Novel food-based approach for prevention of age-associated cognitive decline inolder adults with obesity

预防肥胖老年人与年龄相关的认知能力下降的基于食物的新方法

• 批准号: 10395140
• 负责人: RONALD A COHEN
• 金额: $ 118.94万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10395140
• 关键词: Activities of Daily Living; Address; Adherence; Adult; Age; Age-associated memory impairment; Alzheimer' s Disease; Auditory; Behavioral; Biological Markers; Blood Flow Velocity; Blood Pressure; Body Weight decreased; Body mass index; Brain; Brain Injuries; Catechin; Cerebrovascular Circulation; Cerebrum; Child; Cocoa Powder; Cognition; Cognitive; Consumption; Core-Binding Factor; Crystallization; Data; Dementia; Dietary Intervention; Dietary Practices; Diffuse; Digit structure; Docosahexaenoic Acids; Effectiveness; Eicosapentaenoic Acid; Elderly; Enrollment; Fasting; Flavanol; Food; Formulation; Foundations; Future; Genes; Glucose; Glycosylated hemoglobin A; Goals; Health; Impaired cognition; Impairment; Individual; Inflammation; Insulin; Intake; Intention; Intervention; Learning; Liquid substance; Long-Term Effects; Malnutrition; Measures; Metabolic; Micronutrients; Modeling; Neurocognitive; Neuropsychological Tests; Nutrient; Obesity; Omega-3 Fatty Acids; Oral; Outcome; Overweight; Oxidative Stress; Participant; Performance; Placebos; Prevalence; Prevention; Prevention approach; Prevention strategy; Public Health; Randomized; Research; Research Project Grants; Risk; Secondary to; Source; Spectrum Analysis; Standardization; Structure; Subgroup; Testing; Time; Trail Making Test; Transcranial Doppler Ultrasonography; United States National Institutes of Health; Variant; Verbal Learning; Weight; Word Association Tests; Work; adult obesity; aged; attentional control; base; brain health; brain remodeling; cardiometabolism; cerebral hemodynamics; cognitive function; cognitive performance; cognitive testing; comorbidity; dementia risk; design; effective therapy; epicatechin; executive function; high risk population; human old age (65+); improved; mild cognitive impairment; multidisciplinary; novel; nutrition; oxidative damage; predicting response; primary outcome; randomized placebo controlled trial; randomized trial; response; tool; weight loss intervention

Older adults with overweight and obesity are vulnerable cognitive decline, and have twice the risk of dementia and Alzheimer's Disease compared to adults without overweight or obesity. However, research on nutritional interventions to support cognitive health has been fragmented, and largely restricted to testing individual nutrition factors or generally healthy dietary patterns. The overarching goal of this proposal, responding to PAR-18-877, is to identify effective nutrition-based interventions to improve cognitive and brain functioning in older adults with overweight and obesity. Our central hypothesis is that age-sensitive cognitive functions and cerebral blood flow (CBF, an important biomarker of brain health) can be significantly increased in older adults with overweight or obesity by consumption of a novel multiple-component nutrition supplement (MCNS) used alone or in combination with a behavioral weight loss (WL) intervention. The scientific premise is that older adults with overweight and obesity have pathophysiological changes in the brain secondary to excess weight that damage brain structure and function, and as a result are particularly susceptible to nutritional deficiencies and oxidative stress; thus, optimal nutritional interventions for cognitive health should provide a comprehensive panel of nutrients and other food constituents to support structural and functional remodeling while reducing inflammation and oxidative damage. The project is proposed by a multidisciplinary team with expertise in all aspects of the research. The conceptual basis of the work is supported by our recent compelling data demonstrating effectiveness of a MCNS for improving executive function and cerebral blood flow in young children, which is a landmark advance because less comprehensive supplement formulations have been found to be ineffective. A 1-year randomized placebo-controlled trial will be conducted in 268 older adults with overweight and obesity, low intakes of target nutrients, and normal cognition or mild cognitive impairment. A 2x2 factorial design will randomize participants to: i) a MCNS supplement containing flavanols including epicatechin and catechin, essential micronutrients and omega-3 fatty acids, or to an isocaloric placebo; and b) to receive a behavioral WL intervention or an attentional Control. The primary outcome will be change in a composite cognitive z-score of well-established standardized scores on 5 neuropsychological tests. We hypothesize improved cognitive function in participants randomized to MCNS, WL and MCNS+WL compared to Controls, with greatest mean benefits in MCNS+WL participants. The primary analysis is intention-to-treat. Linear mixed-effects models will be applied to assess the effects of MCNS, WL, and MCNS+WL vs. Control and MCNS+WL vs. MCNS and WL alone. Additional cognitive tests will be drawn for other reliable sources, and microvascular cerebral blood flow and macrovascular cerebral blood flow velocity will be measured using diffuse correlation spectroscopy and transcranial Doppler ultrasound. This research will identify practical nutrition-based interventions for improving cognitive health in vulnerable older adults to support transformational advances in public health initiatives.

