Light Physical Activity for Brain Health in Older Adult Breast Cancer Survivors

轻度体力活动有利于老年乳腺癌幸存者的大脑健康

• 批准号: 10689020
• 负责人: Brett Ryan Gordon
• 金额: $ 7.4万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689020
• 关键词: Address; Advisory Committees; Aftercare; Alcohol consumption; Alcohols; Alzheimer' s disease risk; American; American Cancer Society; Anxiety; Biometry; Breast Cancer Treatment; Breast Cancer survivor; Cancer Survivor; Carcinogens; Cessation of life; Clinical Trials; Consensus; Consumption; Data; Dementia; Diagnosis; Dose; Ecological momentary assessment; Elderly; Exercise; Face; Fellowship; General Population; Grant; Guidelines; Health; Health behavior; Human; Impaired cognition; Individual; Inflammatory; International; Intervention; Knowledge; Late Effects; Learning; Light; Mental Health; Mentors; Obesity; Obesity Epidemic; Oncology; Outcome; Participant; Patient Self-Report; Physical activity; Population Study; Postdoctoral Fellow; Process; Randomized; Randomized, Controlled Trials; Recurrence; Reporting; Research; Research Personnel; Risk; Risk Reduction; Role; Series; Sports Medicine; Survival Rate; Survivors; Symptoms; Training; United States; United States National Institutes of Health; Work; aged; anxiety reduction; anxiety symptoms; arm; brain health; cancer diagnosis; cognitive function; college; drinking; efficacy evaluation; efficacy trial; exercise intervention; experience; health care settings; improved; light effects; light intensity; malignant breast neoplasm; meetings; modifiable behavior; mortality; multidisciplinary; novel; obese person; physical conditioning; primary outcome; psychological symptom; randomized trial; response; treatment as usual; treatment effect; vigorous intensity

Project Summary/Abstract Although breast cancer is the most frequently diagnosed cancer in the world, recently, the survival rate has greatly improved. With this improved survival rate, there is a growing population of obese, older adult breast cancer survivors facing unique challenges and late effects on brain health. Breast cancer survivors suffer cognitive impairments before, during, and post- treatment; more than one third experience persistent cognitive impairment lasting decades. Anxiety is the most common psychological symptom among cancer survivors, and frequently unrecognized and undertreated in health care settings. These survivors are also at increased risk of Alzheimer’s disease or dementia. There is unanimous consensus that physical activity and alcohol consumption are key modifiable behaviors to improve the physical and mental health of cancer survivors. Further, the American Cancer Society promotes increasing physical activity, and avoiding alcohol to manage treatment-related cognitive impairment. Although the benefits of physical activity for cancer survivors are well-established, the evidence is predominantly derived from guidelines-based, moderate-to-vigorous-intensity physical activity. However, survivors often do not meet guidelines for moderate-to-vigorous-intensity physical activity, do not adhere to physical activity interventions set at this intensity, and enjoy and prefer lighter-intensity activities. Much less is known about the effects of light-intensity physical activity on cognitive function and anxiety symptoms, and the 2018 United States Physical Activity Guidelines Advisory Committee Scientific Report identified the need to determine the role and contribution of light-intensity activity to diverse health outcomes as an overarching research need. Additionally, less is known about the effects of physical activity interventions on changes in alcohol consumption. Recent findings indicate physical activity may unintentionally increase alcohol consumption among cancer survivors. Increasing alcohol consumption places survivors at increased risk of recurrence, and may confound the positive effects of physical activity. Therefore, in the process of evaluating the effects of light-intensity physical activity on brain health outcomes among obese, older adult breast cancer survivors, the effects on alcohol consumption should be evaluated as well, to avoid unintended consequences. The light- intensity physical activity-breast cancer survivors (LIPA-BCS) trial addresses multiple knowledge gaps, with a primary and secondary focus on improving cognitive function and anxiety symptoms. The proposed work builds on this existing randomized controlled trial that randomizes obese, older adult breast cancer survivors 1-10 years post-breast cancer treatment, to either 15 weeks of light-intensity physical activity, or usual care. I will take advantage of this existing clinical trial to quantify and describe the effects on cognitive function, anxiety symptoms, and observe associated changes in alcohol consumption. To achieve this aim, we will assess cognitive function, anxiety symptoms, and alcohol consumption both pre- post, and utilizing ecological momentary assessments in 14-day bursts throughout the 15 week intervention. Through this research experience, and proposed post-doctoral fellowship, I will learn about the conduct of high quality human clinical trials among obese, older adult cancer survivors, and receive mentored training in ecological momentary assessments, biostatistics, and becoming an independent investigator in exercise oncology.

项目摘要/摘要 尽管乳腺癌是世界上最常见的癌症，但最近的生存率大大提高。 随着这种生存率的提高，肥胖的老年乳腺癌存活人数越来越 挑战和对大脑健康的后期影响。乳腺癌的存活率遭受认知障碍之前，之中和之后 治疗;超过三分之一的经历持续了数十年的持续认知障碍。焦虑是最常见的 癌症存活中的心理症状，在医疗保健环境中经常无法识别和反应。 这些表面也有增加阿尔茨海默氏病或​​痴呆症的风险。有一致的共识，即身体上的共识 活动和饮酒是改善癌症身心健康的关键可修改行为 幸存者。此外，美国癌症协会促进了增加的体育锻炼，并避免酒精进行管理 与治疗相关的认知障碍。尽管体育锻炼对癌症存活的好处是良好的，但 证据主要来自基于准则的，中度到vi的强度的体育活动。然而， 幸存者通常不符合现代至持vigof的体育锻炼的准则，不遵守身体 以这种强度设定的活动干预措施，并享受并更喜欢更轻的强度活动。关于 轻度强度体育锻炼对认知功能和动画症状的影响，以及2018年美国物理 活动指南咨询委员会科学报告确定有必要确定的作用和贡献 作为总体研究需求，对潜水健康结果的光强度活动。此外，对 体育锻炼干预对饮酒变化的影响。最近的发现表明身体活动可能 无意间增加癌症存活中的饮酒量。增加饮酒场所的生存位置 增加复发的风险，并可能混淆体育锻炼的积极影响。因此，在 评估体育活动对肥胖，老年乳腺癌中脑健康结果的影响 幸存者，还应评估对饮酒的影响，以避免意外的后果。光 - 强度体育活动 - 胸癌存活（LIPA-BCS）试验涉及多个知识差距，主要和主要知识差距 次要关注改善认知功能和动画症状。拟议的工作建立在现有的基础上 随机对照试验将肥胖，老年乳腺癌随机生存1 - 10年后乳腺癌后1至10年 处理15周的光强度体育锻炼或通常的护理。我将利用这个现有的临床 试验以量化和描述对认知功能，动画符号的影响，并观察到酒精的相关变化 消耗。为了实现此目标，我们将评估认知功能，动画症状和饮酒 在整个15周的干预过程中，在14天的爆发中使用生态时刻评估。通过这个 研究经验和拟议的博士后奖学金，我将了解高质量人类临床的行为 肥胖，老年癌症生存的试验，并接受了生态瞬时评估的心理培训， 生物统计学，并成为运动肿瘤学的独立研究者。