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Background: Instrumental activities of daily living (IADL) are complex activities which involve multiple cognitive processes, and which are expected to be susceptible to the early effects of cognitive impairment. Informant-based questionnaires are the most common tools used to assess IADL performance in dementia, but must be adjusted for use in early stages of impairment. Objective: To investigate the differences in IADL on the continuum of cognitive decline (i.e. no cognitive decline - subjective cognitive decline - mild cognitive impairment- mild dementia - moderate dementia) using the Spanish version of the Amsterdam IADL Questionnaire (A-IADL-Q). Methods: A total of 500 volunteer participants were included: 88 participants with no signs of cognitive decline, 109 participants with subjective cognitive complaints, 114 participants with mild cognitive impairment (MCI), 81 participants with mild dementia and 108 participants with moderate dementia. IADL was assessed with the A-IADL-Q, a computerized and adaptive questionnaire that calculates scores according to the specific pattern of responses of each participant. The data were examined by ANOVAs and regression analysis. Multinomial logistic regression analysis was used to evaluate the capacity of the A-IADL-Q to distinguish between diagnostic groups. Results: Participants with no cognitive decline and those with subjective cognitive decline obtained higher A-IADL-Q scores than MCI participants, and participants with MCI obtained higher scores than patients with dementia. The A-IADL-Q showed excellent discrimination between non-cognitive impairment and dementia, and significant but low discrimination between non-cognitive impairment and MCI. Conclusion: A-IADL-Q can discriminate IADL functioning between groups across the dementia spectrum.

Individuals with subjective cognitive decline (SCD) are at increased risk of Alzheimer's disease and could benefit from a prevention strategy targeting lifestyle factors. Making a program available through the Internet gives a widespread reach at low cost, but suboptimal adherence is a major threat to effectiveness. As a first step in developing an online lifestyle program (OLP), we aimed to identify factors that are barriers and/or facilitators for the use of an OLP in individuals with SCD in three European countries.

The Alzheimer's Association's Research Roundtable met in November 2016 to explore how best to measure changes in cognition and function in the preclinical stage of Alzheimer's disease. This review will cover the tools and instruments currently available to identify populations for prevention trials, and measure subtle disease progression in the earliest stages of Alzheimer's disease, and will include discussions of suitable cognitive, behavioral, functional, composite, and biological endpoints for prevention trials. Current prevention trials are reviewed including TOMMOROW, Alzheimer's Prevention Initiative Autosomal Dominant Alzheimer's Disease Trial, the Alzheimer's Prevention Initiative Generation Study, and the Anti-Amyloid Treatment in Asymptomatic Alzheimer's to compare current approaches and tools that are being developed.

Cognitive testing in Alzheimer's disease (AD) is essential for establishing diagnosis, monitoring progression, and evaluating treatments. Assessments should ideally be brief, reliable, valid, and reflect clinically meaningful changes. There is a lack of instruments that meet all these criteria. In the Capturing Changes in Cognition (Catch-Cog) study, we seek to correct these deficiencies through the development and validation of a composite measure combining cognition and function: the cognitive-functional composite (CFC). We expect that the CFC is able to detect clinically relevant changes over time in early dementia stages of AD.

To examine older adults' performance on a newly developed tablet-PC-based cancellation test (e-CT) and to study its psychometric properties.

AbstractWe investigated the relationships between gray matter graph properties and cognitive impairment in a sample of 215 patients with Alzheimer's disease (AD) and also whether age of disease onset modifies such relationships. We expected that more severe cognitive impairment in AD would be related to more random graph topologies. Single-subject gray matter graphs were constructed from T1-weighted magnetic resonance imaging scans. The following global and local graph properties were calculated: betweenness centrality, normalized clustering coefficient γ, and normalized path length λ. Local clustering, path length, and betweenness centrality measures were determined for 90 anatomically defined areas. Regression models with as interaction term age of onset (i.e., early onset when patients were ≤65 years old and late onset when they were >65 years old at the time of diagnosis)×graph property were used to assess the relationships between cognitive functioning in five domains (memory, language, visuospatial, attention, and executive). Worse cognitive impairment was associated with more random graphs, as indicated by low γ, λ, and betweenness centrality values. Three interaction effects for age of onset×global graph property were found: Low γ and λ values more strongly related to memory impairment in early-onset patients; low beta values were significantly related to impaired visuospatial functioning in late-onset patients. For the local graph properties, language impairment showed the strongest relationship with decreased clustering coefficient in the left superior temporal gyrus across the entire sample. Our study shows that single-subject gray matter graph properties are associated with individual differences in cognitive impairment.