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: 10343665
• 负责人: ORFEU M BUXTON
• 金额: $ 70.36万
• 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 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10343665
• 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; 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; poor sleep; pre-clinical; prevent; preventive intervention; 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 阿尔茨海默氏病（AD）的患病率预计到2050年将三倍。 需要针对认知能力下降和轻度认知障碍（MCI）或 鉴于缺乏可用的治疗方法，广告。睡眠障碍在老年人中很常见，一个 越来越多的证据表明，睡眠破坏可能是认知能力下降和MCI的先兆。 通过与正在进行的爱因斯坦老化研究计划项目合作（EAS; nia-- AG03949），我们将在EAS密集的“爆发”认知中添加门诊的睡眠健康措施 评估智能手机技术的评估以评估认知性能多次 在自然主义环境中，一天，超过14天。该项目将通过 增加每日睡眠健康措施（手腕行为和每日生态瞬时评估自我 报告的睡眠质量和白天的警觉性），以及对过夜氧气的门诊测量 对EA爆发协议的饱和度，该协议是在四个年度的500个基于社区的老年人之后 评估。使用这种方法，我们将评估短期（几天）和长期（多年） 睡眠健康指数对认知表现，认知能力下降和MCI风险的影响。我们将成为第一个 研究同时评估生态有效的措施，同时使用睡眠健康和认知表现 在老年人队列中进行了深入的测量设计。通过最大程度地减少自然发生的影响 睡眠健康指数和认知表现的差异，密集度量都可以改善 估计的可靠性和提高了随着时间的流逝检测变化的灵敏度。因此，这将阐明如何 睡眠健康的变化与认知能力下降有关。 此外，该设计还将允许对个体内部变异性进行新颖的探索，包括： 表征睡眠健康对认知（日常影响）的近端影响；确定是否 长期认知能力下降的睡眠健康预测变异性；并确定个人是否 睡眠不良对认知的短期影响很容易受到长期认知风险的增加 衰退。对年度随访的纵向评估将使我们能够提高对 通过定义睡眠变化之间的关联，睡眠和认知能力下降之间的关系 随着认知的变化。拟议的新睡眠措施与EAS爆发和核心结合在一起 评估将使我们能够在睡眠健康和多个认知领域的多个维度上这样做 功能。通过解决文献中的差距，拟议的研究将告知方法以提早针对 通过更好地理解代理效应，预防或延迟认知下降的干预措施 睡眠和确定睡眠和认知表现领域的特定维度 最密切相关的。