COGnitive and socio-COGnitive functioning in aging: a comprehensive assessment for early detection of NEurocognitive Disorder
Progetto The aging population is growing across the world, and in Italy: people aged 55
and more accounted for 36.5% of the population in
2019, and predictions suggest that this value will rise to 45.9% by 2050 [1].
Pathological cognitive deterioration is one of the most
prominent health issues in the aging society, impacting individuals,
communities, and the healthcare providers' system. The early
detection of cognitive impairments is crucial to implement treatment strategies
for slowing down the progression of the disease, as
well as to maximize the well-being and daily functioning of patients.
Furthermore, the identification of pre-clinical signs of
neurocognitive disorders is also beneficial for the healthcare system, reducing
the costs of disease management.
A strategy for integrating the assessment based on biomarkers, aimed at a
broader and more resource-saving screening, is to rely
upon a thorough neuropsychological assessment of cognitive functioning.
Crucially, in the last years, researchers urged to
complement standard neuropsychological assessment with the evaluation of
socio-cognitive competence. Social cognition includes a
range of abilities required to navigate daily interpersonal relationships
successfully, and deficits in this competence are associated
with significant impairments in social functioning. Also, previous studies
demonstrated that socio-cognitive competence is impaired
in the prodromic phases of neurocognitive disorders. Nevertheless, to date,
there is no standardized tool for assessing
socio-cognitive skills, such as the theory of mind (ToM) and emotion
recognition (ER), in aging.
The first aim of the present proposal is to answer the call for a comprehensive
assessment of older adults’ daily functioning by
creating and validating an assessment protocol for the early detection of
cognitive impairments, including the measurement of
socio-cognitive competence. We want to compare the predictive power of
neuropsychological and socio-cognitive evaluations
separately and their joint efficacy in discriminating between healthy individuals
and patients with Mild Neurocognitive Disorders
(MND).
The second goal is to mitigate the costs associated with the diagnostic process,
both for the person and the clinicians and the health
system, to increase the accessibility to health care services. To this end, we move
a step forward in adopting effective health
technologies, assessing the feasibility and efficacy of the remote, synchronous,
computer-assisted neuropsychological assessment.
Finally, the project aims to streamline the diagnostic process by developing an
overall risk score that combines different domains of
functioning into a single indicator. This global functioning score, based on
subjects’ performance and the items and tasks' level of
difficulty, will offer a more sensitive and discriminative indicator, helping
clinicians to compare the severity levels of the disease and
to monitor its evolution.