Many factors produce cognitive impairment in the elderly. Because they consume more medications than younger individuals, one of the most common forms of cognitive impairment in this group is that produced by medication side-effects. Currently there are no standard means for assessing medication-induced neurocognitive impairment. We propose to develop a specialized automated device for this purpose. Prior work demonstrates that combinations of EEG, evoked potential and behavioral data are sensitive and specific indicators of level of alertness and ability to sustain attention and hold information in working memory. Building on this knowledge, Phase I feasibility will be evaluated by analyzing task performance and EEG data from elderly subjects after they have ingested a common over-the-counter drug, the antihistamine diphenhydramine. We will derive multivariate behavioral and EEG indices from these data, and evaluate whether they discriminate post-drug conditions from placebo. Additionally, we will identify improvements required for use of our automated signal processing algorithms with elderly subjects, develop an expanded test other functions such as recent episodic memory, and design modifications to a system for administering, analyzing and tracking tests and results. In Phase II, the system would be fully implemented and independently tested.
The proposed system would serve as an enabling technology for researchers interested in objectively evaluating how medications affect neurocognitive function in the elderly. The system could also prove clinically useful as a means for titrating dosages and for detecting cognitive side effects. A second generation device may serve as a more general clinical tool for monitoring changes in cognitive status in the elderly. There is a large and rapidly growing market for such a clinical device.
