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MONTREAL, Oct. 7, 2013 /CNW/ - Results from two new studies add to the body of evidence that supports CognigramTM as a sensitive assessment to detect and monitor cognitive decline over time, namely in healthy individuals and adults with mild cognitive impairment (MCI) that are carriers of a biological marker in the brain - Aß amyloid.1,2 Data from two studies were presented at the Canadian Conference on Dementia (CCD), in Vancouver, British Columbia, between October 3 and 5.
"This is a true advance in the way clinicians will be able to detect and monitor the progression of cognitive disorders in older people. It is the first time that a computerized cognitive assessment has been associated with levels of Aß amyloid in the brain," says Dr. Paul Maruff, Chief Science Officer at Cogstate and one of the authors of the two studies. "Aß amyloid is a biomarker that signifies abnormal proteins in the brain and provides important information to indicate that the Alzheimer's disease process has begun. In our studies presented at CCD, we underscore the sensitivity of CognigramTM to efficiently assess over time (up to 36 months) the decline of cognitive function in people whose brains had been scanned and showed presence of high levels of this biomarker."
Amyloid and Cognition
Aß amyloid biomarkers provide important insights into the clinical course of cognition. Prospective studies in healthy older adults and adults with mild cognitive impairment have shown that high levels of Aß amyloid are often associated with the decline of cognitive function and a more rapid progression to the next clinical disease stage.1
Cognition is the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment. Some decrease in cognition is expected at older ages, but the decline is not uniform across all cognitive tasks or for all individuals. Impaired cognition can have health consequences, such as first stroke, falls, and institutionalization. It may reduce an individual's ability to communicate pain to health care providers, carry out instrumental activities of daily living, cope with chronic disease symptoms, perform self-care and adhere to medication instructions. 3
"Dementia and Alzheimer's disease are marked by a decline in overall cognition and function, having a profound impact on the daily life of patients and their caregivers," says Dr. Louis Verret, Neurologist and Researcher, Interdisciplinary Memory Clinic, Centre hospitalier universitaire (CHU) de Québec. "As these diseases continue to escalate at an alarming rate, research looking at Aß amyloid in the brain and its relationship to changes in cognition is an exciting area that may contribute to therapeutic interventions aimed at modifying the course of Alzheimer's disease-related neurodegeneration."
The number of Canadians living with cognitive impairment, including dementia, was 747,000 in 2012 and will double to 1.4 million by 2031.4 The annual economic burden is expected to increase substantially from approximately $15 billion in 2008 to $153 billion by the year 2038.5
About the Studies1,2
The study "Aß amyloid and cognitive change: Decline in learning and working memory across the preclinical and prodromal stages of Alzheimer's disease," included 177 healthy older adults and 48 adults with mild cognitive impairment (MCI) who underwent positron emission tomography (PET) neuroimaging using Pittsburgh Compound B (PiB) for Aß amyloid, APOE ?4 genotyping, and cognitive assessment using CognigramTM as part of their baseline assessment in the Australian Imaging, Biomarkers, and Lifestyle (AIBL) study. Cognitive function using Cognigram™ was reassessed at 18 and 36 months later.
"The consequences of high Aß amyloid for performance on CognigramTM in healthy older adults and mild cognitive impairment. Implications for early detection of Alzheimer's disease," study included 288 healthy older adults and 56 adults with amnestic MCI from the AIBL study, who underwent PET neuroimaging using PiB for Aß amyloid, and completed the CognigramTM cognitive screen.
Participants from both studies were recruited from the Australian Imaging, Biomarkers, and Lifestyle (AIBL) Study of Ageing, which aims to discover which biomarkers, cognitive characteristics, and health and lifestyle factors determine subsequent development of symptomatic Alzheimer's disease. The AIBL study is supported by the Science and Industry Endowment Fund in Australia.6
Funding for the studies was provided in part by the study partners [Australian Commonwealth Scientific Industrial and Research Organization (CSIRO), Edith Cowan University (ECU), Mental Health Research Institute (MHRI), Alzheimer's Australia (AA), National Ageing Research Institute (NARI), Austin Health, Cogstate Ltd., Hollywood Private Hospital, Sir Charles Gardner Hospital]. The studies also received support from the National Health and Medical Research Council (NHMRC) and the Dementia Collaborative Research Centres program (DCRC2), as well as ongoing funding from the Science and Industry Endowment Fund (SIEF).
About the Results1,2
The study "Aß amyloid and cognitive change: Decline in learning and working memory across the preclinical and prodromal stages of Alzheimer's disease," found that compared to healthy older adults with low Aß amyloid, healthy older adults and adults with MCI with high Aß amyloid showed a moderate decline across 36 months on the CognigramTM learning working memory composite. In contrast, adults with MCI and low Aß amyloid showed a slight improvement on the CognigramTM learning/working memory and psychomotor/attention composites across the 36 months. APOE ?4 carriage did not moderate the relationship between Aß amyloid and cognitive decline.
"The consequences of high Aß amyloid for performance on CognigramTM in healthy older adults and mild cognitive impairment. Implications for early detection of Alzheimer's disease," study found that in healthy adults, performance on the attention/psychomotor function composite was equivalent between low and high Aß amyloid groups. Performance on the learning/working memory composite was slightly worse in the high Aß amyloid group compared to low Aß amyloid group although this did not reach statistical significance. In MCI, performance on the attention/psychomotor function composite was equivalent between low and high Aß amyloid groups however performance on the learning working memory composite was significantly worse in the MCI high Aß amyloid group compared to the MCI low Aß amyloid group.
CognigramTM is a computer-based system designed to measure and monitor cognitive function for neurodegenerative diseases such as mild cognitive impairment and Alzheimer's disease. Merck Canada Inc. promotes CognigramTM in Canada. CognigramTM was created and is supplied by Cogstate Ltd. The partnership is part of the ongoing commitment from Merck to improve disease management involving the central nervous system.
Today's Merck is a global healthcare leader working to help the world be well. Merck is known as MSD outside the United States and Canada. Through our medicines, vaccines, biologic therapies, and consumer and animal products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to healthcare through far-reaching policies, programs and partnerships. For more information about our operations in Canada, visit www.merck.ca.
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1 Maruff, Paul et al. Aß amyloid and cognitive change: Decline in learning and working memory
across the preclinical and prodromal stages of Alzheimer's disease. Poster presented at the Canadian Conference on Dementia on October 4,
2 Maruff, Paul et al. The consequences of high Aß amyloid for performance on Cognigram in healthy older adults and mild cognitive impairment. Implications for early detection of Alzheimer's disease. Poster presented at the Canadian Conference on Dementia on October 5, 2013.
3 Gilmour, Heather. Cognitive performance of Canadian seniors. Statistics Canada. June 2011. Available at: http://www.statcan.gc.ca/pub/82-003-x/2011002/article/11473-eng.pdf.
4 Alzheimer Society of Canada. A new way of looking at the impact of dementia in Canada. Available at: http://www.alzheimer.ca/~/media/Files/national/Media-releases/asc_factsheet_new_data_09272012_en.ashx.
5 The Alzheimer Society. Rising Tide: The Impact of Dementia on Canadian Society. Executive Summary. 2010. Available at: http://www.alzheimer.ca/on/~/media/Files/national/Advocacy/ASC_Rising%20Tide-Executive%20Summary_Eng.ashx.
6 Introducing the AIBL. The Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL). May 14, 2013. Available at: http://www.aibl.csiro.au/.
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