JMIR Publications

ABSTRACT

Progressive difficulty in performing everyday functional activities is a key diagnostic feature of dementia. The neural signature of functional decline, however, is not well-understood – particularly during preclinical stages of dementia. Decline in complex daily function (CdF) such as managing medications precedes impairment in basic activities of daily living (e.g., eating, dressing) during cognitive decline. Our goal is to establish the neural signature of decline in CdF in preclinical dementia. Since gait is central to many CdF and community-based activities, we utilized a novel electroencephalographic (EEG) approach to measure gait-related brain activation while participants perform complex gait-based functional tasks. Our hypothesis is that dementia-related pathology in preclinical dementia is associated with a unique gait-related EEG pattern that will predict subsequent decline in CdF. We propose a prospective observational cohort study in 180 cognitively unimpaired older adults with and without subclinical Alzheimer’s disease (Aβ, p-tau, and hippocampal volume) and vascular (WMH and frontal cortical thickness) pathologies. Our aims are to establish the neural signature of CdF and to link dementia-related brain pathology as well as physical inactivity to incidence of the neural signature of CdF. By establishing the clinical relevance and biological basis of the neural signature of CdF decline, we aim to improve early prediction of Alzheimer’s diseases and other dementias.