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Principal Investigator  
Principal Investigator's Name: Geoffroy Gagliardi
Institution: Brigham and Women's Hospital
Department: Neurology
Country:
Proposed Analysis: ADNI DATA USE APPLICATION Lack of awareness, or anosognosia of memory deficits, is a common manifestation of Alzheimer’s disease (AD). Recent studies demonstrated that a decline in awareness would begin years before the diagnosis of dementia, and even before the prodromal/MCI stage. Moreover, this symptom has been associated with many negative consequences, as much for the patient himself (e.g. decision making, safety), as for his caregiver (e.g. family care costs, caregiver burden). Despite the impact of anosognosia on patients and caregivers, we still know very little about the evolution of awareness of memory function across the AD course, as well as its pathological correlates. Specifically, it remains unclear as to which stage in the AD continuum anosognosia occurs and whether an individual’s self-judgment of his/her own cognitive abilities changes over the course of the disease as pathology increases. The proposed study aims to characterize change in awareness of memory abilities and its relationship to amyloid and tau burden. Specifically, we aim to (1) examine the cross sectional relationship between memory self-awareness by baseline amyloid and tau and clinical stage (CN, MCI, AD), (2) examine the longitudinal change between memory self-awareness and change in AD pathology (amyloid and tau). Self-awareness of memory will be assessed by the discrepancy between the participant’s perception of his own cognitive functioning (i.e. cognitive/memory questionnaires — e.g. ECog scale) and objective measures (i.e. memory performances — e.g. LM-I) or informant’s judgment (e.g. ECog informant’s report). The relationship between the cognitive and biological variables will be assess with correlations and linear mixed effects models (with demographics as covariates). According to previous findings, we expect to find a positive relationship between these awareness and AD pathology. Specifically, we expect that in earlier stages of AD an increase in tau and amyloid burden would results in heightened awareness. Furthermore, these initial pathophysiological changes would be associated with decreased memory self-awareness after longitudinal follow-up, and his would be specifically evident as pathology increases. The long-term rationale for the proposed study is that, once the pathological underpinnings of memory self-awareness is known, we may be able to predict the onset of anosognosia, specifically measured as the loss of self-awareness as objective memory deficits become manifest, due to functional dysfunction and biomarker evidence of Aβ and au pathology.
Additional Investigators  
Investigator's Name: Patrizia Vannini
Proposed Analysis: P.V. will help in analysis and interpretation of data.
Investigator's Name: Kayden Mimmack
Proposed Analysis: New methods of computing ECog scores, for enhanced efficiency toward detection of early awareness alterations.