Application of ambulatory methods for assessing short- and long-term associations of sleep health with cognitive decline in older adults

应用动态方法评估老年人睡眠健康与认知能力下降的短期和长期关系

• 批准号: 9905469
• 负责人: ORFEU M BUXTON
• 金额: $ 77.71万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-15 至 2023-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9905469
• 关键词: Acute; Address; Aging; Alzheimer' s Disease; Behavior Therapy; Cellular Phone; Clinic; Clinical; Cognition; Cognitive; Communities; Complex; Development; Dimensions; Early Intervention; Ecological momentary assessment; Elderly; Evaluation; Exhibits; Future; Goals; Hypoxemia; Impaired cognition; Individual; Infrastructure; Intervention; Link; Literature; Measurement; Measures; Methods; Neurocognitive; Onset of illness; Outcome; Oxygen; Patient Self-Report; Persons; Pharmacologic Substance; Population Study; Prevalence; Preventive; Preventive Intervention; Protocols documentation; Research; Risk; Risk Factors; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep disturbances; Technology; Time; United States National Institutes of Health; Wrist; actigraphy; alertness; awake; base; brain health; cognitive function; cognitive performance; cognitive testing; cohort; design; follow-up; improved; indexing; individual variation; innovation; insight; interest; lifestyle intervention; mild cognitive impairment; modifiable risk; novel; novel strategies; pre-clinical; prevent; prognostic value; programs; prospective; sleep health; sleep pattern; sleep quality

SUMMARY/ABSTRACT Alzheimer’s disease (AD) prevalence is projected to triple by 2050. There is increasing emphasis on the need for preventive interventions targeting cognitive decline and onset of mild cognitive impairment (MCI) or AD given the lack of treatments available. Sleep disturbances are common among older individuals and a growing body of evidence suggests that disrupted sleep may be a precursor of cognitive decline and MCI. By partnering with the ongoing, well-established Einstein Aging Study Program Project (EAS; NIA- AG03949), we will add ambulatory measures of sleep health to the EAS intensive “burst” cognitive assessments in which smartphone technology is applied to assess cognitive performance multiple times per day, over 14-days, in naturalistic settings. The project will measure the major dimensions of sleep health by adding daily measures of sleep health (wrist actigraphy and daily ecological momentary assessment of self- reported sleep quality and daytime alertness), as well as an ambulatory measure of overnight oxygen desaturation to the EAS burst protocol which is following 500 community based older adults over four annual evaluations. Using this approach, we will assess both short-term (over days) and long term (over years) effects of indices of sleep health on cognitive performance, cognitive decline and MCI risk. we will be the first study to concurrently assess ecologically valid measures both of sleep health and cognitive performance using an intensive measurement design in a cohort of older adults. By minimizing the effects of naturally occurring variability in both indices of sleep health and cognitive performance, the intensive measurement improves the reliability of estimates and improves sensitivity for detecting change over time. This will thus clarify how changes in sleep health are associated with cognitive decline. Additionally, this design will also allow for novel explorations of intra-individual variability including: characterizing the proximal effects of sleep health on cognition (day-to-day effects); determining whether variability in sleep health predicts cognitive decline over the long term; and determining whether individuals vulnerable to the short-term effects of poor sleep on cognition are at increased risk for long term cognitive decline. Longitudinal assessments over annual follow-ups will allow us to advance understanding of the relation between sleep and cognitive decline by defining associations between longitudinal changes in sleep with changes in cognition. The proposed new sleep measures combined with the EAS burst and core assessments will allow us to do so over multiple dimensions of sleep health and multiple domains of cognitive function. By addressing gaps in the literature, the proposed study will inform ways to target early interventions for prevention or delay of cognitive decline by better understanding the proximal effects of sleep and by identifying the particular dimensions of sleep and domains of cognitive performance that are most closely related.

摘要/摘要 预计到 2050 年，阿尔茨海默病 (AD) 患病率将增加两倍。人们越来越重视 需要针对认知能力下降和轻度认知障碍（MCI）发作进行预防性干预，或 由于缺乏可用的治疗方法，睡眠障碍在老年人和老年人中很常见。 越来越多的证据表明，睡眠中断可能是认知能力下降和轻度认知障碍的先兆。 通过与正在进行的、完善的爱因斯坦衰老研究计划项目（EAS；NIA- AG03949），我们将在 EAS 强化“爆发”认知中添加睡眠健康的动态测量 应用智能手机技术多次评估认知表现的评估 该项目将在自然环境中测量睡眠健康的主要维度，为期 14 天。 添加睡眠健康的日常测量（手腕活动记录仪和自我生态瞬时评估） 报告的睡眠质量和白天的警觉性），以及夜间氧气的动态测量 EAS 突发协议的饱和度降低，该协议每年跟踪 500 名社区老年人 使用这种方法，我们将评估短期（数天）和长期（数年）。 我们将首先研究睡眠健康指数对认知表现、认知能力下降和 MCI 风险的影响。 研究同时评估睡眠健康和认知表现的生态有效措施 通过最大限度地减少自然发生的影响，对一组老年人进行密集的测量设计。 睡眠健康指数和认知表现的变异性，强化测量可以改善 估计的可靠性并提高检测随​​时间变化的灵敏度，这将阐明如何进行。 睡眠健康的变化与认知能力下降有关。 此外，这种设计还将允许对个体内部变异性进行新颖的探索，包括： 描述睡眠健康对认知的近期影响（日常影响）； 睡眠健康的变化预示着长期认知能力的下降；并确定个体是否会出现认知能力下降； 容易受到睡眠不良对认知的短期影响 长期认知的风险增加 对年度后续行动的纵向评估将使我们能够加深对下降的了解。 通过定义睡眠纵向变化之间的关联来确定睡眠与认知能力下降之间的关系 所提出的新睡眠措施与 EAS 突发和核心相结合。 评估将使我们能够在睡眠健康的多个维度和认知的多个领域进行评估 通过解决文献中的空白，拟议的研究将提供早期目标的方法。 通过更好地了解近期效应来预防或延缓认知能力下降的干预措施 睡眠并通过识别睡眠的特定维度和认知表现的领域 是最密切相关的。