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CIMA-Q

Overview

Alzheimer's (AD) and related diseases affect 10% of individuals after the age of 65 and this percentage increases to 35% after the age of 85. Currently, AD is typically diagnosed when symptoms are already present, with cognition, quality of life, and autonomy already significantly affected, though evidence shows this is often years after neurodegeneration has started in the brain. Efforts are necessary to reduce the psychological, social and economic burden that AD places on patients, their families and society. The Consortium for the early identification of Alzheimer's disease - Québec (CIMA-Q) cohort is a longitudinal, multicentric, multifactorial and intersectorial study that aims to identify trajectories, as well as protective and vulnerability factors, of AD, to improve early diagnosis and to find new targets for prevention and treatment.

Participants

The CIMA-Q cohort participants are representative of different AD stages (pre-symptomatic and symptomatic). Recruitment started at the end of 2014 and as of September 2024, 419 participants aged 65 and over (64,5 % women) ** were recruited for the CIMA-Q cohort and were classified in 4 different groups. Sixty-eight were recruited as cognitively healthy (C) participants, 181 as participants with a subjective cognitive decline (SCD), 134 with a mild cognitive impairment (MCI) and 36 with early-stage AD. The CIMA-Q project continues to recruit participants and is aiming to reach a total of 250 participants with at least one completed follow-up evaluation after their initial assessment (150 SCD and 100 MCI participants). We are also currently recruiting young controls (YC) (between 20 and 45 year old) for CSF sample controls.

Methods and available data

The study’s detailed protocol and procedures for accessing data and biological samples are available at this site. Participants are initially evaluated and then participants recruited as SCD and TCL invited back for a full assessment every 2 years, in addition to which there is a short phone clinical assessment in between the full assessment follow-ups. All the data and biomaterial collected for more than 9 years now are available in the CIMA-Q data and biomaterial bank. All participants included in the study consent to neuropsychological, neuropsychiatric and clinical assessments and to provide blood samples. Apart from these evaluations, participants can consent to a Magnetic Resonance Neuroimaging (MRI), a positron emission tomography (PET) scan and/or cerebrospinal fluid (CSF) sampling. (Belleville, et al. 2019). Participants can also separately consent to brain donation. Access to CIMA-Q data and samples is restricted to CIMA-Q members and conditional upon (i) the approval by the CIMA-Q User Access committee and the CIMA-Q Executive Committee, and (ii) an independent ethical approval of each project.

Clinical Assessment (nurse and medical doctor assessment)

Clinical Assessment (nurse and medical doctor assessment)

Socio-Demographic Information

Nationality, marital status, language, living arrangements, social support network, income, level of education, occupation, retirement, volunteering and types of activities practiced, social activities, etc.

COGNITION

  1. MoCA (Montreal Cognitive Assessment)
  2. Telephone-Mini Mental State Examination (T-MMSE)
  3. Logical Memory test from the Wechsler Memory Scale (short story, immediate and delayed recall)
  4. Cognitive complaint question (Jessen)
  5. Clinical diagnosis

Cognitive Reserve

  1. Cognitive reserve questionnaire (Bartrés score)
  2. Questions on bilingualism

Functional Abilities

  1. Alzheimer’s disease cooperative study (ADCS) – Activities of Daily Living questionnaire
  2. Physical self-maintenance scale (PSMS)
  3. Score – Clinical Dementia Rating (CDR)

Nutrition

  1. Mini Nutritional Assessment® (MNA)

Gender Identity

  1. Question on gender identity

Psychiatric Symptoms

  1. PHQ-9 (Patient Health Questionnaire)
  2. Mild Behavioral Impairment-Checklist (MBI-C)
  3. Childhood Trauma Questionnaire-Short Form (CTQ-SF)
  4. Life Events Checklist for DSM-5 (LEC-5)

Chronic Pain

  1. Chronic pain Self-Assessment

Health Self-Assessment

  1. Health and well-being survey (SF-36)
  2. Health status and auto perception of health status

Sleep

  1. Chronic insomnia
  2. Sleep apnea (+ Stop Bang)
  3. REM sleep disorders

Smell

  1. Olfactory capacity test (UPSIT)

Vital Signs and Physical Measurements

  1. Resting state blood pressure
  2. Orthostatic change
  3. Anthropometric measures
  4. Grip strength
  5. Walking speed