超重和肥胖的老年人认知能力容易下降，患痴呆症的风险是其两倍 和阿尔茨海默病与没有超重或肥胖的成年人相比。然而，营养研究 支持认知健康的干预措施支离破碎，并且很大程度上仅限于测试个人营养 因素或一般健康的饮食模式。该提案的总体目标响应 PAR-18-877， 的目的是确定有效的基于营养的干预措施，以改善患有老年痴呆症的老年人的认知和大脑功能 超重和肥胖。我们的中心假设是年龄敏感的认知功能和脑血流量 （CBF，大脑健康的重要生物标志物）在超重或超重的老年人中会显着增加 单独使用或联合使用新型多成分营养补充剂 (MCNS) 导致肥胖 与行为减肥（WL）干预相结合。科学前提是老年人 超重和肥胖会导致大脑继发于超重的病理生理变化，从而损害大脑 大脑结构和功能，因此特别容易受到营养缺乏和氧化的影响 压力;因此，认知健康的最佳营养干预措施应提供全面的 营养素和其他食物成分支持结构和功能重塑，同时减少炎症 和氧化损伤。该项目是由一个多学科团队提出的，该团队在各方面都有专业知识 研究。我们最近令人信服的数据证明了这项工作的概念基础 MCNS 在改善幼儿执行功能和脑血流量方面的有效性，这是一种 这是具有里程碑意义的进步，因为人们发现不太全面的补充剂配方是无效的。 一项为期 1 年的随机安慰剂对照试验将在 268 名患有超重和肥胖的老年人中进行 肥胖、目标营养素摄入量低以及认知正常或轻度认知障碍。 2x2 因子设计 将随机分配参与者：i) 含有黄烷醇（包括表儿茶素和儿茶素）的 MCNS 补充剂， 必需微量营养素和 omega-3 脂肪酸，或等热量安慰剂； b) 获得行为 WL 干预或注意力控制。主要结果将是综合认知 z 分数的变化 5 项神经心理学测试的完善标准化分数。我们假设认知能力得到改善 与对照组相比，随机分配至 MCNS、WL 和 MCNS+WL 组的参与者的功能，具有最大平均值 MCNS+WL 参与者的好处。主要分析是意向治疗。线性混合效应模型将 用于评估 MCNS、WL 和 MCNS+WL 与对照的效果以及 MCNS+WL 与 MCNS 和 WL 的效果 独自的。将对其他可靠来源进行额外的认知测试，以及微血管脑血流量 使用弥散相关光谱法测量大血管脑血流速度， 经颅多普勒超声。这项研究将确定实用的基于营养的干预措施，以改善 弱势老年人的认知健康，以支持公共卫生举措的变革性进展。

项目成果

Development and Feasibility of an eHealth Diabetes Prevention Program Adapted for Older Adults-Results from a Randomized Control Pilot Study.

适合老年人的电子健康糖尿病预防计划的开发和可行性——随机对照试点研究的结果。

• 发表时间: 2024-03-23
• 影响因子: 5.9
• 作者: Gerber, Suzannah;Silver, Rachel E;Das, Sai Krupa;Greene, Savana S;Dix, Sadie R;Ramirez, Isabella;Morcos, Christina L;Dao, Maria Carlota;Ceglia, Lisa;Roberts, Susan B
• 通讯作者: Roberts, Susan B