School of Psychology, Trinity College Dublin, Dublin, Ireland.
Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
Transl Psychiatry. 2022 Nov 9;12(1):473. doi: 10.1038/s41398-022-02237-w.
Effective strategies for early detection of cognitive decline, if deployed on a large scale, would have individual and societal benefits. However, current detection methods are invasive or time-consuming and therefore not suitable for longitudinal monitoring of asymptomatic individuals. For example, biological markers of neuropathology associated with cognitive decline are typically collected via cerebral spinal fluid, cognitive functioning is evaluated from face-to-face assessments by experts and brain measures are obtained using expensive, non-portable equipment. Here, we describe scalable, repeatable, relatively non-invasive and comparatively inexpensive strategies for detecting the earliest markers of cognitive decline. These approaches are characterized by simple data collection protocols conducted in locations outside the laboratory: measurements are collected passively, by the participants themselves or by non-experts. The analysis of these data is, in contrast, often performed in a centralized location using sophisticated techniques. Recent developments allow neuropathology associated with potential cognitive decline to be accurately detected from peripheral blood samples. Advances in smartphone technology facilitate unobtrusive passive measurements of speech, fine motor movement and gait, that can be used to predict cognitive decline. Specific cognitive processes can be assayed using 'gamified' versions of standard laboratory cognitive tasks, which keep users engaged across multiple test sessions. High quality brain data can be regularly obtained, collected at-home by users themselves, using portable electroencephalography. Although these methods have great potential for addressing an important health challenge, there are barriers to be overcome. Technical obstacles include the need for standardization and interoperability across hardware and software. Societal challenges involve ensuring equity in access to new technologies, the cost of implementation and of any follow-up care, plus ethical issues.
有效的认知衰退早期检测策略,如果大规模实施,将对个人和社会都有益处。然而,目前的检测方法具有侵入性或耗时的特点,因此不适合对无症状个体进行纵向监测。例如,与认知衰退相关的神经病理学的生物标志物通常通过脑脊液收集,认知功能通过专家进行面对面评估来评估,而大脑测量则使用昂贵的、不可移动的设备进行。在这里,我们描述了可扩展的、可重复的、相对非侵入性的和相对廉价的检测认知衰退最早标志物的策略。这些方法的特点是在实验室外的简单数据收集协议:通过参与者自身或非专业人员被动地收集测量数据。相比之下,这些数据的分析通常是在集中的位置使用复杂的技术进行的。最近的发展允许从外周血样中准确检测出与潜在认知衰退相关的神经病理学。智能手机技术的进步促进了对语音、精细运动和步态的非侵入性被动测量,可以用来预测认知衰退。使用标准实验室认知任务的“游戏化”版本可以对特定的认知过程进行测试,这些版本可以让用户在多个测试会话中保持参与。使用便携式脑电图,用户可以在家中定期获得高质量的大脑数据。尽管这些方法在应对重要的健康挑战方面具有巨大的潜力,但仍存在一些需要克服的障碍。技术障碍包括需要在硬件和软件之间实现标准化和互操作性。社会挑战涉及确保新的技术能够公平地获得、实施成本以及任何后续护理的成本,以及道德问题。