社区正常老化及轻度认知障碍的多维评估与实证研究

Alzheimer's disease is one of the major problems that our aging society are facing. The research of mild cognitive impairments is expected to improve the senile dementia for the high-risks groups of Alzheimer's disease as well as prevent and postpone its occurrence. In the current project we are planning to use cognitive-behavioral tests, psycho-social measurements and techniques including EEG and fMRI to carry out a large-scale multi-dimensional assessment of normal elderly community. The empirical research will be conducted through a secondary screening including sets of cognitive behavioral tests, psycho-social measurements, EEG and fMRI studies on memory and resting states studies. We are aiming at identifying sensitive and specific behavioral indicators and EEG imaging indicators for diagnosing Alzheimer’s disease, developing sets of multi-dimensional assessment tools for identifying and evaluating the cognitive functions of the Chinese elderly group and establishing warning and structural models for the mild cognitive impairment. The implementation of the current project will provide credible guidance in community practice for the early diagnosis and aggressive intervention of the pathogenesis of Alzheimer's disease, contribute to an overall understanding of the characteristics of aging population, promote the pathological aging to return to a normal aging and develop into a successful aging, provide positive and effective prospective intervention and treatment to the Alzheimer’s disease, postpone the cognitive aging, early detecting a mild or suspected dementia therefore play an active role in establishing a "healthy aging" society for our country.

老年痴呆是老龄化社会面临的重大问题，成功老化是全人类的共同期望。通过对轻度认知功能障碍的调查研究，有望发现和筛选出老年性痴呆高危人群，预防并推迟其发生。本项目采用认知行为测验、心理-社会测量、脑电与磁共振成像结合的技术手段，较大规模地对社区正常老人开展多维评估，经过二次筛选进行实证研究，包括认知行为成套测验、心理与社会测量、记忆的脑电实验和磁共振的结构像、功能态和静息态研究，提出敏感特异的行为学指标与脑电影像学指标，建立多维成套的中国老人的老化认知评估工具，构建轻度认知功能障碍的结构模型和预警模型。通过探讨影响成功老化的认知功能的因素，有助于全面了解老龄化群体的特征，尽早发现轻度或可疑痴呆者，提供积极有效的老年性痴呆的前瞻性干预与治疗，延缓认知老化，促进病态老龄回归常态老龄并转化为成功老龄，对于我国建立“健康老龄化”社会、构建“生物-心理-社会”模式下健康老年的指标体系起到重要的引领作用。

人口老龄化已成为我国经济社会发展过程中的一个重要人口现象。伴随着人口老龄化进程，神经退行性疾病的发病率不断攀升。轻度认知障碍（mild cognitive impairment, MCI）是阿尔茨海默病（Alzheimer’s disease, AD）的早期表现，因此，研究MCI的发生和进展机制有助于防治AD。本研究通过神经心理学测验、认知行为实验以及机器学习方法，考察社区轻度认知障碍老人认知功能改变的一般特点（如, 邱月虹等, 2018），基于认知控制的信息论视角，从信道容量的角度，考察轻度认知障碍老人认知控制功能的损伤机制，发现认知控制功能减退可能是轻度认知障碍的关键损伤，而且认知控制容量有潜力成为一项重要的MCI诊断指标（如, He et al., 2019）。进一步采用磁共振成像技术，本项目发现轻度认知障碍老人的大脑默认模式网络的功能连接随病情的进展表现出先增强后减弱的非线性改变（如, Tao et al., 2017），以及帕金森病遗忘型轻度认知障碍患者大脑白质结构的改变（如, Zhang et al., 2019）。项目组通过上述研究在国内外核心期刊发表论文14篇，其中SCI论文9篇，CSSCI论文2篇，出版学术专著1部，设计MCI的早期诊断方案1套。本项目对于轻度认知障碍老人的认知行为及大脑神经方面的变化特点的刻画，有助于认知神经科学与医学领域理解轻度认知障碍发生及进展的神经基础，具有较为重要的理论和临床实践意义。