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.

项目概要/摘要 阿尔茨海默病和相关痴呆症 (ADRD) 的患病率预计在未来 20 年将翻一番 少数族裔和种族将承受不成比例的疾病负担，其中最令人震惊。 墨西哥裔美国人和其他西班牙裔群体的预期增长近六倍。 认知轨迹存在显着的变化，大约三分之二的墨西哥裔美国人幸存下来 他们的 80 多岁仍不会患痴呆症。结果的可变性凸显了风险和复原力的影响。 最近的研究表明，可能改变神经退行性疾病进程的因素。 数据显示，40% 的痴呆症病例可能归因于潜在的可改变的风险因素。 支持生活方式因素的保护性益处，例如身体、认知和社交活动参与， 如此引人注目，以至于美国领先的卫生组织已将这些发现采纳为 然而，墨西哥生活方式因素的保护作用。 美国人，这可能与社会经济因素、共病疾病负担、遗传负荷和 文化因素，值得进一步调查，活动参与度的评估通常依赖于自我。 由于记忆的错误、社会期望偏差以及有限的信息，该报告很容易出现不准确的情况。 评估的频率，否定了对响应常见问题的行为变化的更细致的理解 我们俄勒冈健康与科学大学的团队研究了环境和个人因素的波动。 验证了使用技术的协作老龄化研究 (CART) 平台，该平台由 家庭监控设备的集成网络，捕获高密度多模式数据并耦合 通过与大学合作，使用算法得出预测认知能力下降的活动模式。 位于圣安东尼奥的德克萨斯健康科学中心，我们已将该技术推广到 5 名墨西哥人的家中 美国老年人现在建议扩大这一研究范围并利用 CART 平台。 持续监测三年内现实世界的身体、认知和社交活动模式 由 120 名墨西哥裔美国人老年人组成的队列（目标 1a）我们将进一步评估其改变效果。 失业状况、文化适应、性别、抑郁、心血管负担和载脂蛋白 ε4 状态（Aim 1b) 接下来，我们将探讨活动参与与传统和新颖的神经影像学之间的关联。 最后，我们将检查与脑衰老和 ADRD 相关的炎症特征。 活动参与度及其与认知能力下降和神经影像学结果的关联（目标 3）。 利用创新的 CART 技术平台，我们将确定以下活动参与模式： 促进高风险、未充分研究的族群认知能力下降的风险和恢复力。 将确定塑造认知轨迹的多维健康决定因素和炎症途径， 为这一不断增长的人群提供有针对性的 ADRD 预防和治疗策略的见解。