The role of 24-hour activity cycles in preserving cognitive function and preventing Alzheimer's disease and related dementias

24 小时活动周期在保护认知功能和预防阿尔茨海默病及相关痴呆方面的作用

• 批准号: 10455800
• 负责人: Keith M Diaz
• 金额: $ 545.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 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 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10455800
• 关键词: Accelerometer; Activity Cycles; Address; Adult; African American population; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Ancillary Study; Attenuated; Behavior; Behavioral; Biological Factors; Cause of Death; Clinical Treatment; Cognition; Cognitive; Collection; Data; Dementia; Dependence; Diabetes Mellitus; Elderly; Enrollment; Epidemic; Financial Hardship; Future; Goals; Guidelines; Health; Health behavior; Healthcare Systems; Hour; Hyperlipidemia; Hypertension; Impaired cognition; Individual; Intervention; Lead; Light; Link; Longitudinal Studies; Measures; Mediating; Modeling; Movement; Outcome; Participant; Pathway interactions; Pharmacological Treatment; Physical activity; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Procedures; Protocols documentation; Public Health; Race; Research; Resources; Risk; Role; Sleep; Strenuous Exercise; Stroke; Testing; Time; Work; actigraphy; base; biracial; brain health; classification algorithm; cognitive function; cost; disability; geographic disparity; mild cognitive impairment; modifiable behavior; preservation; prevent; prospective; racial disparity; resilience; response; sedentary lifestyle; sex; sleep behavior; vascular risk factor; vigorous intensity

ABSTRACT Alzheimer’s disease and related dementias (ADRD) are the 6th leading cause of death in the U.S and is prevalent in ~6 million U.S. adults. Without effective prevention strategies, ADRD prevalence is expected to triple by 2060. The lack of successful pharmacologic treatments for clinical ADRD necessitates a call-for-action to identify modifiable factors that preserve cognitive function and prevent ADRD. Moderate-vigorous intensity physical activity (MVPA) has been identified as a key strategy that could have the greatest non-pharmacologic impact on the projected ADRD epidemic. However, MVPA corresponds to only a small portion of the 24-h day (~2%). The other movement behaviors that comprise the remaining ~98% of the 24-h day, including sedentary behavior (SB), light physical activity (LPA), and sleep, constitute additional modifiable considerations. Growing evidence suggests that the combined effects of these movement behaviors may be greater than their individual effects. Thus, focusing efforts on a single factor (e.g. MVPA) limits efficacy. Appropriate levels of MVPA, LPA, SB, and sleep may need to be achieved simultaneously (e.g. a “healthy 24-hours”) for optimal resilience to adverse cognitive outcomes. Yet little work has characterized the role of the 24-h activity cycle to preserve cognition and prevent ADRD. To address this critical research gap, we propose an ancillary study to the ongoing REasons for Geographic And Racial Disparities in Stroke (REGARDS) study. The overall goal of this project is to characterize the temporal, bidirectional relationship between the 24-h activity cycle and adverse cognitive outcomes. Specifically, we will test whether: 1) composition of the 24-h activity cycle predicts change in cognitive function and incident mild cognitive impairment (MCI) or dementia, 2) cognitive function and prevalent MCI/dementia predict change in composition of the 24-h activity cycle, and 3) change in the composition of the 24-h activity cycle is associated with change in cognitive function and transitions in cognitive impairment status. We will also determine the most beneficial 24-h activity cycle compositions associated with a lower risk of cognitive impairment. To address our aims, we will leverage the exceptional resources of REGARDS, including assessment of cognitive function at annual and biennial intervals, algorithmic classifications of MCI and dementia, and collection of objective measures of the waking components of the 24- h activity cycle from 2009-2013. In this ancillary study, we propose to augment REGARDS with a 7-day accelerometer and sleep actigraphy protocol to objectively measure the 24-hour activity cycle (SB, LPA, MVPA, and sleep). By elucidating the temporal, bidirectional relationship between the 24-h activity cycle and cognitive function and identifying beneficial 24-h activity cycle compositions, this project will address existing evidence gaps and provide empirical evidence to accelerate a paradigm shift towards an integrated model that incorporates all 24-hour movement behaviors to optimize cognitive health.

抽象的 阿尔茨海默氏病和相关痴呆症 (ADRD) 是美国第六大死因， 如果没有有效的预防策略，ADRD 的患病率预计将上升至约 600 万美国成年人。 到 2060 年将增加三倍。临床 ADRD 缺乏成功的药物治疗，因此需要采取行动 确定可改变的因素，以保持认知功能并预防 ADRD。 体力活动（MVPA）已被确定为一项关键策略，可以发挥最大的非药物作用 对预计 ADRD 流行病的影响 然而，MVPA 仅对应 24 小时一天的一小部分。 (~2%) 占 24 小时剩余时间的其他运动行为，包括久坐。 行为（SB）、轻度体力活动（LPA）和睡眠构成了额外的可改变的考虑因素。 有证据表明，这些运动行为的综合影响可能大于其单独的影响 因此，集中精力于单一因素（例如 MVPA）会限制 MVPA、LPA 的适当水平。 SB 和睡眠可能需要同时实现（例如“健康的 24 小时”），以获得最佳的恢复能力 然而，很少有研究描述 24 小时活动周期在维持不良认知方面的作用。 为了解决这一关键的研究空白，我们提出了一项辅助研究。 正在进行的中风地理和种族差异的原因 (REGARDS) 研究的总体目标。 该项目旨在描述 24 小时活动周期与不利因素之间的时间、双向关系。 具体来说，我们将测试：1) 24 小时活动周期的组成是否可以预测变化。 认知功能和轻度认知障碍 (MCI) 或痴呆症，2) 认知功能和 流行的 MCI/痴呆症预测 24 小时活动周期组成的变化，以及 3) 24小时活动周期的组成与认知功能的变化和认知转变有关 我们还将确定与损伤状态相关的最有益的 24 小时活动周期组合。 降低认知障碍的风险 为了实现我们的目标，我们将利用以下特殊资源。 问候，包括每年和每两年一次的认知功能评估、算法 MCI 和痴呆症的分类，以及收集 24- 2009-2013 年的 h 活动周期 在这项辅助研究中，我们建议增加 7 天的 REGARDS。 加速计和睡眠体动记录仪协议可客观测量 24 小时活动周期（SB、LPA、 MVPA 和睡眠）通过阐明 24 小时活动周期和睡眠之间的时间、双向关系。 认知功能和有益的识别 24 小时活动周期组成，该项目将解决现有的问题 证据差距并提供经验证据，以加速向综合模型的范式转变， 纳入所有 24 小时运动行为以优化认知健康。