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• Other relevant systemic diseases: hepatic Specifically, although the neuropsychological bat-
failure, renal failure, Obstructive Sleep Apnea tery focuses especially on the evaluation of memory
Syndrome (OSA)... processes, attention and executive functions as po-
tential early markers of Alzheimer's disease, the neu-
• Family history with special attention to the ropsychological profile is completed by getting
history of dementia or movement disorders, information related to other cognitive domains such
developmental delay or psychiatric disorders. as language, visuospatial ability and visuoconstruc-
tion. All these data allow identifying the strengths
• Regular drug treatment during the last 5 and weaknesses in the cognitive profile and cha-
years. racterizing, if necessary, the type of cognitive im-
pairment that an individual presents. Following table
4.3.4. General examination lists the different tests that make up the neurops-
ychological battery of the Vallecas Project, as well
All subjects undergo a general and neurological as the visit number in which they have been applied
standard examination: cranial nerves, muscle ba- to all study participants.
lance, coordination, extrapyramidal system, gait, os-
teotendinous reflexes, midline release reflexes, etc. The 4.3.6. Determination of biomarkers
following parameters are analyzed in a special way:
• Gait disturbance It is currently widely accepted that the molecular
changes associated with AD, including the forma-
• Handwriting tion of amyloid plaques and neurofibrillary tangles
begin many years before the appearance of clini-
• Instrumental activities of daily living cal symptoms. In recent years, the need to define
and develop new early biomarkers of AD that allow
4.3.5. Neuropsychological Examination us to assess the risk and early diagnosis of the disease
has become clear. Thus, blood samples will be co-
The neuropsychological evaluation allows to explore llected within the Vallecas Project for the study of
in a holistic way the various cognitive domains (gno- genetic and biochemical markers. Samples are ob-
sias, attention, memory, language, praxis and exe- tained according to the protocol "Collection and
cutive functions), as well as a series of variables Processing of Human Blood Samples in the Vallecas
related to affectivity, behavior and level of auto- Project" and processed to obtain the various frac-
nomy in the daily life of an individual. To do this, the tions indicated in the protocol, which are stored at -
neuropsychologist can use different assessment ins- 80°C. On one hand, DNA is extracted from blood
truments, including clinical interviews, behavioral cells to determine, by PCR and sequencing techni-
observation, cognitive tests and different question- ques, genetic markers associated with the various
naires that allow for collecting information from both polymorphisms in the following genes: APOE, CR1,
the individual and a reliable informant. BIN1, CLU, PICALM, ABCA7, SORL1, PRNP, GRM8, and
BACE1. These genes are studied using DNA obtained
The Vallecas Project neuropsychological examina- from the extraction of samples from the first visit.
tion protocol has been designed to comprehensi- Also, in the context of the project funded by the MI-
vely assess neuropsychological functioning of study NECO (Projects RETOS) entitled "miRNA and lipid me-
participants, as well as their progression during the tabolism markers as potential links between vascular
longitudinal follow-up.
CIEN Foundation Annual Report 2017 / 94
