Aging-associated cognitive decline, whether mild or severe, can profoundly affect the independence, well-being, and quality of life of those aged 65 and older. Development of effective interventions and treatments for this requires standard, psychometrically sound, easy-to-use measures that are sensitive to early indicators of cognitive decline and also capture non-cognitive factors associated with or predictive of cognitive changes. ?Advancing Reliable Measurement in Alzheimer's Disease and cognitive Aging? (ARMADA) proposes to meet this need by validating and expanding the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) for use in studies of cognitive aging beginning with normal cognition through progression into mild cognitive impairment and into early stages of Alzheimer's dementia. The NIHTB, developed with NIH support, provides a multidimensional, state-of-the-art set of measurement tools (available in English and Spanish) assessing key aspects of cognitive, sensory, motor, and emotional function and validated and normed in the general population for ages 3-85 years. To ensure that the NIHTB will be a valuable resource for cognitive aging research we will: 1) Validate English and Spanish versions of an expanded NIHTB (the NIHTB+) in existing, well-characterized, ethnically and racially diverse samples of adults ages 65-85 representing the trajectory of cognitive aging and in cognitively normal individuals 86+ years of age. 2) Expand the NIHTB by adding innovative instruments to assess neurological functions associated with cognitive aging; and 3) Facilitate use of the NIHTB+ in aging research by ensuring it is a readily available resource with robust user support. In order to accomplish these aims, we will form a consortium with the National Alzheimer's Coordinating Center (NACC) and with researchers in cognitive aging and dementia from Alzheimer's Disease Centers and other clinical sites with existing cohorts. The consortium will be supported by Administrative, Technical, and Data and Statistical Analysis Cores.

Public Health Relevance

Cognitive decline and dementia due to Alzheimer's Disease (AD), both associated with advancing age over 65, are increasing in the US due to the reduction of other illnesses that, in the past, limited life expectancy. This project will validate the NIH Toolbox for Assessment of Neurological and Behavioral Functions (NIHTB), including new expanded tests most-relevant to aging research (NIHTB+), among individuals with amnestic mild cognitive impairment (aMCI), AD, and older adult normal controls age 65-85 (NCO), and among the oldest of the old normal controls, aged 86+ (NCOO). The NIHTB+ will provide a brief, comprehensive assessment tool (in English and Spanish versions), applicable to diverse populations, to screen for a decline in cognitive health and associated neurological functions, paving the way for its use in prevention clinical trials.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Resource-Related Research Multi-Component Projects and Centers Cooperative Agreements (U2C)
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Special Emphasis Panel (ZAG1)
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Anderson, Dallas
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Northwestern University at Chicago
Public Health & Prev Medicine
Schools of Medicine
United States
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Besser, Lilah; Kukull, Walter; Knopman, David S et al. (2018) Version 3 of the National Alzheimer's Coordinating Center's Uniform Data Set. Alzheimer Dis Assoc Disord 32:351-358