Alzheimer's disease Dementia
Conditions
Interventions
None listed
Sponsors
Vrije Universiteit Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Age >= 90 years (for the subjects with cognitive impairment an exception will be made; also subjects between 85 and 90 years will be included) Candidate is able to walk 400 meter independently (with or without walking aid) No significant visual or hearing impairment (as judged by clinician), Cognitively intact group: - MMSE >= 27 points, , this inclusion criteria is not applicable to the subjects >= 100 years old (as a consequence of their age, they often score = 0.5 point(s) - Determination that this dysfunction is due to cognitive functional loss and not physical impairment, as judged by a neurologist, internist-geriatrician or General Practitioner (GP)., There is an overlap in MMSE score but this has no effect on the contrast between the two groups. The two groups are based on dementia diagnosis and the MMSE score has no influence on this diagnosis. Someone with a MMSE of 27 can be both dement or cognitively healthy., For the additional follow-up visits only cognitvely intact subjects will be seen for questionnaires, neuropsychological examination and few physical measurements (smelltest, hearingtest and handgrip strength). The second follow up visit will be a repetition of the first, including the same subjects.
Exclusion criteria
Exclusion criteria: Clinical diagnosis of severe AD Severe head trauma, with loss of consciousness Brain tumour (past, present) Schizophrenia, bipolar disorder, or recurrent psychotic disorders Stroke resulting in physical impairment Non-AD neurodegenerative disorders (e.g. Huntington disease, cortical basal degeneration, multiple system atrophy, CreutzfeldtJacob disease, primary progressive aphasia, Parkinson*s disease, diffuse Lewy body disease, frontotemporal dementia, primary vascular dementia) Epilepsy, currently using antiepileptic drugs (AEDs) Brain infections (e.g. herpes simplex encephalitis) Cancer with terminal life expectancy (life expectancy 80 mmol/mol) Known thyroid disease without treatment History of recreational drug use Alcohol consumption: >35 units per week (1 unit = 10ml of pure alcohol) Physical morbidity or illness which will not permit attendance at visit sessions Contraindication for MRI (e.g. metal implants, pacemaker etc.) Medications that may impair cognition, at the discretion of the investigator, e.g.: - Benzodiazepine with known effects on cognitive functioning - Lithium carbonate - Antipsychotics including atypical agents - Antidepressants with known effects on cognitive functioning - Parkinson*s disease medicines
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary study parameters are: 1. To understand how clinical markers and biomarkers previously identified (and published) in younger and older dementia cohorts apply to the extreme elderly. 2. To identify novel biomarkers linked with resilience to developing AD in extreme elderly subjects. 3. To investigate the association of biomarkers tested at baseline for change in cognitive fuction and progression to dementia during a 3 year follow-up period. The clinical markers and biomarkers we will test, can be divided into the following 6 domains: - brain reserve capacity - comorbidity - genetics - physical performance - senescence state - biomarkers for AD For each domain we will test one or more parameters. For each parameter we will study whether this parameter is associated with resilience for dementia in the oldest old. Follow-up: 1. The main outcome at follow-up is cognitive performance after 1-2 years. 2. To identify predictors for cognitive decline in non-demented extreme elderly. | — |
Secondary
| Measure | Time frame |
|---|---|
| The secundary study parameters are: 1. Generate normative data for the oldest old. 2. To measure the concordance between amyloid pathology as assessed in CSF and by PET in the oldest old. | — |
Countries
Netherlands
Outcome results
None listed