Informations générales (source: ClinicalTrials.gov)
The Potential Impact of Aging Stereotypes in the Assessment of Memory Deficits and Screening for Prodromal State of Alzheimer's Disease (AGING)
Interventional
N/A
Assistance Publique Hopitaux De Marseille (Voir sur ClinicalTrials)
juillet 2018
juillet 2023
29 juin 2024
Because of the lengthening of life expectancy, more and more people are concerned with
the effects of aging on their mental faculties (e.g., memory decline) and with the
possibility of getting Alzheimer's Disease (AD) or other forms of dementia. This
increasing awareness of AD has already resulted in a growing demand for
neuropsychological testing. AD's research also emphasizes the need for early screening to
improve the prediction of the disease progression and the efficacy of any future therapy.
Such a drive to screen for pre-dementia raises the challenging issue of frontline
identification of individuals in the preclinical or early clinical stages of AD. Mild
Cognitive Impairment (MCI) is typically considered to be the prodromal state of AD, and
is therefore at the core of the drive for early screening. Moreover, Pre-MCI so called
SCI (Subjective Cognitive Impairment) can precede AD for 15 years. However, many
individuals diagnosed with MCI do not convert to AD, some remaining stable and others
even reversing back to normal (with rates of reversion to normal varying from 4.5% to as
high as 53%). This over-diagnosis bias, which has been largely overlooked, is at the core
of the present project at the interface of human and life sciences. Here, we argue that
an important source of overdiagnosis in the prodromal state of AD comes from negative
aging stereotypes (e.g., the culturally shared beliefs that aging inescapably causes
severe cognitive decline and diseases such as AD) that permeate neuropsychological
screening. There is ample evidence in the laboratory that such stereotypes contribute to
the differences observed in the healthy population between younger and older adults in
explicit memory tasks. Additionally, three pilot (lab) studies specifically conducted for
the present ANR project showed that the threat of being judged stereotypically undermines
the controlled use of memory of healthy older adults and simultaneously intensifies their
automatic response tendencies, resulting in impaired memory performance. The present
proposal goes several steps further by examining for the first time whether aging
stereotypes are powerful enough to implicitly permeate the clinical neuropsychological
testing and thus inflate memory deficits in older adults judged "at risk" (based on
either epidemiological criteria or memory complaints), resulting in false-positive
detection of SCI and MCI. This provocative hypothesis will be tested while 1) using
biomarkers of neurodegeneration to distinguish false-positives from true MCI, and 2)
using biomarkers of stress to examine whether and how aging stereotypes can lead to acute
physiological stress during neuropsychological testing. This innovative project has the
potential to offer new recommendations to improve the diagnosis accuracy of prodromal
state of AD, with positive consequences for older people's wellbeing.
Etablissements
| Les établissements hors Île-de-France dont les données sont issues de ClinicalTrials.gov Origine et niveau de fiabilité des données | |||||
|---|---|---|---|---|---|
| Assistance Publique Hôpitaux de Marseille - 13354 - Marseille - France | Bernard MICHEL, PH | Contact (sur clinicalTrials) | |||
Critères
Tous
Inclusion Criteria:
- Patients must be at least 50 years old
- Patients must report memory complaints
- Patients must show signs of MCI (amnestic single or multiple domain) on the
following short cognitive tests
- Patients must be at least 50 years old
- Patients must report memory complaints
- Patients must show signs of MCI (amnestic single or multiple domain) on the
following short cognitive tests
- Probable Alzheimer's Disease according to NINCDS-ADRDA criteria (MA patients will be
excluded from the study because false-positive errors only concern MCI status, not
AD)
- Psychiatric disorders (schizophrenia, bipolar disorder)
- Cranial trauma
- Developmental pathologies
- Depression (score greater than or equal to 10 on GDS)
- Psychotropic medication if modified in the last 3 months