The aim of this study is to find out whether a new image analysis technique called Cortical Disarray Measurement (CDM) could be used to help better diagnose Alzheimer's disease. This study will see whether changes on CDM can be used to identify Alzheimer's disease from a group of people living with memory and thinking problems. The study will also explore how CDM relates to changes in memory or thinking over time.
This is a multi-centre observational longitudinal cohort study to evaluate and optimise the Cortical Disarray Measurement (CDM) technique for diagnosis and prognosis in patients with mild cognitive impairment and prodromal / mild Alzheimer's Disease. CDM is a novel MRI analysis tool that quantifies cortical and regional diffusion tensor imaging signals in grey matter to observe pathological changes related to neurodegeneration. Participants in this study will be monitored for 2 years. Research Aims: * Assess the accuracy of CDM in detecting progressive change in cognitive and functional measures over 2 years in participants presenting with mild cognitive impairment or early dementia. * Determine the relationship between CDM (both cross-sectionally and longitudinally) and change on standard cognitive and functional assessment measures. * Explore patient and companion views and experiences of the diagnostic journey for dementia and their views on CDM implementation. * To explore the costs and consequences of introducing CDM-augmented MRI as a form of early diagnosis of Alzheimer's disease in people presenting with MCI or mild AD compared to current practice.
Study Type
OBSERVATIONAL
Enrollment
400
University Hospital Southampton NHS Foundation Trust
Southampton, Hampshire, United Kingdom
RECRUITINGDorset Healthcare University NHS Foundation Trust
Bournemouth, United Kingdom
NOT_YET_RECRUITINGCardiff and Vale University Health Board
Cardiff, United Kingdom
RECRUITINGCDR Progression
CDR Progression defined as a binary variable (yes/no) indicating either an increase in global outcome on Clinical Dementia Rating (CDR) scale (which takes value 0, 0.5, 1, 2 or 3, with higher scores reflecting more severe dementia), or an increase greater than, or equal to, 2 points on CDR Sum of Boxes (which takes values from 0 to 18 with higher values indicating a worse outcome)
Time frame: Baseline (Study day 1) to month 24
CDR Sum of Boxes
Change from baseline in the Clinical Dementia Rating (CDR) Sum of Boxes. CDR Sum of boxes is the sum over 6 domains (memory, orientation, judgment \& problem solving, community affairs, home \& hobbies, and personal care), each rated on a 5-point scale (0, 0.5, 1, 2, 3), giving a total score that ranges from 0 to 18, with higher values indicating a worse outcome.
Time frame: Baseline (Study day 1) to month 24
ADAS-cog
Change from baseline in Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-cog). Higher scores for ADAS-Cog represent a worse outcome.
Time frame: Baseline (Study day 1) to month 24
MMSE
Change from baseline in Mini Mental State Examination (MMSE). MMSE ranges from 0 to 30, with lower scores representing a worse outcome.
Time frame: Baseline (Study day 1) to month 24
ADCOMS
Change from baseline in Alzheimer's disease composite score (ADCOMS). The range of ADCOMS is between 0 and 1.97, with higher scores representing a worse outcome.
Time frame: Baseline (Study day 1) to month 24
RBANS
Change from baseline in the RBANS total score. The repeatable battery for the assessment of neuropsychological status (RBANS) is a brief neuropsychological battery. The total score can classify patients as follows: Average/Mild Impairment (standard scores of 70 or above), Moderate Impairment (standard scores from 55 to 69), and Severe Impairment (standard scores \<54), such that lower scores indicate a worse outcome.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Baseline (Study day 1) to month 24
ADCS-ADL
Change from baseline in Alzheimer's Disease Cooperative Study Activities of Daily Living Scale (ADCS-ADL). ADCS-ADL
Time frame: Baseline (Study day 1) to month 24
Functional Activities Questionnaire (FAQ)
The Functional Activities Questionnaire (FAQ) measures instrumental activities of daily living. Scores range from 0 (independent) to 30 (dependent), with higher scores indicating a worse outcome.
Time frame: Baseline (Study day 1) to month 24
Institutionalisation or POC
Institutionalisation in care home or nursing home or implementation of package of care (POC) for dementia. Binary outcome (yes, no), with "yes" indicating a worse outcome.
Time frame: Baseline (Study day 1) to month 24
Death (any cause)
Death due to any cause
Time frame: Baseline (Study day 1) to month 24
EQ-5D-5L (Patient Participant)
EuroQuol EQ-5D-5L is an instrument to describe and value health on five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.
Time frame: Baseline (Study day 1) to month 24
EQ-5D-5L (Study Companion)
EuroQuol EQ-5D-5L is an instrument to describe and value health on five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems.
Time frame: Baseline (Study day 1) to month 24
Zarit Burden Interview
The Zarit Burden Interview (ZBI) assesses caregiver perceptions of burden. Higher scores indicate a worse outcome.
Time frame: Baseline (Study day 1) to month 24
Health and social care resource usage
Health and social care resource usage questionnaire. Higher values indicate a worse outcome.
Time frame: Baseline (Study day 1) to month 24