Clinical trial NCT00880555: Semantic Memory, Financial Capacity, and Brain Perfusion in Mild Cognitive Impairment (MCI) (CASL)
Official title: Semantic Memory, Financial Capacity and Brain Perfusion in MCI
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Alzheimer Disease
Dementia
Keywords: Magnetic Resonance Imaging
Alzheimer disease
Mild cognitive impairment
Continuous arterial spin labeling
Semantic memory
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
Collaborators: name: University of Alabama at Birmingham
First posted: 2009-04-13
Enrollment: 78
Sex: ALL
Minimum age (years): 50
Maximum age (years): 89
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: 160 subjects are anticipated, with the expectation that initial cognitive evaluations will exclude about 60 subjects. We intend to maintain and follow 100 subjects, 40 with non-dementia memory impairment (meeting criteria for amnestic MCI) and 40 with no cognitive impairment, and 20 with mild Alzheimer disease

Brief summary: 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: 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.

Eligibility criteria: 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)

Primary outcomes:
measure: FCI Score at Follow-up
timeFrame: Year 1, Year 2, Year 3
Secondary outcomes:
Other outcomes:
Locations:
city: Birmingham
country: United States
facility: Birmingham VA Medical Center, Birmingham, AL
state: Alabama
Study officials:
affiliation: Birmingham VA Medical Center, Birmingham, AL
name: David G Clark, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Clark DG; Alzheimer Disease Neuroimaging Initiative. Residual vectors for Alzheimer disease diagnosis and prognostication. Brain Behav. 2011 Nov;1(2):142-52. doi: 10.1002/brb3.19.
citation: Clark DG, Wadley VG, Kapur P, DeRamus TP, Singletary B, Nicholas AP, Blanton PD, Lokken K, Deshpande H, Marson D, Deutsch G. Lexical factors and cerebral regions influencing verbal fluency performance in MCI. Neuropsychologia. 2014 Feb;54:98-111. doi: 10.1016/j.neuropsychologia.2013.12.010. Epub 2013 Dec 30.
citation: Clark DG, Kapur P, Geldmacher DS, Brockington JC, Harrell L, DeRamus TP, Blanton PD, Lokken K, Nicholas AP, Marson DC. Latent information in fluency lists predicts functional decline in persons at risk for Alzheimer disease. Cortex. 2014 Jun;55:202-18. doi: 10.1016/j.cortex.2013.12.013. Epub 2014 Jan 16.