Project Grant F31AG099691

ADVANCING A NOVEL PERFORMANCE-BASED TEST OF COGNITION AND DAILY FUNCTIONING TOWARDS SCREENING FOR PRECLINICAL ALZHEIMER'S DISEASE - PROJECT SUMMARY ALZHEIMER'S DISEASE (AD) CLINICAL TRIALS ARE COSTLY AND TIME CONSUMING, WITH PER-PARTICIPANT SCREENING COSTS COMMONLY BEING THE MOST EXPENSIVE FACTOR. PRECLINICAL AD TRIALS IN ASYMPTOMATIC INDIVIDUALS ARE PARTICULARLY COSTLY, WITH TYPICAL SCREEN-FAILURE RATES OF 88% AND RUNNING FOR ~8 YEARS, MUCH HIGHER AND LONGER THAN CLINICAL TRIALS IN OTHER THERAPEUTIC AREAS. THUS, THERE IS AN URGENT NEED FOR LOW-COST ENRICHMENT TOOLS THAT CAN IMPROVE THE EFFICIENCY OF PRECLINICAL AD TRIALS BY SCREENING POTENTIAL PARTICIPANTS FOR ELIGIBILITY AND LIKELIHOOD OF NATURAL DECLINE DURING TRIAL ENROLLMENT (~18-24 MONTHS). HOWEVER, CURRENT ENRICHMENT STRATEGIES LIKE BLOOD-BASED BIOMARKERS DO NOT RELIABLY PREDICT AN INDIVIDUAL'S COGNITIVE AND FUNCTIONAL TRAJECTORY IN THE SHORT TERM. ONE ENRICHMENT SOLUTION THAT HAS POTENTIAL CURRENTLY IS THE BRIEF EVALUATION OF COGNITION AND DAILY FUNCTION (BEAN), AN OBJECTIVE PERFORMANCE-BASED TEST THAT USES HOUSEHOLD ITEMS TO ASSESS THE INTEGRATION OF COGNITION INTO DAILY ACTIVITIES THAT TAKES LESS THAN FIVE MINUTES. THE LONG-TERM GOAL OF THIS PROJECT IS TO MERGE THE PI'S EXPERIENCE IN ENGINEERING, CELLULAR NEUROSCIENCE, AND HUMAN SUBJECTS EXPERIMENTATION WITH HER INTEREST IN AD-FOCUSED RESEARCH TO ENHANCE HER CAREER IN UNDERSTANDING PRECLINICAL AD FROM A NEUROEPIDEMIOLOGICAL CONTEXT. THE OVERALL OBJECTIVE OF THIS APPLICATION IS TO LEVERAGE EXISTING DATA FROM LONGITUDINAL STUDIES IN ASYMPTOMATIC ADULTS AGES 50+ WITHIN THE ARIZONA ALZHEIMER'S CONSORTIUM TO DETERMINE THE NEUROBIOLOGICAL MECHANISMS UNDERPINNING THE BEAN AND ITS SPECIFICITY TO AD, AND TO ESTABLISH NORMATIVE VALUES FOR CHANGE IN BEAN SCORES OVER TIME. THE CENTRAL HYPOTHESIS IS THAT THE BEAN WILL BE SENSITIVE AND SPECIFIC TO AD PATHOLOGY WITH MINIMAL ANNUAL CHANGE. SINCE THE BEAN IS QUICK (