for Detecting Cognitive Impairment, Including Dementia (DetectCID) is another robust initiative to identify and validate cognitive assessment tools for primary care settings. Led by the NIH National Institute of Neurological Disorders and Stroke in collaboration with NIA, the goal is to better address the under-detection of cognitive impairment in diverse American populations. Other advances have evolved from the NIH Toolbox, a dynamic set of health assessments for all ages, which launched in 2015 for iPads and has since been developed into several mobile apps.