Semantic Memory, Financial Capacity, and Brain Perfusion in Mild Cognitive Impairment (MCI) (CASL)

Study Overview
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Brief Summary
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Alzheimer's disease (AD) often manifests as a memory disorder before dementia develops. Dementia is considered to be present when a person can no longer handle complex activities of daily living, such as managing finances. This study will investigate the relationship between changes in the ability to manage finances and brain perfusion, which will be measured using continuous arterial spin-labeling (an experimental MRI). Subjects will also undergo neuropsychological tests focusing on several types of memory and thought process, with special emphasis on semantic memory. An important question to be addressed is whether changes in function are better predicted by the neuropsychological tests or by the brain scan.

Detailed Description
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Alzheimer's disease (AD) often manifests as a memory disorder before dementia develops. Dementia is considered to be present when a person can no longer handle complex activities of daily living, such as managing finances. This study will investigate the relationship between changes in the ability to manage finances and brain perfusion, which will be measured using continuous arterial spin-labeling (an experimental MRI). Subjects will also undergo neuropsychological tests focusing on several types of memory and thought process, with special emphasis on semantic memory. An important question to be addressed is whether changes in function are better predicted by the neuropsychological tests or by the brain scan. Participants will undergo a single MRI scan, baseline financial capacity instrument (FCI) and cognitive evaluation, and then will be followed approximately annually to repeat the functional and cognitive assessments. Linear mixed effects models will be used to fit a model predicting financial capacity based on baseline cognitive tests. Measures from the MRI scan will be added to the model to determine whether imaging improves the predictions.

Official Title
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Semantic Memory, Financial Capacity and Brain Perfusion in MCI

Conditions
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Alzheimer Disease, Dementia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Veteran or non-veteran Age 50-89 With normal cognition or memory impairment (MCI or mild AD) English speaking Right handed Adequate vision and hearing to take part in tests Able and willing to undergo MRI scan Medically and psychiatrically stable No other brain disease (such as tumor, Parkinson's disease, major stroke) Exclusion Criteria: Pregnancy Inability to tolerate MRI (due to metal in body or claustrophobia)

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 89 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Arm 1: Non-Dementia Memory Disorder<br>Elderly patients with non-dementia memory disorder (mild cognitive impairment) | |
| Arm 2: Control<br>Elderly controls without memory impairment | |
| Arm 3: Mild Alzheimer Disease<br>Patients with mild Alzheimer disease (but preserved routine activities of daily living) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| FCI Score at Follow-up | At each research visit, participants undertook 5 portions of the Financial Capacity Instrument (Domains 2, 3, 4b, 5, and 7). We report the total FCI score across the five domains tested, which has a range of possible scores from 0-191. Higher scores reflect greater capacity for understanding financial concepts and handling financial tasks. | Year 1, Year 2, Year 3 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Magnetic Resonance Imaging, Alzheimer disease, Mild cognitive impairment, Continuous arterial spin labeling, Semantic memory