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（由申请人提供）：到 2050 年，美国人口中将有 8850 万老年人，其衰弱患病率不断上升。“衰弱”一词被用来识别那些生理储备能力下降的人，并且越来越多地被用来识别那些面临再住院和手术死亡高风险的人。和医疗保健资源利用。 通过流行病学的高级培训，我每天都在努力照顾复杂、虚弱的患者，并认识到需要准确的工具来量化虚弱风险、趋势进展，重要的是，指导干预措施自我报告的体力活动参与度低是临床的一部分。虚弱综合症，但由于固有的偏见，自我报告无法充分识别那些在日常生活中表现出这一标准的人，仅依靠自我报告可能会导致无法充分识别高风险个体，并限制我们解决这一潜在可改变因素的能力。关于通过客观监测测量的活动和久坐行为模式与衰弱相关结果如何相关，以及如何在临床上应用这些措施来预测衰弱进展并指导个体化治疗，人们知之甚少。的目的是研究活动（活动）测量如何与虚弱和衰老结果相关，以及如何利用它们来为虚弱干预提供信息，我通过活动监测器测量的独特的、可识别的活动（活动）模式将预测那些人。继续经历衰退为了检验这些假设，提出了以下目标： 目标 1) 使用活动监测器和活动监测器来表征非虚弱、虚弱前和虚弱亚组的活动和久坐行为。这些措施与 5 年衰弱和衰老结果相关；目标 2) 在我的独立、纵向衰弱研究中，将活动、久坐行为、坐站转换和节奏与衰弱变化联系起来。目标 3) 设计并试点测试一种衰弱干预工具，该工具可解决衰弱成年人的活动障碍，并使用已确定的加速度计缺陷为衰弱个体定制活动目标，并将与国家社会生活的活动监测器输出联系起来。 ，健康与老龄化项目数据（2010-2011 年、2015-2016 年）到 5 年后的虚弱和老龄化结果，然后我将在我建立的临床队列中转化这些发现。 （成功的老龄化和衰弱评估诊所）主要使用活动监测和一年的结果对体弱前和体弱的成年人进行评估。最后，我将结合患者和专业利益相关者的意见，使用这些研究的结果来设计适合的可持续干预措施。这些拟议的研究将确定可改变的活动和久坐行为，可以通过活动监测来测量，以检测虚弱的危险因素，预测进展并指导治疗，从而加深我们对活动和久坐行为在老年人中的作用的理解。在获奖期间，我将获得全国公认的衰老研究人员 Linda Waite 博士和 William Dale 博士的重要指导，以及活动专家（Amy Luke 博士）、久坐行为（Dr. David Conroy）、能量消耗（Dale Schoeller 博士）、虚弱（Jeremy Walston 博士）、纵向调查和临床试验分析（Masha Kocherginsky 博士）以及老年人的介入试验（Le Lindquist 博士）。我将获得虚弱、活动监测、统计、临床设计和写作方面的高级培训，这项工作将为我成为一名具有诊断和专业知识的独立临床研究者的长期目标奠定基础。虚弱的管理。