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Why should you join P.O.N.D.E.R ?

It is important that you participate in the P.O.N.D.E.R project in order to assess you current risk of Neuro-
degenerative Diseases, strengthen you mind with cognitive training, prevent the onset of disease, and contribute to the fundamental research of this field. Up until now there hasn't been a study that has been able to completely understand how to prevent Neurodegenerative Diseases, and so a longitudinal study must be employed. Finally, by participating in this project, not only can you improve your own mental health, your data may help provide guidelines to better shape society.

How can P.O.N.D.E.R help you ?

In order to understand how P.O.N.D.E.R can help you, consider the following example of Alzheimer's (a major Neurodegenerative Diseases):

One of the best known and widely accepted stage theories of Alzheimer's disease is the Global Deterioration Scale by (Reisberg et al., 1982). Although it is intended for clinicians to categorize and describe the symptoms and the course of the disease after the onset, stages 1 and 2 describe the general characteristics that subjects experience prior to the onset of the disease. At stage 1 ('no cognitive decline'), subjects do not report any cognitive decline or memory deficits. Given that Alzheimer disease is developing over a long period of time, and can be ongoing for several decades before the first symptoms occur, we can however still expect that some biological changes are already manifesting itself in the central nervous system, in subjects who will eventually develop the disease. Since this stage is practically symptom free, no systematic cognitive testing or assessment occurs, and anecdotal testing at this stage reveals no deviations from appropriate age-equivalent norms. In fact, since the subject is considered healthy, his or her test scores would be used to establish these age-appropriate norms.

At stage 2 (very mild cognitive decline), the subject complains about a beginning memory deficit, which most often manifests itself in forgetting names or placement of familiar objects (e.g., car keys). Although the subject at this state is showing concern about his or her symptoms, clinical interviews and cognitive assessments are unable to establish any objective deficits. According to the author of the scale (Reisberg et al., 1994), with the beginning of stage 3 (mild cognitive decline), objective evidence of memory deficit can be obtained through intensive testing.

In the context of the current application we challenge the view that assessment of cognitive decline is impossible before stage 3, and hypothesize that our program will allow cognitive training and establish the possibility to assess individual cognitive decline in stages 1 and 2.

Why participate in a longitudinal study ?

Almost all current cognitive assessment programs are based on cross-sectional assessments. The major problem with this approach is that it fails to take into account interindividual differences in cognitive abilities; thus, age-appropriate norms to compare the individuals performance with the average performance need to account for the normal range of cognitive abilities that occurs within the population. To exemplify this using the example of IQ: Normative range for adults suggest that 95% of the population score above 78; thus, for a person with an IQ of 110, which is at the higher end of the average range (50% of the population fall into the range from 90 to 110), to become noticed using conventional cross-sectional testing, his or her IQ would need to fall a staggering 32 points before being considered 'abnormal'. Now if you were to employ some statistics, you could calculate that a change in score of around 5 digits would be sufficient to consider the assessment suspicious - obviously a very significant improvement over the cross-sectional approach, where a change of 32 points need to occur. In this context, since P.O.N.D.E.R is a longitudinal study that compares your results with your previous results over time, we would easily be able to detect a change of 5 points.