My Healthy Brain: a mindfulness-based lifestyle intervention to modify early risk of dementia in older adults

我的健康大脑：基于正念的生活方式干预，可降低老年人患痴呆症的早期风险

基本信息

批准号：
10350813
负责人：
Ryan Andrew Mace
金额：
$ 19.28万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10350813
关键词：
Address Adherence Age Aging Alcohols Alzheimer disease prevention Alzheimer&apos s disease related dementia Alzheimer&apos s disease risk Attention Award Awareness Behavior Behavior Therapy Benchmarking Brain Cardiovascular Diseases Cellular Phone Chronic stress Clinic Clinical Clinical Trials Cognition Cognitive Complement Dementia Detection Education Elderly Elements Enhancement Technology Environment Exercise Feedback Focus Groups Funding General Hospitals Goals Grant Habits Health Health Technology Health behavior Hyperphagia Impaired cognition Incidence Individual International Intervention Interview Life Expectancy Life Style Link Massachusetts Medical Medical Staff Mental Health Mentors Mentorship Methodological Studies Methodology Mind-Body Intervention Modeling Monitor Myristica fragrans Neurobehavioral Manifestations Outcome Palliative Care Patient Care Patient Self-Report Patients Peer Review Peripheral Persons Physicians Population Population Intervention Prevalence Prevention Procedures Proctor framework Provider Psyche structure Psychiatrist Psychologist Publications Publishing Qualitative Methods Research Research Personnel Risk Risk Factors Scientist Services Sleep Deprivation Smoking Telephone Interviews Testing Time Training Unhealthy Diet Work acceptability and feasibility actigraphy base behavior change behavioral adherence biological adaptation to stress cardiovascular risk factor cognitive control cognitive function cognitive interview dementia risk efficacy testing efficacy trial experience global health health data healthy aging healthy lifestyle human old age (65+)implementation barriers implementation framework implementation science improved interest lifestyle factors lifestyle intervention mHealth medical schools mind control mindfulness mindfulness intervention modifiable lifestyle factors multidisciplinary new technology novel patient engagement personalized strategies pilot test prevent primary outcome programs recruit reinforced behavior skills smartphone Application social statistics therapy development virtual

项目摘要

PROJECT SUMMARY In this K23, I (Dr. Ryan Mace) will acquire training in mindfulness-based lifestyle intervention development for the prevention of Alzheimer’s Disease and Related Dementias (ADRD). I am a clinical health psychologist at Massachusetts General Hospital (MGH) and Harvard Medical School, with a strong research background in the cognitive underpinnings of mental health and aging. My long-term goal is to become an independent investigator and leading developer of technology-enhanced behavioral interventions, from pilot testing to implementation, for the large-scale promotion of healthier lifestyles with aging. Through this K23 project, and the rich multidisciplinary training environment at MGH, I will achieve the following Training Goals: 1) identify implementation barriers using qualitative methods with medical stakeholders; 2) optimize lifestyle and mindfulness-based interventions for specific aging populations; 3) conduct rigorous technology-enhanced clinical trials; and 4) collect and analyze mobile health data on lifestyle behavior change. To achieve these goals, I have assembled an exemplary mentorship team led by my primary mentor, Dr. Ana-Maria Vranceanu, a clinical health psychologist and a leader in live video mind-body intervention development; co-mentor, Dr. Christine Ritchie, a geriatrician and palliative care physician with decades of research on improving the detection and treatment of ADRD; advisor, Dr. Stephen Bartels, a geriatric psychiatrist and national expert in implementation science; advisor, Dr. Judson Brewer, a psychiatrist and neuroscientist internationally renowned for app-based mindfulness programs for behavior change; advisor, Dr. Olivia Okereke, a geriatric psychiatrist specializing in modifiable lifestyle risk factors of ADRD; and advisor, Dr. Bettina Hoeppner, an experimental psychologist with expertise in statistics and longitudinal modeling of mobile health data. This proposal logically builds on my prior work co-developing My Healthy Brain (MHB) – the first mindfulness-based lifestyle program to modify ADRD risk factors in older adults with subjective cognitive decline (SCD). SCD is a critical window for ADRD prevention, while cognitive symptoms are at the earliest stage, yet prior trials targeting multiple lifestyle factors have shown limited adherence, are time-intensive, and failed to produce behavior change. In contrast, MHB 1) teaches mindfulness skills to improve lifestyles; 2) uses mobile health technologies (ActiGraph watches, smartphone app) to assess and reinforce behaviors; and 3) is delivered via live video. For Aim 1, I will conduct live video focus groups with medical stakeholders (N = 20) using elements from Proctor’s implementation framework to address barriers to efficient referrals, develop participant engagement strategies, and optimize study procedures. For Aim 2, I will establish — via a live video pilot RCT in older adults (age ≥ 60) with SCD and ADRD risk factors — the feasibility, acceptability, appropriateness, and fidelity of the MHB versus an education control (N=50) following predetermined benchmarks. The findings will inform an efficacy trial (R01) that will also test mechanisms of improvements in lifestyle and cognition. This K23 aligns with the NIA funding priority of developing feasible and personalized strategies for promoting adherence to lifestyles that are protective of ADRD. The experiences gained during the award will facilitate my independence as a leading clinician scientist focused on healthy aging and ADRD prevention.

