Longitudinal Impact of Health and Lifestyle Behaviors on Cognition in Individuals with Multiple Sclerosis

健康和生活方式行为对多发性硬化症患者认知的纵向影响

• 批准号: 10708744
• 负责人: Michelle H Chen
• 金额: $ 11.65万
• 依托单位: RUTGERS BIOMEDICAL AND 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: 2022-09-22 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708744
• 关键词: Accounting; Adherence; Affect; Aging; Behavior; Behavioral; Biometry; Blood Vessels; Clinical; Clinical Investigator; Clinical Trials Design; Cognition; Cognitive; Community Participation; Conduct Clinical Trials; Data; Dementia; Diet; Disease; Double-Blind Method; Elderly; Epidemiology; Equipment and supply inventories; Exercise; Funding; Goals; Grant; Health; Health behavior; Impaired cognition; Individual; Intervention; Interview; Investigation; Laboratories; Learning; Life Style; Link; Literature; Long-Term Effects; Longitudinal, observational study; Manuscripts; Measures; Medical center; Mentors; Mentorship; Mission; Monitor; Multiple Sclerosis; Neuropsychology; Participant; Patient Self-Report; Performance; Persons; Pharmaceutical Preparations; Population; Qualitative Research; Randomized, Controlled Trials; Recommendation; Rehabilitation therapy; Research; Research Design; Research Personnel; Risk; Risk Factors; Role; Secondary Prevention; Sleep; Smoking; Social support; Standardization; Structure; Surveys; Symptoms; Techniques; Time; Training; United States National Institutes of Health; Work; Writing; career; cognitive change; cognitive rehabilitation; cognitive testing; cognitive training; cohort; comorbidity; design; follow-up; good diet; health belief; health care availability; improved; instrumental activity of daily living; interest; lifestyle factors; lifestyle intervention; modifiable risk; multidisciplinary; multiple sclerosis patient; neuroimaging marker; neuroprotection; pharmacologic; population based; prospective; psychosocial; rehabilitation research; skill acquisition; skills; social; social health determinants; standard care; substance use; symptom management; systematic review

Project Summary/Abstract This CDA proposal seeks to investigate the long-term impact of modifiable health-related behaviors (e.g., smoking, exercise) on cognitive decline over time among persons with multiple sclerosis (MS; Specific Aim 1). This is important given the detrimental impact of cognitive impairment in MS, affecting symptom management, instrumental activities of daily living, and independence. Since there are no proven treatments for cognitive impairment, it is imperative to identify modifiable risk factors – specifically health-related behaviors – that can serve as potential treatment targets. Moreover, in order to modify these behaviors, this proposal will explore disease (MS)-related, person-specific, and environmental facilitators and barriers to engaging in health-related behaviors (Specific Aim 2). Such aims are consistent with the mission of the National Center for Medical Rehabilitation Research (NCMRR) to “determine the impact of modifiable lifestyle and health-related behaviors on prevention of secondary conditions, psychosocial functioning, and community participation,” as outlined in the 2016 NIH Research Plan on Rehabilitation. The Specific Aims will be accomplished via two longitudinal, observational studies among persons with MS. Cognitive trajectories will be established by standardized neuropsychological assessments. Health- related behaviors will be evaluated using self-report inventories. Facilitators/barriers to engaging in health-related behaviors will be determined by quantitative inventories and qualitative semi-structured interviews. Data from this investigation will serve as pilot data for a R01 grant in which a multicomponent lifestyle intervention to improve cognition among persons with MS will be proposed. Such intervention has been recently conducted in older adults at-risk of developing dementia, with ongoing replications around the world. Information from this project will help adapt this type of intervention to individuals with MS by accounting for MS-specific facilitators and barriers to engaging in health behaviors. I have assembled a multidisciplinary mentoring team, with expertise in clinical neuropsychology, cognitive rehabilitation, epidemiology, advanced biostatistics, and clinical trial design. By completing the proposed training and research plans, I will be able to achieve my training goals, including: (1) applying population-based survey research design to the role of the social determinants of health on lifestyle behaviors; (2) learning qualitative research design and advanced statistical techniques; (3) learning how to conduct clinical trials; and (4) honing my professional development skills, such as manuscript writing, grantsmanship, laboratory management, and mentorship. Achieving these goals will help me transition into an independent clinical investigator, with a long career of grant-funded research.

项目摘要/摘要 该CDA提案旨在研究可修改的与健康相关行为的长期影响（例如， 吸烟，运动）多发性硬化症患者的认知能力下降（MS；特定 目标1）。考虑到MS认知障碍的有害影响，这很重要，影响了 症状管理，日常生活的工具活动和独立性。因为没有 认知障碍的经过验证的治疗方法，必须确定可修改的危险因素 - 特别是与健康相关的行为 - 可以用作潜在的治疗目标。而且，为了 修改这些行为，该提案将探索疾病（MS）相关的，特定于人的和 环境促进者和参与健康相关行为的障碍（特定目标2）。这样的 目标与国家医疗康复研究中心的任务一致 （NCMRR）“确定可修改的生活方式和与健康相关的行为对 预防次要条件，社会心理功能和社区参与， 在2016年NIH康复研究计划中概述了。 具体目标将通过两项纵向观察研究来实现 多发性硬化症。认知轨迹将通过标准化的神经心理学评估来建立。健康- 相关行为将使用自我报告清单进行评估。促进者/参与的障碍 与健康相关的行为将由定量库存和定性半结构化确定 访谈。这项投资的数据将作为R01赠款的试点数据，其中 将提出多组分的生活方式干预，以改善MS患者的认知。 最近在老年人中进行了这种干预措施， 世界各地正在进行的复制。该项目的信息将有助于适应这种类型的 通过考虑MS特定的促进者和参与的障碍，向患有MS的人进行干预 健康行为。 我已经组建了一个具有临床神经心理学专业知识的跨学科指导团队 认知康复，流行病学，高级生物统计学和临床​​试验设计。通过完成 拟议的培训和研究计划，我将能够实现我的培训目标，包括：（1）应用 基于人群的调查研究设计，以健康的社会决定者在生活方式中的作用 行为； （2）学习定性研究设计和高级统计技术； （3）学习如何 进行临床试验； （4）磨练我的专业发展技巧，例如手稿写作， 授予技巧，实验室管理和心态。实现这些目标将帮助我过渡 进入独立的临床研究者，拥有良好的资助研究职业生涯。