Characterizing Older Mexican (American) Participation in Activity Digitally, Reliably, and Ecologically with the CART Platform (COMPADRE CART): Implications for Cognition and ADRD

使用 CART 平台 (COMPADRE CART) 以数字化、可靠且生态的方式描述墨西哥（美国人）老年人对活动的参与：对认知和 ADRD 的影响

• 批准号: 10630182
• 负责人: Zachary Beattie
• 金额: $ 75.64万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2023-10-13
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10630182
• 关键词: Acculturation; Adopted; Adult; Age; Aging; Algorithms; Alzheimer' s disease related dementia; American; Apolipoproteins; Atrophic; Attenuated; Behavioral; Biological; Blood; C-reactive protein; Cardiovascular system; Cellular Phone; Chitinase; Cognition; Cognitive; Collection; Computers; Coupled; Data; Dementia; Development; Devices; Diabetes Mellitus; Dimensions; Elderly; Enrollment; Ethnic Population; Evaluation; Frequencies; Funding; Genetic; Genetic Load; Glial Fibrillary Acidic Protein; Health; Health Sciences; Hispanic Populations; Home; Impaired cognition; Individual; Inflammation; Inflammatory; Injury; Interleukin-6; Investigation; Length; Machine Learning; Measurement; Measures; Memory; Mental Depression; Mexican; Mexican Americans; Monitor; Neurodegenerative Disorders; Not Hispanic or Latino; Obesity; Oregon; Outcome; Outcome Assessment; Pathway interactions; Patient Self-Report; Pattern; Peripheral; Population; Population Study; Prevalence; Prevention; Prevention strategy; Proteins; Questionnaires; Recommendation; Research; Risk; Risk Factors; Science; Shapes; Social Desirability; Socioeconomic Factors; Socioeconomic Status; TNF gene; Tablets; Technology; Texas; Time; Travel; Underrepresented Populations; United States; United States National Institutes of Health; Universities; Weather; White Matter Hyperintensity; affective disturbance; aging brain; burden of illness; cognitive benefits; cohort; comorbidity; dementia risk; density; digital; digital technology; ethnic minority; fitness; follow-up; health determinants; health organization; high risk; hippocampal atrophy; indexing; innovation; insight; lifestyle factors; low socioeconomic status; modifiable risk; monitoring device; motion sensor; multimodal data; neuroimaging; neuroinflammation; novel; prevent; protective effect; racial minority; resilience; resilience factor; response; sex; social; social engagement; sociocultural determinant; socioeconomics; technology platform; treatment strategy

PROJECT SUMMARY/ABSTRACT The prevalence of Alzheimer’s disease and related dementias (ADRD) is projected to double over the next 20 years. Ethnic and racial minorities will bear a disproportionate burden of disease with the most staggering increase of nearly six-fold anticipated among Mexican Americans and other Hispanic groups. Nonetheless, there is marked variability in cognitive trajectories, and approximately two-thirds of Mexican Americans surviving into their 80’s will remain dementia-free. The variability in outcomes highlights the influence of risk and resilience factors, which may alter neurodegenerative disease course. Recent studies have suggested that upwards of 40% of all dementia cases may be attributable to potentially modifiable risk factors. Among these, the data supporting the protective benefits of lifestyle factors, such as physical, cognitive, and social activity engagement, are so compelling that the nation’s leading health organizations have adopted these findings as recommendations for attenuating ADRD risk. However, the protective effects of lifestyle factors in Mexican Americans, which may interact with socioeconomic factors, comorbid disease burden, genetic loading, and cultural factors, warrants further investigation. Assessment of activity engagement has typically relied on self- report, which is prone to inaccuracies due to the fallibility of memory, social desirability biases, and the limited frequency of evaluation, negating more nuanced understanding of behavioral change in response to common fluctuations in environmental and individual factors. Our team at Oregon Health & Science University has validated the Collaborative Aging Research using Technology (CART) platform, which is comprised of an integrated network of in-home monitoring devices that capture high-density multi-modal data and are coupled with algorithms to derive activity patterns that predict cognitive decline. Through a partnership with The University of Texas Health Science Center at San Antonio, we have extended the technology to the homes of 5 Mexican American older adults. We now propose to expand upon this line of research and leverage the CART platform to continuously monitor real-world physical, cognitive, and social activity patterns across a three-year period in a cohort of 120 older Mexican Americans adults (Aim 1a). We will further evaluate the modifying effects of socioeconomic status, acculturation, sex, depression, cardiovascular burden, and apolipoprotein ε4 status (Aim 1b). Next, we will explore the associations between activity engagement and traditional and novel neuroimaging indices of brain aging and ADRD (Aim 2). Finally, we will examine the inflammatory profile associated with activity engagement, as well as their associations with cognitive decline and neuroimaging outcomes (Aim 3). Leveraging the innovative CART technology platform, we will identify the activity engagement patterns that promote risk and resilience of cognitive decline in a high-risk, understudied ethnic group. Results of the study will identify multidimensional health determinants and inflammatory pathways that shape cognitive trajectories, providing insights into targeted ADRD prevention and treatment strategies within this growing population.

项目摘要/摘要 阿尔茨海默氏病和相关痴呆症（ADRD）的患病率预计将在接下来的20次中加倍 年。种族和种族少数群体将遭受疾病的不成比例燃烧，最惊人的 在墨西哥裔美国人和其他西班牙裔群体中，预计将增加近六倍。尽管如此，那里 是认知轨迹的明显变异性，大约三分之二的墨西哥裔美国人生存到 他们的80年代将保持无痴呆症。结果的变异性突出了风险和弹性的影响 因素，可能会改变神经退行性疾病病程。最近的研究表明 在所有痴呆症病例中，有40％可能归因于潜在的可修改风险因素。其中，数据 支持生活方式因素的受保护益处，例如身体，认知和社交活动， 如此引人注目，以至于国家领先的卫生组织采用了这些发现 建议减轻ADRD风险的建议。但是，墨西哥生活方式因素的受保护影响 美国人可能与社会经济因素相互作用，合并症伯恩伯恩，遗传负荷和 文化因素，需要进一步调查。活动参与的评估通常已经减轻了自我 报告，由于记忆，社会可取性偏见和有限 评估的频率，否定对行为改变的更细微的理解，以应对共同 环境和个人因素的波动。我们在俄勒冈健康与科学大学的团队 使用技术平台（CART）平台验证了协作性衰老研究，该平台已完成 捕获高密度多模式数据并耦合的室内监视设备的集成网络 使用算法来得出预测认知能力下降的活动模式。通过与大学的合作关系 在圣安东尼奥的德克萨斯健康科学中心的位置，我们将技术扩展到5墨西哥的房屋 美国老年人。现在，我们建议扩展这一研究线并利用购物车平台 在三年内，不断监视现实世界中的身体，认知和社交活动模式 组成的120名墨西哥裔美国人成年人（AIM 1A）。我们将进一步评估 社会经济状况，适应，性别，抑郁，心血管烧伤和载脂蛋白ε4状态（目的 1b）。接下来，我们将探讨活动参与与传统和新颖的神经影像之间的关联 大脑衰老和ADRD的指标（AIM 2）。最后，我们将检查与 活动参与及其与认知能力下降和神经影像学结果的关联（AIM 3）。 利用创新的购物车技术平台，我们将确定活动参与模式 在高风险的族裔群体中促进认知下降的风险和韧性。研究结果 将确定塑造认知轨迹的多维健康决定者和炎症途径， 提供对这一不断增长的人群中有针对性的预防和治疗策略的见解。