I want to contribute to early accurate recognition of Alzheimer Disease and similar neurodegenerative disorders to improve our understanding of early disease processes and opportunities for intervention. I also want to contribute to the quality of life of those in more advanced stages of these diseases.
Cognitive impairments in early Alzheimer Disease and Frontotemporal Lobar Degeneration (FTLD), Cognitive function after subcortical stroke, MRI and FDG-PET, Clinical meaningfulness in treatment monitoring, Non-pharmacological interventions including music therapy, exercise, and cognitive stimualtion
The primary focus of my research program is on the early accurate diagnosis of neurodegenerative disease. I believe that treatments with disease-modifying effects will be identified, and that it will be of critical importance to determine cognitive impairment and its cause early in the pathogenesis, so that treatment can be initiated. Together with international experts, I have built a framework for the early diagnosis of Alzheimer Disease (AD). In addition to validating this framework with empirical data, it is essential to characterize the early manifestations of other neurodegenerative diseases. AD accounts for most dementia cases in old age but Frontotemporal Lobar Degeneration (FTLD) is the second most common type with earlier onset. The presymptomatic and prodromal stages of this devastating disease are not well characterized. I am collaborating on a large multi-disciplinary study on FTLD at UBC that has accrued a cohort of at-risk members of families with autosomal dominant forms of the disease. I am also investigating the cognitive sequelae of small subcortical strokes (S3), known risk factors for progression to Vascular Dementia (VaD) in the large cohort of participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial, designed to identify optimal treatments for individuals who have had an S3. My initial work has shown that the impact of lacunar stroke on cognition may outweigh that on physical function, with significant cognitive deficits in about half of those affected. Within my primary research area, I am developing C-TOC (Cognitive Testing On Computer) to facilitate and support early diagnosis of neurodegenerative diseases, with cognitive test paradigms designed to be highly sensitive to impairment, and to the specific performance patterns associated with different dementias. These aims are supported by, and may in turn benefit my work on AD and non-AD prodromal and preclinical stages.
My secondary research focus is on the management of cognitive disorders, specifically the measurement of response to pharmacological and psychosocial interventions. There is a recognized limitation in current cognitive and clinical outcome measures that have been criticized to have no inherent clinical meaning for an individual patient and family. I have co-developed the CLIMAT (Clinical Meaningfulness in Alzheimer Disease Treatment ) scale, which evaluates and weights the social impact of symptoms in the assessment of treatment response. I am also involved in designing and testing non-pharmacological interventions in cognitive impairment and dementia, including physical and cognitive exercise, and music therapy.
- Photography, Playing piano, Running & Hiking
- Dubois B, Feldman H, Jacova C et al. Revising the definition of Alzheimer’s Disease: A new lexicon. Lancet Neurology 2010;9(11):1118-27.
- Liu-Ambrose, T, Eng, JJ, Boyd LA, Jacova C, et al. Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise in older adults with vascular cognitive impairment. BMC Neurol 2010:Feb 17;10-14.
- Feldman, H., Jacova, C. Predicting response to acetylcholinesterase inhibitor treatment in Alzheimer disease: Has the time come? Nat Clin Pract Neurol 2009;5(3):128-9.
- Feldman, H., Jacova, C., Robillard, A., Garcia, A., et al. A. The diagnosis of dementia. Canadian Medical Association Journal 2008 March 25; 178(1):825-36.
- Jacova, C., Peters, K.R., Wong, E. , Beattie, B.L. et al. Cognitive-Impairment-No-Dementia (CIND) – Neuropsychological and neuroimaging characterization of an amnestic subtype. Dementia and Geriatric Cognitive Disorders 2008; 25(3):238-247.
- Dubois, B., Feldman, H., Jacova, C., DeKosky, S., et al. Research criteria for the diagnosis of Alzheimer’s disease: Revising the NINCDS-ADRDA criteria. Lancet Neurology 2007 Aug;6(8):734-46.
- Jacova, C. and Feldman, H.H. Mild Cognitive Impairment. In Gelder, M., Lopez-Ibor, J., Andreasen, N. and Geddes, J. Eds. New Oxford Textbook of Psychiatry 2/e. Oxford: Oxford University Press 2011.
- Jacova, C., Mudge, B., and Woodward, M. Prevention of Alzheimer’s Disease. In Feldman, H. (ed), Atlas of Alzheimer Disease, Informa Healthcare:London 2007.
- Jacova C, Slack P, Ory J, Kirkland K, Hsiung GYR, Boyd L. An fMRI study of music familiarity and brain activation in Alzheimer Disease. Presented at ICAD 2011, Paris July 2011.
- Tawankanjanachot I, Jacova C, Hsiung GYR, Lee HS, McCormick S, et al. Anterior and subcortical glucose hypometabolic rate in presymptomatic progranulin carriers. Oral presentation & poster at the 7th International Conference on Frontotemporal Dementias, Indianapolis October 2010.
- Jacova, C, Lee HS, Le Huray, S, McGrenere, J, Beattie, BL, et al. Cognitive Testing on Computer (C-TOC): Designing a computerized test battery for evaluation of cognitive impairment with user and community health professional input. ICAD10, Honolulu, July 2010.
Operating grants from BC Ministry of Health, Canadian Institutes of Health Research, Canadian Stroke Network, Alzheimer Society of Canada