0-TESTO COMPLETO.pdf - Fondazione Santa Lucia

RF07.39.3 – Cognitive and behavioural indicators of conversion from mild cognitive impairment…
– Dubois B, Feldman HH, Jacova C, Dekosky ST, Barberger-Gateau P, Cummings J,
Delacourte A, Galasko D, Gauthier S, Jicha G, Meguro K, O’brien J, Pasquier F,
Robert P, Rossor M, Salloway S, Stern Y, Visser PJ, Scheltens P (2007) Lancet Neurol
6(8):734-746.
What the project adds to the information already available
This research project will attempt to identify clinical characteristics useful
for predicting: a) the risk of developing neurodegenerative dementia from
the 4 different forms of MCI (i.e., pure amnestic MCI-single domain, amnestic
MCI multiple domains, nonamnestic MCI single domain, and nonamnestic
MCI multiple domains); b) the type of dementia more frequently associated
with each clinical characteristics; c) the progression severity of the illness;
d) the effect of caregiver support on the illness progression; e) the efficacy of
cognitive rehabilitation on every subtype of clinical characteristics. Finally,
the method of open study on cognitive rehabilitation will give an early clinical
indication of the potential of this treatment.
OBJECTIVE(S)
The primary aims of the present project are: 1) to characterize an independent
series of neuropsychiatric and cognitive dimensions useful in the
diagnostic distinction among the four subtypes of Mild Cognitive Impairment
(MCI) (i.e., pure amnestic MCI-single domain, amnestic MCI multiple
domains, nonamnestic MCI single domain, and nonamnestic MCI multiple
domains); 2) to identify new cognitive and behavioural clinical-diagnostic
characteristics, predictors of the course of the illness; 3) to investigate
the effect of cognitive rehabilitation on the rate of conversion from MCI to
AD; 4) to analyze the effect of caregiver support on the illness progression.
Secondary aim is: 1) to evaluate the role of environmental predisposition
(such as stress of caregivers and stressful psychosocial events) in the MCI-AD
conversion.
METHODS
One hundred patients diagnosed with Mild Cognitive Impairment (MCI)
will be included in the study. The criteria for inclusion are: 1) MCI diagnosis
consistent with Petersen guidelines; 2) Mini Mental State Examination
(MMSE) score >24; 3) Clinical Dementia Rating (CDR) equal to 0.5; 4) sufficient
compliance to the tests administered; 5) Hachinski index less than or
equal to 4; 6) vision and hearing sufficient for compliance with testing procedures;
7) laboratory values within the appropriate reference intervals or considered
to be clinically insignificant by the investigators. Exclusion criteria
are: 1) major medical illnesses, e.g., diabetes (not stabilized), obstructive pulmonary
disease, or asthma; hematologic/oncologic disorders; vitamin B12 or
folate deficiency as evidenced by blood concentrations below the lower limits
of the reference intervals; pernicious anemia; clinically significant and unstable
active gastrointestinal, renal, hepatic, endocrine, or cardiovascular system
2009 717