Project Personalized Cognitive Diagnostics

Personalized Cognitive Diagnostics for Early Detection of Dementia [PhD Project]

Due to aging societies, the number of people with Alzheimer’s disease is on the rise. Dr. Ruth Mark and her colleagues hope to improve the early diagnosis of dementia (including Mild Cognitive Impairment). Statistical learning methods will be employed to develop personalized ‘norms’ for an online “famous faces test”. This project is part of the Personalized Prevention and Care theme.

Societies are aging worldwide and age is the strongest predictor of cognitive decline and dementia. Alzheimer’s disease is the primary cause of dementia. Over 270.000 people suffer from Alzheimer’s disease in the Netherlands alone and this number is expected to double over the next decade. The need to diagnose as early as possible is based on the assumption that addressing the deterioration in the brain before it tips into dementia would both help the people concerned to live impairment-free for longer and save the world’s economies from the enormous costs dementia creates. However, despite its high prevalence, Alzheimer’s disease is often caught late. A reason for this might be that Alzheimer ’s disease is very heterogeneous. Individuals differ in age of onset, genetic and other risk factors, on their clinical symptomology and on the type and rate of their cognitive decline, while memory loss is a hallmark of cognitive decline in Alzheimer’s disease.

Early stage symptoms such as memory decline are often mistaken for normal aging, creating a barrier for patients to seek care. Furthermore, when individuals do find their way to a clinician, current, standard neuropsychological tests ignore inter-individual differences in the variables mentioned above and individual characteristics (e.g., cultural or educational background), which modulate cognitive task performance and thus introduce variance, requiring higher detection thresholds. This is unfortunate (and costly), since early detection of Alzheimer ’s disease could significantly increase the effectiveness of possible interventions as there is currently no cure.

The Personalized Health Care framework stresses that we cannot treat all patients the same: therefore, we need to change our approach to diagnosing dementia and focus instead on the individual rather than on global, group-based, neuropsychological test norms. A cognitive test sensitive and specific enough to identify preclinical dementia at the individual level would be ideal. We think that the “famous faces test” is a good candidate which may ultimately help to identify early signs of dementia.

This project brings together a well-rounded team with complementary expertise in healthy (Brehmer) and pathological aging (Mark), age-related memory changes and Alzheimer’s disease (Mark, Brehmer), and in online data collection, data processing, statistical modelling, and scale development/validation (Lang; Mark, Brehmer & van Wingerden).

Cross-cutting themes

The Herbert Simon Research Institute for Health, Well-being, and Adaptiveness is a research center devoted to carrying out excellent, state of the art research in order to contribute to healthy and resilient people. We have selected three themes, which involve the collaboration between various Departments  and address actual themes in need of both fundamental and applied research.