Medical History

  1. Medical history
  2. Family history of dementia
  3. Alcohol and other drug use
  4. Tobacco use
  5. History and evolution: cognitive complaint
  6. Surgical history
  7. Personal psychiatric history
  8. Psychiatric history of the family
  9. Allergies

Neurological Examination

  1. Level of consciousness
  2. Cranial nerves
  3. Nervous system
  4. Cerebellar functions
  5. Gait

Evaluation Scales

  1. Charlson Score
  2. Hachinski Ischemic Scale
  3. Fried frailty index

Complete Physical Exam

Including a blood test and a haematological profile

  1. Head and neck
  2. Eyes
  3. ENT
  4. Lymph nodes
  5. Lungs
  6. Heart
  7. Blood vessels
  8. Abdomen
  9. Muscular-skeletal
  10. Skin and appendages

Medication

  1. List of current medication

COVID-19

  1. History of infection and vaccination

Study Partner Questionnaires

  1. Sociodemographic information on study partner: age, level of education and relation with the participant.
  2. Cognitive complaint question (Jessen)
  3. Neuropsychiatric Inventory (NPI-Q)
  4. Apathy Inventory
  5. Questionnaire relating to activities of daily living (ADCS-PI)
  6. Mild Behavioral Impairment Checklist (MBI-C)
Neuropsychological, Neuropsychiatric and Psychosocial Assessment

Neuropsychological, Neuropsychiatric and Psychosocial Assessment

Episodic Memory

  1. Rey Auditory Verbal Learning Task (RAVLT)
  2. Face-Name memory test (associative episodic memory)
  3. Memoria free and cued recall

Prospective Memory

  1. Envelope Task

Semantic Perception

  1. Object Decision test (BORB)

Visual Discrimination

  1. Visual Perception line orientation test (BORB)

Executive Functions

  1. Stroop-D-KEFS (4 conditions)
  2. Trail making test A and B
  3. Computerized Hayling task
  4. Digit Symbol test (WAIS-III)
  5. Alpha-span (short form)

Language

  1. Verbal fluency (category – animals)
  2. Boston Naming Test
  3. Vocabulary test (WAIS-III)

Psychiatric Symptoms

  1. Geriatric Depression Scale (GDS-30)
  2. Geriatric Anxiety Inventory (GAI)
  3. Apathy inventory

Cognitive Complaint

  1. Cognitive Change Index (CCI)
  2. Memory auto-administered questionnaire (QAM, short form)

Psychosocial

  1. Siegrist’s Questionnaire (effort-reward imbalance at work)
  2. Karasek’s Questionnaire (Work related stress)

Sleep

  1. Insomnia Severity Index (ISI)
  2. Epworth Sleepiness Scale
  3. Sleep quality questionnaire

Dementia Literacy

  1. Knowledge about Alzheimer’s disease (ADKS)
  2. Dementia Attitude Scale (DAS)
  3. Perception Regarding Investigational Screening for Memory in Primary Care (PRISM)

Expertise

  1. Mobile Device Proficiency
  2. Technology experience profile
Neuroimaging Assessment

Neuroimaging Assessment

MRI

  1. ANATOMICAL: 3DT1w
  2. PATHOLOGICAL: PD and T2w
  3. VASCULAR: FLAIR and T2*
  4. CONNECTIVITY / FUNCTIONAL
    • 30-direction DTI
    • Resting state BOLD
    • Task related activation
Blood Biosamples

Blood Biosamples

  1. Plasma
  2. Serum
  3. Red blood cells
  4. PBMCs / iPSC / Neuron-stem cells
  5. DNA / Buffy coat
  6. RNA

Results:

  1. Adiponectine (2)
  2. IGFBP2 (2)
  3. p-Tau 181 / p-Tau 231/ p-Tau 217 (1)
    1. Apo E genotype (5)

Blood Test Results:

