Study to Identify Factors associated with Resilience to Clinical Dementia at Old Age

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 114

Inclusion Criteria

Age >= 90 years (for the subjects with cognitive impairment an exception will be
made; also subjects between 85 and 90 years will be included)
Candidate is able to walk 400 meter independently (with or without walking aid)
No significant visual or hearing impairment (as judged by clinician),
Cognitively intact group:
- MMSE >= 27 points, , this inclusion criteria is not applicable to the subjects
>= 100 years old (as a consequence of their age, they often score < 27 points
without having dementia)
- Clinical Dementia Rating (CDR) = 0.0 points, Cognitive impairment group:
- MMSE: 20-28 points inclusively
- CDR >= 0.5 point(s)
- Determination that this dysfunction is due to cognitive functional loss and
not physical impairment, as judged by a neurologist, internist-geriatrician or
General Practitioner (GP)., There is an overlap in MMSE score but this has no
effect on the contrast between the two groups. The two groups are based on
dementia diagnosis and the MMSE score has no influence on this diagnosis.
Someone with a MMSE of 27 can be both dement or cognitively healthy., For the
additional follow-up visits only cognitvely intact subjects will be seen for
questionnaires, neuropsychological examination and few physical measurements
(smelltest, hearingtest and handgrip strength). The second follow up visit will
be a repetition of the first, including the same subjects.

Exclusion Criteria

Clinical diagnosis of severe AD
Severe head trauma, with loss of consciousness
Brain tumour (past, present)
Schizophrenia, bipolar disorder, or recurrent psychotic disorders
Stroke resulting in physical impairment
Non-AD neurodegenerative disorders (e.g. Huntington disease, cortical basal
degeneration, multiple system atrophy, CreutzfeldtJacob disease, primary
progressive aphasia, Parkinson*s disease, diffuse Lewy body disease,
frontotemporal dementia, primary vascular dementia)
Epilepsy, currently using antiepileptic drugs (AEDs)
Brain infections (e.g. herpes simplex encephalitis)
Cancer with terminal life expectancy (life expectancy <12 months)
Cancer chemotherapy or radiotherapy within the last 3 months
Known B12 vitamin deficiency without treatment
Uncontrolled diabetes mellitus (last measure HbA1c >80 mmol/mol)
Known thyroid disease without treatment
History of recreational drug use
Alcohol consumption: >35 units per week (1 unit = 10ml of pure alcohol)
Physical morbidity or illness which will not permit attendance at visit sessions
Contraindication for MRI (e.g. metal implants, pacemaker etc.)
Medications that may impair cognition, at the discretion of the investigator,
e.g.:
- Benzodiazepine with known effects on cognitive functioning
- Lithium carbonate
- Antipsychotics including atypical agents
- Antidepressants with known effects on cognitive functioning
- Parkinson*s disease medicines