MemClin

A project that aims to increase the knowledge of the cognitive examination’s complexity

Skeppsbrokajen
Skeppsbrokajen. Photo: Julian Herzog

Stockholm MemClin is a project that started on a smaller scale in 2016 and has since increased in magnitude and since 2019, 9 out of 10 of Stockholm's Memory clinics are included in the project. The purpose is, among others, to increase the understanding of how cognitive (mental abilities such as memory and attention) disorders (such as Alzheimer disease, Lewy-body disease, Parkinson's disease dementia, frontotemporal dementia and vascular dementia ) manifest themselves in different stages for the population seeking care at Memory clinics.

Unlike many other databases, MemClin is a naturalistic database, which means that it mimics the clinical reality and complexity as closely as possible and have no exclusion criteria for those included in the study. A cognitive disease often comes gradually, and covers a spectrum from normal cognition, to a reduced ability in many different cognitive areas. The first step on the cognitive spectrum is subjective cognitive impairment (SCI), when the individual experiences that they have more difficulty with, for example, memory but still performs normally on cognitive tests, then comes mild cognitive impairment (MCI) where the performance on cognitive tests is affected and lastly dementia with more affected cognitive test performance and greater difficulties in everyday life. During normal aging, it is common to experience that the cognitive capacity has been reduced compared to a younger age.

However, normal cognitive aging can be difficult to distinguish from an early-stage cognitive disorder. An additional difficulty with the diagnosis of cognitive disorders is that cognition can also be affected by other factors in life such as stress, depression, or grief. Additionally, common diseases or conditions can affect cognition temporarily or permanently, which means that at an early stage it can be difficult to determine what is a cognitive disease and what is not.


Purpose

The goal of MemClin is to generate new knowledge about how cognitive test profiling, brain imaging, cerebrospinal fluid (CSF) biomarkers and other health assessments predict the development over time from SCI via MCI to dementia in a large-scale naturalistic environment. Increasing the understanding of the complexity of cognitive disorders and understanding the large overlaps between them will give us a clearer insight into the underlying disease mechanisms.

An additional goal is to increase knowledge about; and to improve the ability to differentiate between more unusual cognitive diseases such as Lewy-body dementia, Parkinson's disease dementia, frontotemporal dementia as well as vascular dementia. We aim for the MemClin project to lead to earlier and more accurate cognitive diagnosis. The clinical perspective and population-based nature of the MemClin project increase the possibilities of introducing reliable research results into the clinical routine.

 

Steering committee

The Steering Committee provides guidance and reviews the MemClin study and ensures that articles are in line with the established research objectives.

Steering Committee members:

Urban Ekman, Assistant Professor, Licensed Psychologist, Karolinska Institutet and Karolinska University Hospital

Eric Westman, Professor in Neurogeriatrics, Master of Science in Engineering, Karolinska Institutet

Maria Eriksdotter, Professor in Clinical Geriatrics, Chief Physician, Karolinska Institutet and Karolinska University Hospital

Lars-Olof Wahlund, Professor in Clinical Geriatrics, Chief Physician, Karolinska Institutet and Karolinska University Hospital

Interest in collaboration

MemClin is a unique clinical research database and we are open to collaboration. If you are interested in conducting research on MemClin data, send an e-mail to: urban.ekman@ki.se to make an inquiry. Data is handled in accordance with current laws regarding personal data and we use infrastructure described in Muehlboeck, J.S., Westman, E., & Simmons, A. (2014). TheHiveDB image data management and analysis framework. Frontiers in Neuroinformatics, 7, 49.

Scientific publications from MemClin

Wallert J, Ekman U, Westman E, Madison G. The worst performance rule with elderly in abnormal cognitive decline. Intelligence 2017; 64: 9-17. https://doi.org/10.1016/j.intell.2017.06.003 

https://www.sciencedirect.com/science/article/pii/S016028961730017X?via%3Dihub

Wallert J, Westman E, Ulinder J, Annerstedt M, Terzis B, Ekman U. Differential diagnostics accuracy of several simple reaction time metrics: a supervised machine learning approach with memory clinic patients. Frontiers of Aging Neuroscience 2018; 10: article 144. https://www.frontiersin.org/articles/10.3389/fnagi.2018.00144/full

Wallert, J., Rennie, A., Ferreira, D., Muehlboeck, J. S., Wahlund, L.-O., Westman, E., & Ekman, U. (2021). Cognitive dedifferentiation as a function of cognitive impairment in the ADNI and MemClin cohorts. Aging, 13(10), 13430-13442.

Ekman, U., Ferreira, D., Muehlboeck, J.S., Wallert, J., Rennie, A., Eriksdotter, M., Wahlund, L.-O., & Westman, E. (2020). The MemClin project: a prospective multi memory clinics study targeting early stages of cognitive impairment. BMC geriatrics., 20(1), 93[AR1]

Ongoing research projects in MemClin

Currently, there are three ongoing manuscripts either in preparation or under review in scientific journals:
Memory functions separate normal aging, subjective cognitive impairment, mild cognitive impairment, and dementia. This study is about the association between different memory functions (episodic memory, semantic memory and working memory) and how these can be diagnostically relevant.

Comparing subtyping approaches in subjective and mild cognitive impairment from the large naturalistic multi memory clinic sample MemClin This study is about how different approaches to sub-grouping people with cognitive impairment (SCI, MCI) can differ and how it relates to biological markers.


The role of cognitive reserve on the relationship between temporal lobe atrophy and episodic memory. This study is about how educational level can be linked to cognitive reserve (increased resistance to neurodegeneration).

 

Financing

We have graciously received funding from the following funds and organisations.

Vetenskapsrådet (Swedish Research Council)

Forskningsrådet för hälsa, arbetsliv och välfärd (FORTE) (Swedish Research Council for Health, Working Life and Welfare (FORTE))

Demensfonden (Dementia fund)

 [AR1]Lägg till länk till artikeln

https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-1478-3