Poster Presentations: P3 P483

completed (median interval¼109 days) telephone interviews, featuring the

same 7-item questionnaire and a 9-measure neuropsychological battery en-

compassing: general cognition (Telephone Interview for Cognitive Status);

immediate and delayed word and paragraph (East Boston Memory Test) re-

call; category fluency; working memory (digit span-backwards); executive

function (Oral Trail-Making Test-B [OTMT-B]). Informants completed

self-administered, validated questionnaires (Structured Interview and

Scoring Tool-MADRC-Informant Report). Results: Absolute agreement

between self- and telephone-administered STIDA items ranged from 58-

94%. Several items were infrequently endorsed; thus, chance-corrected

agreement was predictably low (kappa range¼0.05-0.41; weighted kappa

for sum-of-items¼0.33). Participants were more likely to endorse memory

complaints (e.g., remembering a list of items) in self-administered vs. tele-

phone-interview formats (45% v. 31%, McNemar’s P¼0.04). Participants

were more likely to endorsememory problems (e.g., overall change in mem-

ory ability) than informants (80% vs. 52%,McNemar’s P<0.001); however,

informants appeared more likely to report “executive” symptoms (e.g., trou-

ble following group conversations or a plot: 16% vs. 7%, McNemar’s

P¼0.06). Regarding neuropsychological testing, STIDA responses were

generally uncorrelated with performance. However, informant reports were

significantly related to objective testing: e.g., mean difference in global z

-score averaging all tests¼-0.37 units (P¼0.03) for "trouble following group

conversions/plots "-yes/no; mean difference in OTMT-B¼11.1 seconds

(P¼0.05) for "difficulty understanding/following instructions "-yes/no.

Conclusions: Participants were more likely to endorse complaints when pro-

viding unobserved, written responses versus during interviews, which may

have important implications for screening in healthy samples without self-

identified memory concerns. Participants were more likely to report memory

concerns, and informants to report executive problems. Finally, informant-

reported problems were associated with significantly worse objective global

cognitive and executive performance, indicating validity and value of infor-

mant reports in cognitive studies using remote assessment methods.

P3-088 THEAD8DEMENTIA SCREENINGTESTDETECTS

MILD COGNITIVE IMPAIRMENT

James Galvin1, Catherine Roe2, John Morris3, 1New York University, New

York, New York, United States; 2Washington University School of Medicine,

St Louis, Missouri, United States; 3Washington University, St. Louis,

Missouri, United States.

Background: Detection of mild cognitive impairment (MCI) and early-stage

Alzheimer’s disease (AD) can be done either by comparing individual cogni-

tive performance with normative values or assessing cognitive decline within

an individual. TheAD8 is awidely used, validated, 8-itemdementia screening

tool; endorsement of >2 questions suggests cognitive impairment. The AD8

may improve detection of MCI and early-stage dementia in clinical practice

and enrollment into MCI clinical trials. Methods: 810 individuals (CDR 0,

Controls¼528; CDR 0.5/MCI¼102; CDR 0.5/AD¼180) were evaluated at

the Washington University Knight Alzheimer’s Disease Research Center.

Participants underwent identical assessments including all items from the

Uniform Data Set, Clinical Dementia Rating (CDR) and Sum Boxes

(CDR-SB). TheAD8 questions were embedded throughout the interview. Re-

ceiver operator characteristic curves assessed ability of the AD8 to discrimi-

nate between CDR 0, CDR 0.5/MCI and CDR 0.5/AD.Results: The sample’s

mean age¼75+ 8y; education¼15+ 3y; 56% female. Informants largelywere

spouses (52%) or adult children (26%). Mean CDR-SB was higher in AD

(2.5) vs. MCI (0.9, P<.001). In MCI, the most frequently endorsed CDR do-

mains were Memory (93.2%), Judgment and Problem Solving (47.1%) and

Home and Hobbies (21.6%); these domains were also most frequently en-

dorsed in AD. Mean AD8 scores for CDR 0¼0.5, CDR 0.5/MCI¼2.9, and

CDR 0.5/AD¼5.3. MCI informants most frequently endorsed problems

with judgment (61%); repeats questions/statements/stories (56%); daily

problems with memory (52%); and trouble operating tools/gadgets/

appliances (37%). The AD8 discriminated Controls from (1) any cognitive

impairment (.946; 95% CI: .92-96); (2) CDR 0.5 MCI (.879; 95% CI: .84-

.92); and (3) CDR 0.5 AD (.985; 95%CI: .98-.99) using a cut-off score¼2.

