Chinese University-Alzheimer's Disease With Vascular and Other Co-pathology: Towards Actionable Neuro-Cognitive-Omic Evaluations (CU-ADVANCE)

Condition(s) studied

Study summary

Population aging is transforming the epidemiological landscape of the Asia-Pacific region at an unprecedented pace. By 2050, more than one quarter of the region's population will be aged over 60, with 36.7% of countries projected to become" super-aged" societies.

Within Hong Kong specifically, the age- and gender-adjusted prevalence rates of mild and major neurocognitive disorder (NCD) among adults aged 60 years or above have been estimated at 21.8% and 9.7%, respectively. The scale of this burden intensifies considerably within institutional care environments, where roughly seven in ten long-term care (LTC) residents have been identified as having major NCD. Recent local survey data also indicate that severe cognitive impairment affects up to 49.8% of residents aged above 85 years. Given current demographic trajectories, the number of individuals living with dementia in Hong Kong is projected to triple over the next two decades. These trends underscore an urgent, time-sensitive need for scalable, accurate, and population-appropriate tools for the early detection and prognostic stratification of cognitive impairment, tools that must be actionable at the point of care and deployable at population scale.

This study aim to generate a large database of cognitive, neuroimaging, plasma biomarkers, lifestyle and psychological information of the subjects who suffered from neurocognitive disorders

Eligibility

Primary outcome measure(s)

• Hong Kong Montreal Cognitive Assessment (HK-MoCA) — Baseline, 1 year, 2 years, 3 years, 4 years, 5 years and 6 years follow up
  The HK-MoCA is a locally validated, brief cognitive screening tool assessing multiple domains including attention, executive function, memory, language, visuospatial ability, and orientation, and is widely used to detect mild cognitive impairment in the Hong Kong Chinese population. The total score is 30. The lower the score, the higher risk of cognitive impairment
• Clinical Dementia Rating — Baseline, 1 year, 2 years, 3 years, 4 years, 5 years and 6 years follow up
  The CDR is a semi-structured interview-based staging instrument that evaluates both cognitive and functional performance across six domains (memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care), yielding a global score that reflects overall severity of cognitive impairment (0 = normal, 0.5 = questionable/very mild, 1 = mild, 2 = moderate, 3 = severe).
• Hong Kong List Learning Test — Baseline, 1 year, 2 years, 3 years, 4 years, 5 years and 6 years follow up
  The HKLLT is a culturally adapted verbal list-learning test modeled after the California Verbal Learning Test, used to assess verbal learning and memory, with Trial 4 (T4, delayed recall) serving as a sensitive index of episodic memory decline. The lower the standard deviation of the Trial 4 recall, the higher the risk of cognitive impairment
• Simple Mild Neurocognitive Disorder due to Alzheimer's Disease Risk Test (SMART) — Baseline, 1 year, 2 years, 3 years, 4 years, 5 years and 6 years follow up
  The SMART is a novel digitalised tool that incorporates both subjective and objective measures of cognitive impairment. it incorporates immediate recall, delayed recall, and verbal fluency tasks. The lower the z-score, the higher the risk of cognitive impairment

Trial sites (1)

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