  1. Hemoglobin A1c
  2. Total Cholesterol
  3. Triglycerides
  4. HDL-Cholesterol
  5. LDL-Cholesterol
  6. TSH
  7. B12 Vitamin
  8. Urea
  9. Serum Folate/ folic acid
  10. Alkaline Phosphatase
  11. Serum alanine aminotranferase (ALT)
  12. Serum aspartate aminotransferase (AST)
  13. ALT/AST ratio
  14. C-Reactive protein (CRP)/Ultra-sensitive CRP
  15. Calcium
  16. Creatinine
  17. Estimate DFG/DFGe/New TFGe
  18. Fasting Glucose
  19. Sodium
  20. Potassium
  21. Chlorine/Chlorides
  22. GB/WBC
  23. GB/WBC
  24. GR/RBC/Erythro
  25. Hb/HGB
  26. Hte/Ht/HCT
  27. VGM/MCV
  28. TGMH/MCH
  29. CCMH/CGMH/MCHC
  30. DVE/RDW
  31. P1t/PLAT/PLAQ
  32. VPM
  33. Neu ab/NE#Neutrophils
  34. LYM ab/LY#Lymphocytes
  35. Mon ab/LY#Monocytes
  36. Eos ab/EO#Esinophils
  37. Baso ab/BA#Basophils
CSF Biosamples (60 participants)

CSF Biosamples (60 participants)

Results:

  1. Amyloid Beta 38
  2. Amyloid Beta 40
  3. Amyloid Beta 42
  4. Total Tau
Brain Bank

Brain Bank

6 Brains

Planned Neuropathological Evaluation:

  1. Thal phase of amyloid-beta deposits
  2. Braak Scale of neurofibrillary degeneration and Tau
  3. CERAD score for neuritic plaques
  4. Detailed vascular pathology
  5. Braak Scale (alpha-synuclein/Lewy bodies)
  6. Protein Transactive Response DNA-binding protein-43 (including LATE)
  7. Diagnosis
COVID-19 / Special Project - Data collected during the COVID-19 lockdown

COVID-19 / Special Project - Data collected during the COVID-19 lockdown

CIMA-Q participants were interviewed during the first lockdown regarding health parameters suspected to be affected by the lockdown and all the sanitary measures during the COVID-19 pandemic.

  1. Socio-demographic information
  2. T-MMSE
  3. COVID-19 restrictions
  4. COVID-19 virus
  5. Social distancing
  6. Social network
  7. Changes in sleep routine
  8. Sleep habits
  9. Insomnia Severity Index (ISI)
  10. Physical activity
  11. Geriatric Anxiety Inventory (GAI)
  12. Problems and symptoms related to the pandemic
  13. Auto-perception of health
  14. Geriatric Depression Scale (GDS-30)
  15. Cognitive/ Memory complaint question (Jessen)
  16. Short auto administered memory questionnaire (QAM)
  17. Pain Self-Assessment Questionnaire (short form)
  18. Alcohol and drug use
Available in the Data and Biosample CIMA-Q Bank

Available in the Data and Biosample CIMA-Q Bank

As of September 2024

  • COHORT: 419 participants / Woman: 64.5%

Full Assessment: Clinical, Neuropsychology and neuropsychiatry evaluations + Blood samples

  • Number of full assessments: 921
  • Number of participants with a full assessment at different timepoints:
    • Initial assessment: 419 (+248 MRI)
    • 2-year follow-up: 190 (+114 MRI)
    • 4-year follow-up: 140(+59 MRI)
    • 6-year follow-up: 118 (+64 MRI)
    • 8-year follow-up: 54 (+26 MRI)

Participants who came back for at least 1 complete follow-up after their initial evaluation: 223

  • Number of follow-up assessments by participants:
    • Participants with only 1 follow-up evaluation: 78
    • Participants with only 2 follow-up evaluations: 56
    • Participants with only 3 follow-up evaluations: 49
    • Participants with 4 follow-up evaluations: 40

Neuroimaging

  • Total MRI: 511

  • Participants with at least 1 MRI: 284

    • Participants with only 1 MRI: 154
    • Participants with only 2 MRIs: 74
    • Participants with only 3 MRIs: 23
    • Participants with only 4 MRIs: 25
    • Participants with 5 MRIs: 8

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