Neurocognitive Study for the Aging (NEUROAGE)

Given the fact that older adults are expected to live longer while maintaining their social and professional activities, the development of effective cognitive retraining methodologies designed to maximize independence has been of interest. In addition to changes caused by the normal aging process, older adults over 70 are at a high risk for developing dementia. About 8-12% of the older adult population will demonstrate a pre-dementia syndrome referred to as Mild Cognitive Impairment (MCI) which is considered the prodrome to dementia. Consequently, it is important to identify variables that contribute to the development of MCI as well as neurocognitive therapy approaches to help patients improve their level of functioning.

Categorization is one of the most fundamental cognitive processes. The ability to divide the world into discrete categories is a rudimentary process beginning early in life and continues to be developed and refined across the lifespan. (ref.1,2,10) This underlying process is crucial to a variety of neurocognitive abilities including attention and memory and can influence vocational and educational reintegration. Normal aging results in categorization deficits which in turn can interfere with the individual's ability to attend, remember, and organize information. This difficulty could hamper activities of daily living, social participation, and independence. This project implements an innovative treatment program based on current theoretical models of human cognition designed to improve neurocognitive abilities.

The primary objective of this project is to provide evidence on the effectiveness of a systematic and hierarchical neurocognitive therapy method, the Categorization Program (CP) in adults with MCI and in normal older adults. It is hypothesized that the CP will be an effective treatment approach to improve categorization abilities in both groups of subjects.

The following activities will take place:

1. First, a population-based sample of 500 older adults will be tested using a battery of neuropsychological measures. Normal older adults will be reassessed in two years; individuals with indication for MCI will be assessed further to determine the presence of MCI.
2. Second, normal OA and adults with MCI will be randomly assigned into either the treated or untreated groups. The treated groups will receive the CP training in order to test its effectiveness.
3. Third, the long term effects of cognitive retraining up to 1 year post treatment will be assessed.
4. Finally, the project will examine the relationship between the categorization tasks, neuropsychological performance, functional outcome measures, and subject characteristics including health indices, education, and biomarkers.

The long-term objective of this research program is to determine variables that influence cognitive decline in older adults and develop effective neurocognitive therapy techniques.