The Role of Daily Social Interactions in Cognitive Decline and Impairment

项目摘要/摘要 阿尔茨海默病(AD)是65岁及以上人群的第五大死亡原因，并对 给患者、照顾者和医疗保健系统带来巨大负担。检测认知能力是至关重要的。 阿尔茨海默病早期干预和治疗时认知功能下降和向轻度认知功能障碍的转变 可能是最有效的，并确定可延展的风险因素，以便制定量身定制的预防干预措施。 最近的证据表明，社会关系可能在认知能力下降的风险因素中起到双重作用 和MCI以及这些认知变化的指标。然而，之前的大多数研究都依赖于全球 对单个时间点的社会关系的评估，因此无法检查 社会关系和认知功能的改变。这个项目的总体目标是使用“实时” 自然主义环境中的生态瞬时评估(EMAS)，以更好地捕捉日常社会变化 互动--日常生活中社会关系的表现--与认知能力下降、解脱有关 社会互动作为认知衰退的指标和风险因素的功能，并确定具体的 最具前瞻性的日常社交活动的特点(频率、伴侣类型的多样性、质量) 预测短期和长期的认知衰退。拟议中的项目将使用来自600个年龄较大的样本的数据 成年人参加了著名的爱因斯坦老龄化研究项目(EAS)，将日常社交联系起来 在从几天到几年的不同时间尺度上与认知功能的交互作用。参与者 每天5次，每年完成4次为期14天的社会互动和认知表现EMA(a 测量突发设计)，以及基于临床的年度认知评估和全球社会 人际关系调查。目标1将研究日常社交互动的变化是否表明认知能力下降 通过测试患有MCI和不患有MCI的个体是否表现出不同的日常社交模式来测试损害 横向和纵向的相互作用。目标2将检查短期和长期预测效果 日常社交活动对认知能力下降和功能障碍的影响。该方法的创新之处在于使用了 对日常社会互动和认知功能进行密集的纵向评估并进行分析 研究日常社会互动和认知之间的时间关联的方法 跨不同时间尺度的性能。这个项目意义重大，因为它将提高我们对 阿尔茨海默病发病前日常社会交往与认知功能之间的动态关联。这 知识将有助于将日常社会互动的具体特征确定为指标或风险因素 对于认知功能下降和损害，协助早期发现向MCI的过渡和发展 将日常社会互动的特定特征作为风险因素的干预方案。

PROJECT SUMMARY/ ABSTRACT Alzheimer’s disease (AD) is the fifth-leading cause of death for those age 65 and older and imposes substantial burden on patients, caregivers, and the health care system. It is critical to detect the cognitive decline and transition to mild cognitive impairment (MCI) when early interventions and treatments against AD could be most effective, and identify malleable risk factors in order to develop tailored preventive interventions. Recent evidence suggests that social relationships may play a dual role as risk factors for cognitive decline and MCI as well as indicators of these cognitive changes. However, most prior studies have relied on global assessments of social relationships at a single time point and thus are unable to examine temporal ordering in change in social relationships and cognitive function. The overall goal of this project is to use ‘real time’ ecological momentary assessments (EMAs) in naturalistic settings to better capture changes in daily social interactions--the manifestation of social relationships in daily life--associated with cognitive decline, disentangle the function of social interactions as indicators vs. risk factors for cognitive decline, and identify specific features of daily social interactions (frequency, diversity in types of partners, quality) that best prospectively predict short- and long-term cognitive decline. The proposed project will use data from a sample of 600 older adults enrolled in the well-established Einstein Aging Study Program Project (EAS) to link daily social interactions with cognitive function across different timescales ranging from days to years. Participants complete 4 annual 14-day EMAs of social interactions and cognitive performance 5 times per day (a measurement burst design), as well as annual clinic-based cognitive assessments and global social relationships surveys. Aim 1 will examine whether changes in daily social interactions indicate cognitive decline and impairment by testing whether individuals with vs. without MCI exhibit different patterns of daily social interactions, cross-sectionally and longitudinally. Aim 2 will examine short-term and long-term predictive effects of daily social interactions on cognitive decline and impairment. The approach is innovative in its use of intensive longitudinal assessments of both daily social interactions and cognitive function and analytic approaches that examine the temporal associations between daily social interactions and cognitive performance across different timescales. This project is significant because it will improve our understanding of dynamic associations between daily social interactions and cognitive function prior to the onset of AD. This knowledge will facilitate identification of specific features of daily social interactions as indicators or risk factors for cognitive decline and impairment, assisting in the early detection of the transition to MCI and development of intervention programs targeting specific features of daily social interactions as risk factors.