项目概要在这个 K23 中，我（Ryan Mace 博士）将接受基于正念的生活方式干预开发的培训，以帮助预防阿尔茨海默病和相关痴呆症 (ADRD) 我是马萨诸塞州的一名临床健康心理学家。综合医院 (MGH) 和哈佛医学院，在认知基础方面拥有强大的研究背景我的长期目标是成为心理健康和衰老的独立研究者和领先开发者。技术增强的行为干预措施，从试点测试到实施，以大规模推广通过这个 K23 项目以及麻省总医院丰富的多学科培训环境，我受益匪浅。将实现以下培训目标：1）使用医学定性方法确定实施障碍利益相关者；2) 针对特定老龄化人群优化生活方式和正念干预措施；3) 实施严格的干预措施；技术增强的临床试验；4) 收集和分析有关生活方式行为变化的移动健康数据。为了实现这些目标，我组建了一支模范导师团队，由我的主要导师 Ana-Maria Vranceanu 博士领导，她是一名临床健康心理学家、实时视频身心干预开发领域的领导者 Christine 博士； Ritchie 是一位老年病学家和姑息治疗医生，在改善老年痴呆症的检测和治疗方面进行了数十年的研究 ADRD；顾问 Stephen Bartels 博士，老年心理学和国家实施科学专家；贾德森·布鲁尔（Judson Brewer）是一位精神病患者和神经科学家，因基于应用程序的正念项目而享誉国际。行为改变；顾问，Olivia Okereke 博士，一位老年精神病专家，专门研究可改变的生活方式风险因素 ADRD；顾问 Bettina Hoeppner 博士，一位具有统计和纵向专业知识的实验心理学家该提案逻辑上建立在我之前共同开发“我的健康大脑”(MHB) 的工作基础上。 – 第一个基于正念的生活方式计划，旨在改变具有主观认知的老年人 ADRD 风险因素认知衰退（SCD）是 ADRD 预防的关键窗口，而认知症状仍处于最早阶段。先前针对多种生活方式因素的试验显示，依从性有限、耗时且未能产生效果相比之下，MHB 1) 教授正念技能以改善生活方式；2) 使用移动健康技术；（ActiGraph 手表、智能手机应用程序）来评估和强化行为；3) 通过实时视频进行传递。将使用 Proctor 实施中的元素与医疗利益相关者 (N = 20) 进行实时视频焦点小组讨论框架解决高效转诊的障碍，制定参与者参与策略并优化研究对于目标 2，我将通过实时视频试点 RCT 在患有 SCD 和 ADRD 风险的老年人（年龄 ≥ 60 岁）中建立。因素 — MHB 与教育控制的可行性、可接受性、适当性和保真度 (N=50) 遵循预定的基准，研究结果将为功效试验（R01）提供信息，该试验也将测试其机制。该 K23 与 NIA 资助的开发可行和认知的优先事项相一致。促进坚持预防 ADRD 的生活方式的个性化策略。该奖项将促进我作为一名专注于健康老龄化和 ADRD 预防的领先临床科学家的独立性。