Cognitive Aging Study "I'm Interested" Form
**Seeking approximately 40 participants from now through end of summer 2024**

With this form you can indicate your interest in possibly participating in a Cornell University study on cognitive aging. The study investigates a brain region that is important for keeping the brain healthy throughout aging. The long-term goal of this work is to be able to learn how to identify those at risk for cognitive decline well before any symptoms emerge. Participation of volunteers is extremely valuable to our research team.

This study investigates the brain by tracking your eyes with cameras (pupillometry), MRI, and a variety of paper and computerized tests. The study collects an optional saliva sample for analysis of two genes. You may also receive blood pressure measurements. The MRI component of the test is lengthy (more than 1 hour). It is not appropriate for those with claustrophobia, those with body weight above 240 pounds (due to the size of the MRI machine itself), and may not be appropriate for those with severe back pain, because participants need to lie on their back with minimal movement for the entire duration of the MRI portion.

The study pays $100 in cash. We may be able to arrange and pay for transportation to Ithaca, NY if you live 20-90 minutes away from our lab.

By filling out this form, you are simply indicating potential interest in this study. You are not committing to anything. Your name, age, phone number and email address will be stored by study personnel so that we can contact you. 

If you have any questions please email the study's Principal Investigator, Dr. Elizabeth Riley, at er482@cornell.edu. You can reach study study staff at brain.aclab@cornell.edu   If necessary you may also call or text Dr. Riley at 607-253-2046.  This study is approved by the Cornell Institutional Review Board, protocol ID 1910009087.
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Email *
What is your age? *
What is your name? *
What is your phone number? *
Do you have any reason to believe that you should not receive an MRI? If you aren't sure, pick "other" and explain. *
Approximate height and body weight in pounds *
Are you comfortable walking approximately two blocks to the building next door for the MRI portion? If you need any assistance in walking, please bring it!
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Have you ever had a serious neurological disorder or disease, such as schizophrenia, epilepsy, stroke, brain tumor, spinal cord injury or a moderate to severe head injury? Do you have a pacemaker, cochlear implant, or heart arrhythmia? If you aren't sure, pick "other" and explain. *
Are you colorblind? *
Do you have cataracts, or have you ever had cataract surgery? *
Are you vision and hearing normal, or corrected to normal, or *nearly* corrected to normal? *
Are you comfortable making responses with a computer keyboard, mouse and/or touchscreen? *
Are you willing to give a complete list of any drugs or medications you use regularly? *
Do you think that you may be experiencing cognitive decline? If you do not wish to answer, please write N/A. *
How did you hear about the study?
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