Early Frailty Biomarkers: Patterns of Activity and Energy Expenditure

早期衰弱生物标志物：活动模式和能量消耗

• 批准号: 9275909
• 负责人: Megan J Huisingh-Scheetz
• 金额: $ 15.49万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-01 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9275909
• 关键词: Accelerometer; Acute; Address; Adult; Aging; American; Area; Award; Beds; Biological Markers; Body Weight decreased; C-reactive protein; Caring; Cellular Phone; Clinic; Clinical; Clinical Investigator; Clinical Trials; Cognition; Complex; Data; Data Set; Detection; Diagnosis; Elderly; Energy Metabolism; Epidemiology; Evaluation; Exhibits; Foundations; Frail Elderly; Functional disorder; Future; Gait speed; Goals; Guidelines; Health; Health Services Accessibility; Health Status; Healthcare; Hospitalization; Hospitals; Individual; Institutionalization; Intervention; Intervention Trial; Knowledge; Life; Light Exercise; Longitudinal Surveys; Measures; Mental Depression; Mentorship; Minority; Monitor; Operative Surgical Procedures; Outcome; Outcome Measure; Output; Patient Self-Report; Patients; Pattern; Physical activity; Physiological; Population; Prevalence; Public Health; Recommendation; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Factors; Role; Safety; Sampling; Scientist; Subgroup; Syndrome; Technology; Testing; Time; Training; Translating; Work; Wrist; Writing; base; clinical risk; cohort; design; disability; exercise intervention; exhaustion; experience; frailty; high risk; improved; individualized medicine; insight; instrumental activity of daily living; interest; mortality; older patient; public health relevance; sedentary lifestyle; social; social engagement; statistics; success; tool; trend

 DESCRIPTION (provided by applicant): By 2050, the American population will consist of 88.5 million older adults with a rising prevalence of frailty. Frailty identifies those with diminished physiologic reserve and is increasingly being used to recognize individuals at high risk of rehospitalization, surgical mortality, and health care resource utilization. As a geriatrician with advanced training in Epidemiology, I struggle daily to care for complex, frail patients and recognize the need for accurate tools to quantify frailty risk, trend progression, and to, importantly, guide interventions. Low self-reported physical activity participation is part of the clinical frailty syndrome, yet self- report fails to adequately identify those exhibiting this critrion in their daily lives due to inherent biases. Relying on self-report alone risks under-identifying high-risk individuals and limiting our ability to address this potentially modifiable component. Very little is known about how patterns of activity and sedentary behavior measured by objective monitoring are related to frailty-associated outcomes and how these measures can be applied clinically to predict frailty progression and to guide individualized treatment. My immediate goal and the objective of this proposal is to study how measures of (in)activity relate to frailty and aging outcomes and how they can be used to inform a frailty intervention. I hypothesize that unique, identifiable patterns of (in)activity as measured by activity monitors will predict those who go on to experience a decline in their frailty and aging measures and can be used to tailor treatment recommendations. To test these hypotheses, the following aims are proposed: Aim 1) Characterize activity and sedentary behavior among non-frail, pre-frail, and frail subgroups using activity monitors and relate these measures to 5-year frailty and aging outcomes; Aim 2) In my independent, longitudinal frailty study, relate activity, sedentary behavior, sit-to-stand transitions and cadence to change in frailty components and aging outcomes at 1-year; and Aim 3) Design and pilot test a frailty intervention tool that addresses activity barriers among frail adults and tailors activity targets for frail individuals using identified accelerometry deficits. will relate activity monitor output from the National Social Life, Health and Aging Project data (2010-2011, 2015-2016) to frailty and aging outcomes at 5 years. I will then translate these findings in my established clinical cohort (Successful Aging and Frailty Evaluation clinic) of predominantly pre-frail and frail adults using activity monitoring and 1-year outcomes. Finally, I will use the findings from these studies in combination with patient and professional stakeholder input to design a sustainable intervention appropriate for frail elders. These proposed studies will identify modifiable activity and sedentary behaviors that can be measured using activity monitoring to detect frailty risk factors, predict progression, and guide treatment, and thus advance our understanding of the role of activity and sedentary behavior in the pathophysiology and treatment of frailty. During the award period, I will receive critical mentorship from nationally-recognized aging researchers, Drs. Linda Waite and William Dale, and supplementary guidance from experts in activity (Dr. Amy Luke), sedentary behavior (Dr. David Conroy), energy expenditure (Dr. Dale Schoeller), frailty (Dr. Jeremy Walston), longitudinal survey and clinical trial analysis (Dr. Masha Kocherginsky), and interventional trials in older adults (Dr. Le Lindquist). I will obtain advanced training in frailty, activity monitoring, statistics, clinical tial design, and writing. This work will lay the foundation for my long-term goal of becoming an independent clinical investigator with expertise in the diagnosis and management of frailty.

