Investigating cognitive-motor variability to predict driving performance in stroke survivors with MCI

研究认知运动变异性以预测 MCI 中风幸存者的驾驶表现

• 批准号: 10569035
• 负责人: Neha Lodha
• 金额: $ 12.58万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10569035
• 关键词: Acceleration; Affect; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Ankle; Automobile Driving; Behavioral; Blood Vessels; Clinical Data; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Science; Cognitive aging; Colorado; Complex; Computers; Data; Dementia; Development; Diagnosis; Early Diagnosis; Elderly; Elements; Executive Dysfunction; Exercise; Goals; Health; Impaired cognition; Impairment; Individual; International; Intervention; Investigation; Knowledge; Licensing; Longevity; Measures; Mentors; Methodology; Modeling; Motor; Movement; Nervous System Trauma; Neurologic; Neurologist; Outcome; Participant; Performance; Process; Psychologist; Quality of life; Research; Research Personnel; Science; Stroke; Survivors; System; Technology; Testing; Training; Universities; Work; age related; aging population; baby boomer; behavior measurement; career; cognitive development; cognitive performance; cognitive process; cognitive task; cognitive testing; experience; functional decline; functional disability; functional independence; impaired driving performance; improved; indexing; individual variation; innovation; interest; mild cognitive impairment; motor control; motor impairment; neglect; nervous system disorder; neurophysiology; novel; novel strategies; post stroke; pre-clinical; predictive marker; primary outcome; processing speed; professor; statistics; stroke survivor

PROJECT SUMMARY/ABSTRACT Dr. Neha Lodha is an Assistant Professor in the Department of Health and Exercise Science at Colorado State University (CSU). Dr. Lodha's long-term career goal is to become an independent investigator advancing the science of functional mobility to improve the quality of life in aging and age-related neurological disorders and dementias. Up to this point, Dr. Lodha has acquired strong scientific background in neurophysiology and motor control. To accomplish her career goal, a key additional element required is the training in cognitive sciences. Understanding how cognitive and motor systems interact to enable independent mobility is important for identifying the precise mechanisms and developing interventions to promote functional mobility. The short-term training goals of the current K01 application are to train in 1) conducting cognitive assessments with specific emphasis on the intra-individual variability (IIV) approach, 2) clinical trials design and analysis, 3) multivariate statistics, 4) driving technology, and 5) transition to independence. To achieve these goals, Dr. Lodha has assembled a mentoring team that consists of 1) an eminent gerontologist, Dr. Manfred Diehl (primary mentor) with expertise in aging, IIV and cognitive development across the lifespan, 2) an experimental psychologist, Dr. Karlene Ball (co-mentor) who is internationally renowned for her work in cognitive correlates of driving mobility in aging and dementia, 3) a vascular neurologist, Dr. Sharon Poisson (advisor) with extensive experience in clinical trials in stroke survivors, and 4) a renowned biostatistician, Dr. Haonan Wang (co-advisor) with experience in statistical inference and modeling for clinical data. The proposed research plan focuses on identifying the motor and cognitive impairments underlying driving deficits in older stroke survivors with mild cognitive impairment as they are most likely to resume on-road driving after stroke. Conventionally, driving impairments are shown to be independently influenced by mean-level performance in specific motor and cognitive domains. However, this mean-level approach neglects the well-established fact that performance becomes highly variable and unstable in older adults with neurological disorders, such as those at preclinical stages of Alzheimer's disease and mild cognitive imapirment. The proposed research will apply the novel intra- individual variability (IIV) approach to investigate driving mobility in older stroke survivors. The goal of the research plan is to identify the impact of stroke on IIV in motor and cognitive performance (Aim 1); determine the contribution of IIV measures to predict driving performance (Aim 2); and use IIV measures to predict change in driving performance over a two-year period (Aim 3). The training plan will accelerate Dr. Lodha's career to pursue a unique and independent line of research that combines cognitive and motor processes to promote the functional mobility of older adults and is directly aligned with NIA's AD/ADRD goal to identify sensitive behavioral measures for earliest manifestations of functional impairments in older adults.

项目摘要/摘要 Neha Lodha博士是科罗拉多州卫生与运动科学系的助理教授 大学（CSU）。 Lodha博士的长期职业目标是成为一名独立的调查员 功能流动性科学，以改善与年龄和年龄有关的神经系统疾病的生活质量以及 痴呆症。到目前为止，Lodha博士已经获得了神经生理学和运动的强大科学背景 控制。为了实现她的职业目标，需要的关键要素是认知科学的培训。 了解认知和运动系统如何相互作用以启用独立移动性对于 确定精确的机制和制定干预措施以促进功能流动性。短期 当前K01应用的培训目标是在1）进行特定的认知评估进行培训 强调个体内变异性（IIV）方法，2）临床试验设计和分析，3）多变量 统计，4）驾驶技术，以及5）向独立过渡。为了实现这些目标，Lodha博士拥有 组建了一个由1）著名的老年医生曼弗雷德·迪尔（Manfred Diehl）（主要导师）组成的指导团队 在整个生命周期中，具有衰老，IIV和认知发展的专业知识，2）实验心理学家博士 卡琳·鲍尔（Karlene Ball）（联盟）因在驾驶流动性方面的认知相关性而享有国际知名 在衰老和痴呆症中，3）一位血管神经科医生，莎朗·托隆（Sharon Poisson）（顾问），拥有丰富的经验 中风幸存者的临床试验，以及4）著名的生物统计学家Haonan Wang博士（共同顾问）与 统计推断和临床数据建模的经验。拟议的研究计划的重点是 确定较温和的较老的中风幸存者的运动和认知障碍的障碍 认知障碍，因为它们最有可能在中风后恢复公路驾驶。通常，开车 损伤显示受到特定电动机中平均水平性能的独立影响， 认知领域。但是，这种平均水平的方法忽略了表现的公认事实 在患有神经系统疾病的老年人（例如临床前的年轻人）中，变化很高且不稳定 阿尔茨海默氏病和轻度认知兴趣的阶段。拟议的研究将应用新颖的内部 个人变异性（IIV）方法是研究较老的中风幸存者驱动流动性的方法。目标的目标 研究计划是确定中风对运动和认知性能的IIV的影响（AIM 1）；确定 IIV措施预测驾驶绩效的贡献（AIM 2）；并使用IIV措施预测变化 在两年内驾驶性能（AIM 3）。培训计划将加速Lodha博士的职业 一个独特而独立的研究系列，结合了认知和运动过程，以促进 老年人的功能活动性，并与NIA的AD/ADRD直接一致以识别敏感行为 老年人功能障碍最早表现的措施。