The AD8 also discriminated MCI from AD (.840; 95%CI: .79-.89) using

a cut-off score¼5. Conclusions: The AD8 detected the very mildest forms

of cognitive impairment due to AD: CDR 0.5/MCI and CDR 0.5/AD. Cut-

off scores 2-5 suggest MCI and cut-off scores >5 suggest AD. Higher AD8

scores correlated with more impaired ratings in clinical, cognitive, functional

and behavioral domains and MCI does indeed affect everyday functio-

ning.Thus, if simple and efficient screening for MCI in applied settings is

the goal the AD8 could be recommended on the basis of utility and brevity.

P3-089 COMMUNITY LIFE WITHDRAWALWITH MCI

PROGRESSION

Jeffrey Kaye, Nora Matteck, Tamara Hayes, Daniel Austin, Hiroko Dodge,

Oregon Health and Science University, Portland, Oregon, United States.

Background: The development of MCI may be associated with decreased

levels of activity or withdrawal from the world as cognitive decline prog-

resses. This change may be difficult to detect by self-report methods. Unob-

trusive home-based sensing technologies may allow the detection of subtle

changes in activity indicative of MCI.Methods: Volunteers enrolled in the

Intelligent Systems for Assessing Aging Change (ISAAC) cohort study

were followed longitudinally in their homes outfittedwith embeddedmotion

and contact sensors to detect 24/7 activity patterns. Time out of the home

was the primary outcome of interest. Sensor data was used to sum the total

time (in hours) out of house per month per participant. This timewas divided

by the number of valid days with monitored data per month to get average

hours out of home per day per subject-month. Data were analyzed using

a mixed effect model with random intercept and time effects adjusted for

age, gender, education, Cumulative Illness Rating Scale and Geriatric De-

pression Scale score at baseline. Results: Data from 148 participants (28

with MCI; 10 with amnestic MCI), mean age, 84.2 6 5.0 were assessed

for a mean of 2.86 1.2 years. During the first month after enrollment, par-

ticipants spent a mean of 4.56 3.7 hours/day out of their home; therewas no

difference in time out of house between MCI and cognitively normal partic-

ipants during the post-baseline month. In cognitively intact participants

there was no longitudinal change in time out of home. MCI participants

had a significantly greater decline in time out of home over time compared

to cognitively intact participants. During the last month of monitored data,

cognitively intact participants left their home 3.8 hours/per day on average;

MCI participants left their home 2.9 hrs/day. Conclusions: With the pro-

gression of MCI increasingly less time is spent outside the home. This sug-

gests a progressive narrowing of interaction with the outside world. This

phenomenon may form a novel measure that can be used to unobtrusively

detect early activity changes indicative of evolving MCI.

P3-090 COMPROMISED CEREBRAL AUTOREGULATION

IN PATIENTS WITH MILD COGNITIVE

IMPAIRMENT

Jie Liu1, Estee Brunk1, Yong-Sheng Zhu1, Kyle Armstrong1,

Kristin Martin-Cook2, Linda Hynanc3, Myron Weiner3, Ramon Diaz-

Arrastia2, Benjamin D Levine1, Rong Zhang1, 1Institute for Exercise and

Environmental Medicine,Texas Health Presbyterian Hospital Dallas,

Dallas, Texas, United States; 2Alzheimer’s Disease Center, University of

Texas Southwestern Medical Center, Dallas, Texas, United States;3Alzheimer’s Disease Center, University of Texas Southwestern Medical

Center, Dallas, Texas, United States.

Background: Cardiovascular risk factors appear to influence the develop-

ment of Alzheimer’s disease (AD). However, the underlying mechanisms by

which cerebrovascular dysfunction in particular contributes to AD is un-

known. We tested the hypothesis that static cerebral autoregulation (sCA) is

compromised in patients with amnestic mild cognitive impairment (MCI),

a transitional state between normal cognitive aging and AD. Methods: 26

MCI patients (12 males, 67 6 6 yr) and 18 age-and education-matched nor-

mal control subjects (6 males, 68 6 7 yr) underwent cerebral autoregulation

study. Mean Arterial blood pressure (MAP) was decreased stepwise by intra-

venous infusion of sodium nitroprusside (SNP) and then increased by phen-

ylephrine. Transcranial and color duplex Doppler were used to measure

cerebral blood flow (CBF) velocity of the middle cerebral artery (MCA, V

MCA) and volumetric blood flow of the internal carotid (ICA, F ICA) and