Variability and Volume of Day-to-Day Lifestyle Activity in Sustaining Cognitive Function among Insufficiently Active Older Adults at Risk for Alzheimer's Disease and Related Dementias

日常生活方式活动的变异性和活动量对有阿尔茨海默病和相关痴呆风险的活动不足的老年人维持认知功能的影响

• 批准号: 10662088
• 负责人: Chih-Hsiang Yang
• 金额: $ 21.68万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662088
• 关键词: Accelerometer; Adult; Aerobic Exercise; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Behavioral; Behavioral Model; Cellular Phone; Cognition; Cognitive; Data; Data Set; Dementia; Devices; Dimensions; Distal; Economic Burden; Elderly; Enrollment; Ethnic Origin; Exercise; Expenditure; Family; Foundations; Funding; Future; Gender; Goals; Guidelines; Health; Health Care Costs; Heterogeneity; Impaired cognition; Incidence; Individual; Intervention; Joints; Knowledge; Life Style; Light; Literature; Masks; Measurement; Measures; Medical; Medicine; Mental Health; Methodology; Methods; Modeling; Monitor; Motivation; Noise; Older Population; Outcome; Participant; Pattern; Persons; Phase; Physical activity; Population; Prevention strategy; Prospective, cohort study; Public Health; Race; Recommendation; Reliability of Results; Reporting; Research; Resources; Risk; Role; Sampling; Sex Differences; Sleep; Societies; Statistical Methods; Stress; Subgroup; Surveys; Testing; Time; Uncertainty; United States National Institutes of Health; Variant; Walking; age difference; cognitive benefits; cognitive function; cognitive testing; dementia risk; demographic disparity; demographics; disease registry; efficacy trial; eligible participant; ethnic difference; ethnic diversity; evidence base; experience; follow-up; gender difference; high risk; light intensity; longitudinal design; mobile computing; novel; pedometer; pre-clinical; prevent; programs; prospective; racial difference; recruit; sex; sleep quality; social; social engagement; statistics; success; therapy development; tool

The escalating incidence of Alzheimer’s disease and related dementias (ADRD) places a tremendous economic burden on society and families, making up the largest healthcare cost expenditure in the US. To date, medical approaches for preventing and treating ADRD have yielded limited success. Non-pharmacological preventive strategies, such as physical activity, hold promise for sustaining cognition and thus reducing ADRD risks in older adults. Unfortunately, it is not feasible and practical for many older adults to engage in the recommended higher- intensity physical activities (or aerobic exercise), especially for those with mobility limitations, physical barriers, and predisposing health conditions. Existing evidence suggests that even engaging in lower-intensity lifestyle activities, such as walking, may benefit cognitive health. However, this literature has exclusively focused on the total amount or mean volume of light-intensity physical activity (LPA) or steps and identified small-to-moderate effects on cognition. Beyond the total volume performed, the day-to-day variability (or stability) of LPA or steps also represents a behavioral target that potentially can amplify the cognitive benefits, but this variable has not been tested in the literature. Using an experimental medicine approach, this proposal will bridge the knowledge gap by determining whether older adults’ daily variability and volume of LPA/steps jointly predict their proximal and distal cognitive function. This study will recruit ethnically diverse older adults (ages 60+) who are insufficiently active and have higher risks for developing ADRD. Eligible participants will wear an accelerometer for 30 days to estimate each person’s typical variability and volume of their daily LPA/steps. They will complete daily e-surveys during the same 30-day period to assess their daily stress, sleep, and social engagements. These factors influence older adults’ daily physical activity and cognition, so they will be considered (modeled) when estimating each person’s typical LPA and step patterns. After the 30-day monitoring period, participants will complete three follow-up cognitive measures on Day 31, at 2.5 months, and 4 months. These cognitive measures involve validated in-lab and smartphone-based tools (MoCA, scales, NIH-funded M2C2 app). Lastly, this study will examine whether subgroup differences (based on demographics) exist in the proposed associations between daily lifestyle activity patterns (variation and volume of LPA/steps) and cognitive function. To enhance the rigor of our study findings, we will apply the novel MixWILD statistical program in our analysis. This program accounts for uncertainties in unbalanced datasets, which can enhance estimation precision and provide reliable results. The first study aim is to determine if both variation and volume of daily LPA/steps are joint targets for sustaining proximal and distal cognitive function in older adults at risk for ADRD. The second aim is to investigate if there are sex, gender, age, and race/ethnicity differences in the associations between LPA/step patterns and cognitive function. Findings have the potential to identify achievable and scalable behavioral targets that can be engaged in future efficacy trials to reduce ADRD risks in older adults’ daily lives.

阿尔茨海默氏病和相关痴呆症（ADRD）的不断升级的事件置于巨大的经济状态 社会和家庭负担，构成了美国最大的医疗费用支出。迄今为止，医疗 预防和治疗ADRD的方法取得了有限的成功。非药理预防性 诸如体育锻炼之类的策略有望维持认知，从而降低了年龄较大的ADRD风险 成年人。不幸的是，许多老年人参与建议的更高 - 强度的体育活动（或有氧运动），尤其是对于具有活动限制，身体障碍， 和易于健康状况。现有证据表明，即使从事较低强度的生活方式 步行等活动可能会受益于认知健康。但是，这些文献专注于 光强度体育锻炼（LPA）或步骤的总量或平均体积 对认知的影响。超出执行总量，LPA或步骤的日常变异性（或稳定性） 还代表了可能可以扩大认知益处的行为目标，但是该变量尚未 在文献中进行了测试。使用实验医学方法，该建议将弥合知识 通过确定老年人的每日变异性和LPA/步骤的数量是否共同预测他们的差距 近端和盘状认知功能。这项研究将招募种族潜水员老年人（60岁以上） 没有足够的活动，并且有更高的风险开发ADRD。合格的参与者会穿 加速度计30天，以估算每个人的典型变异性和每日LPA/步骤的体积。他们 将在同一30天期间完成每日电子疗法，以评估他们的日常压力，睡眠和社交 参与。这些因素会影响老年人的日常体育锻炼和认知，因此它们将是 在估计每个人的典型LPA和步骤模式时考虑（建模）。经过30天的监控 时期，参与者将在第31天，2.5个月和4个月完成三项随访认知措施。 这些认知措施涉及通过LAB和智能手机的工具（MOCA，SCALES，NIH资助）验证的措施 M2C2应用程序）。最后，这项研究将检查亚组差异（基于人口统计学）是否存在 每日生活方式活动模式（LPA/steps的变化和体积）与认知之间的拟议关联 功能。为了增强我们的研究结果的严格性，我们将在我们的 分析。该程序在不平衡数据集中说明不确定性，这可以增强估计 精确并提供可靠的结果。第一个研究的目的是确定每日的变化和数量是否 LPA/步骤是维持ADRD风险的老年人的近端和盘状认知功能的关节目标。 第二个目的是调查协会中是否存在性，性别，年龄和种族/种族差异 在LPA/步骤模式和认知功能之间。发现有可能识别可实现和可扩展的 可以参与将来的效率试验的行为目标，以减少老年人日常生活的ADRD风险。