Life-Space and Activity Digital Markers for Detection of Cognitive Decline in Community-Dwelling Older Adults: The RAMS Study

用于检测社区老年人认知衰退的生活空间和活动数字标记：RAMS 研究

• 批准号: 10662702
• 负责人: Jane Chung
• 金额: $ 69.3万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662702
• 关键词: Affect; Alzheimer' s disease diagnosis; Alzheimer' s disease related dementia; Area; Attitude; Behavioral; Biological Markers; Case/Control Studies; Characteristics; Chronic Disease; Classification; Clinical; Cognitive; Communities; Complex; Computers; Consumption; Data; Dementia; Detection; Deterioration; Diagnosis; Digital biomarker; Early Diagnosis; Early identification; Early treatment; Elderly; Evaluation; Exhibits; Frequencies; Global Positioning System; Goals; Health; Health Status; Health Technology; Impaired cognition; Individual; Intention; Interview; Life; Loneliness; Longitudinal Studies; Low income; Measurement; Measures; Medicare claim; Methods; Monitor; Movement; Neuropsychology; Participant; Performance; Physical activity; Population; Prevention; Privacy; Public Health; Race; Resources; Risk; Risk Factors; Role; Social isolation; Specific qualifier value; Speed; Surveys; Symptoms; Technology; Time; Translations; Travel; Visit; Work; Wrist; actigraphy; aging population; biomarker identification; burden of illness; clinically relevant; cognitive change; cognitive function; community based research; data visualization; dementia risk; digital; digital health; digital measure; digital technology; digital tool; early detection biomarkers; effective intervention; ethnic minority; ethnic minority population; follow-up; functional decline; functional status; health care availability; health disparity; human old age (65+); implementation barriers; improved; insight; interest; low socioeconomic status; medically underserved; mild cognitive impairment; modifiable risk; neuroimaging marker; portability; preference; prevent; programs; prospective; racial minority; racial minority population; real time monitoring; recruit; sedentary; sensor; social; social influence; socioeconomics; tool; trend; wearable device; willingness

PROJECT SUMMARY/ABSTRACT Markers of functional decline begin years before clinical symptoms of Alzheimer’s disease and related dementias (ADRD). It is essential to capture these functional changes as early as possible to intervene before symptoms arise to prevent further deterioration and loss of independence. Resources to assess cognitive changes and detect the progression to mild cognitive impairment (MCI) and ADRD are limited among older adults with health disparities. The digital technology-based assessment of cognitively complex activities, such as life-space mobility (LSM), has the potential to identify those at risk for cognitive decline. The proposed longitudinal, case-control study aims to develop sensitive, practical, and ecologically acceptable LSM digital markers that could be clinically relevant markers of subsequent cognitive decline among older adults, including those with health disparities. Additionally, we will examine the moderating role of social health factors (e.g., social isolation, loneliness) in the relationship between sensor-based LSM features and cognitive function. We will create a Real-Life Activity and Life-Space Mobility Monitoring Solution (RAMS), consisting of a GPS data logger and wrist-worn actigraphy to assess real-life mobility performance objectively. The RAMS measures will include spatial and temporal mobility measures (e.g., movement size, outdoor time) and physical activity measures (e.g., sedentary time, activity fragmentation). We propose to recruit individuals aged ≥ 65 from a racially and socioeconomically diverse group. Participants will be classified as cognitively normal (CN; n=157) or MCI (n=157) based on a neuropsychological battery at baseline and will be prospectively followed up for 3 years to collect 7-day RAMS data and neuropsychological evaluations every 6 months. The specific aims are to (1) Compare baseline and longitudinal trajectories of RAMS measures between CN and MCI groups and determine the impact of social health factors on RAMS indicators and cognitive function; (2) Determine RAMS indicators that classify CN and MCI groups at baseline and evaluate the ability of RAMS indicators to predict the subsequent onset of MCI and dementia over a 3-year period; and (3) Evaluate older adults’ attitudes towards and willingness to use digital health technology for monitoring risks of cognitive decline using a mixed- methods approach. The public health impact of this study will provide unique insights into clinically meaningful digital measures and modifiable risk factors to support the need for early treatment and prevention of progression into MCI and dementia in older adults, including low-income ethnic minority older adults. Understanding digital health monitoring acceptance will inform the translation of RAMS markers as a clinically relevant tool for early detection of cognitive decline. Results will support our long-term goal to implement RAMS as a platform for real-time monitoring to reduce functional and cognitive decline and maintain independent functional living in an aging population.

项目摘要/摘要 功能下降的标志开始在阿尔茨海默氏病临床症状及相关的临床症状之前开始几年 痴呆症（ADRD）。必须尽早捕获这些功能更改以进行干预至关重要 出现症状是为了防止进一步的定义和失去独立性。评估认知的资源 在较旧的情况下，变化并检测到轻度认知障碍（MCI）和ADRD的进展受到限制 健康差异的成年人。基于数字技术的认知复杂活动的评估，例如 作为寿命流动性（LSM），有可能确定那些处于认知能力下降的风险的人。提议 纵向，病例对照研究旨在开发敏感，实用和生态可接受的LSM数字 可能是随后在临床上相关标志的标记，包括老年人的认知能力下降，包括 患有健康差异的人。此外，我们将研究社会健康因素的调节作用（例如， 社会隔离，孤独）在基于传感器的LSM特征与认知功能之间的关系中。我们 将创建现实生活中的活动和寿命流动性监测解决方案（RAMS），由GPS数据组成 记录仪和腕上的行为图客观地评估现实生活中的流动性绩效。公羊的测量将 包括空间和临时活动措施（例如，运动尺寸，室外时间）和体育锻炼 措施（例如久坐时间，活性碎片）。我们建议从A招募≥65岁的个人 种族和社会经济多样化的群体。参与者将被归类为认知正常（CN; n = 157） 或基于基线的神经心理电池的MCI（n = 157），预计将跟踪3 每6个月收集7天RAMS数据和神经心理学评估的年。具体目的是 （1）比较CN和MCI组之间的​​RAMS测量的基线和纵向轨迹以及 确定社会健康因素对RAMS指标和认知功能的影响； （2）确定公羊 在基线时对CN和MCI组进行分类并评估RAMS指标预测能力的指标 随后在3年的MCI和痴呆症发作； （3）评估老年人的态度 使用混合 方法方法。这项研究的公共卫生影响将为临床意义提供独特的见解 数字措施和可修改的风险因素，以支持早期治疗和预防的需求 老年人（包括低收入少数民族老年人）中的MCI和痴呆症的发展。 了解数字健康监测的接受度将为RAMS标记的翻译作为临床上的翻译 早期发现认知能力下降的相关工具。结果将支持我们实施的长期目标 公羊作为实时监控的平台，以减少功能和认知能力下降并维持 独立的职能生活在老龄化的人口中。