 描述（由应用程序提供）：到2050年，美国人口将由8850万老年人组成，脆弱的患病率上升。脆弱的人可以识别出生理储备降低的人，并且越来越多地被用来认识到重新住院，手术死亡率和医疗保健资源利用的高风险的人。作为老年医生 流行病学的高级培训，我每天都在努力照顾复杂，脆弱的患者，并认识到需要准确的工具来量化脆弱的风险，趋势进展，以及重要的是指导干预措施。低自我报告的体育活动参与是临床脆弱综合症的一部分，但是自我报告未能充分识别那些由于继承偏见而在日常生活中经历这种犯罪的人。仅依靠自我报告就有识别高风险个人的风险，并限制了我们解决这一可能修改的组件的能力。关于通过客观监测测得的活动模式和久坐行为的模式与脆弱相关的结果以及如何在临床上应用这些措施来预测脆弱的进展并指导个性化治疗方面，知之甚少。我的直接目标和该提案的目的是研究如何衡量与脆弱和衰老结果有关的（在）活动中的量度，以及如何使用它们来告知脆弱的干预措施。我假设通过活动监测器衡量的（在）活动中的独特，可识别的模式将预测那些继续下降的人，他们的脆弱和衰老措施会下降，并且可以用于量身定制治疗建议。为了检验这些假设，提出了以下目的：目标1）使用活动监测器表征非网络，招聘前和脆弱的亚组之间的活动和久坐行为，并将这些措施与5年的脆弱和衰老成果联系起来；目标2）在我独立的，纵向脆弱的研究中，活动，久坐行为，静止性的过渡和节奏与脆弱的成分和1年的衰老结局的变化相关； AIM 3）设计和试验测试一种脆弱的干预工具，该工具解决了脆弱的成年人的活动障碍，并使用已确定的加速度计为脆弱的个体定制活动目标。将将活动监视器的产出与国家社会生活，健康和衰老项目数据（2010-2011，2015-2016）相关联，将其与5年的脆弱和衰老结局联系起来。然后，我将使用活动监测和1年的成年人的临床队列（成功的衰老和脆弱评估诊所（成功的衰老和脆弱评估诊所）中翻译这些发现。最后，我将与患者和专业利益相关者的意见结合这些研究的结果来设计适合脆弱的edgers的可持续干预措施。这些提出的研究将确定可修改的活动和久坐行为，可以使用活动监测来测量这些活动，以检测脆弱的危险因素，预测进展和指导治疗，从而促进我们对活动和久坐行为在病理生理学和脆弱治疗中的作用的理解。在奖励期间，我将获得全国认可的老化研究人员Drs的关​​键遗产。琳达·怀特（Linda Waite）和威廉·戴尔（William Dale），以及活动专家（艾米·卢克（Amy Luke）博士），久坐行为（戴维·康罗伊（David Conroy）博士），能源支出（Dale Conroy博士）（Dale Schoeller博士），Flailty（Jeremy Walston博士），纵向调查和临床试验分析（Masha Kocherginsky）和老年人LINCERS（MASHA KOCHERGINSKY）（博士）将获得脆弱，活动监测，统计，临床设计和写作的高级培训。这项工作将为我的长期目标奠定基础，即成为一名独立的临床研究者，具有较弱的诊断和管理方面的专业知识。