A Personalized Behavioral Intervention to Improve Physical Activity, Sleep and Cognition in Sedentary Older Adults

改善久坐老年人身体活动、睡眠和认知的个性化行为干预

• 批准号: 10163919
• 负责人: Junxin Li
• 金额: $ 24.9万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-01 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10163919
• 关键词: Accelerometer; Achievement; Affect; Aging; Attention; Behavior Therapy; Biological Markers; C-reactive protein; Characteristics; Circadian Rhythms; Cognition; Cognitive; Complex; Control Groups; Dementia; Devices; Effectiveness; Elderly; Ensure; Exercise; Foundations; Frequencies; Future; Goals; Health; Heart Rate; Impaired cognition; Individual; Inflammatory; Interleukin-1 beta; Interleukin-6; Intervention; Intervention Studies; Learning; Longitudinal cohort; Mediating; Mentors; Mission; Monitor; Napping; National Institute of Nursing Research; Outcome; Outcome Study; Participant; Pathway interactions; Phase; Physical Exercise; Physical activity; Pilot Projects; Preparation; Public Health; Randomized Controlled Trials; Reporting; Research Personnel; Retrospective Studies; Risk Factors; Serum; Short-Term Memory; Sleep; Structure; TNF gene; Technology; Testing; Time; Training; United States; Work; Wrist; base; behavior change; career; career development; circadian; cognitive benefits; cognitive function; cognitive performance; cohort; cytokine; efficacy evaluation; exercise intervention; follow-up; healthy aging; improved; improvement on sleep; innovation; insight; laboratory experience; novel; older men; older women; physical conditioning; preservation; processing speed; prospective; prototype; sedentary; sedentary lifestyle; smart watch; vigilance; wearable device

PROJECT SUMMARY/ABSTRACT The proposed project aims to identify the optimal features of daytime napping and physical activity for cognition in older adults (K99) and examine the effects of an innovative, personalized behavioral intervention on promoting physical activity, healthy napping, sleep and cognitive function in sedentary older adults (R00). In the K99 phase, to ensure the successful completion of the R00 project and facilitate the achievement of my career development goals, I will follow an intensive training plan that incorporates courses, laboratory training, mentoring, and structured activities. In addition, a retrospective study will be conducted using two large longitudinal cohorts of older adults in the United States to examine the associations of daytime physical activity and nocturnal sleep with cognitive decline over 4-6 years. The K99 study will examine: 1) baseline associations of napping characteristics, physical activity and nocturnal sleep duration with cognition; 2) whether baseline napping, physical activity and nocturnal sleep duration predict cognitive decline at the 4-6 year follow-up; and 3) relationships between changes in physical activity and nocturnal sleep duration and changes in cognitive function at follow-up. Building off the K99, in the R00 phase, a randomized controlled trial will be conducted in older adults (without dementia) with both sedentary lifestyle and nocturnal sleep complaints to examine the effectiveness of a 24-week personalized behavioral intervention implemented with smartwatch technology on promoting physical activity, nocturnal sleep, and cognition compared against a control group; we have successfully tested this in a pilot study. Serum inflammatory biomarkers will be assessed to explore hypothesized mechanisms for associations among the study outcomes. In order to optimize outcomes at the subject level, a personalized physical activity plan will be calculated based on the individual’s characteristics, personal circadian rhythm at baseline, and the optimal characteristics of napping and physical activity that were identified in the K99 phase. The R00 study will examine: 1) whether the intervention increases participants’ non-nap period physical activity, optimizes napping duration, and enhances nocturnal sleep; 2) whether the intervention improves participants’ overall cognitive performance; 3) whether the relationship between the study intervention and cognitive performance is mediated by changes in physical activity, healthy nap duration, and nocturnal sleep duration; and 4) (exploratory aim) if the proposed intervention changes serum inflammatory biomarkers, including cytokines (IL-6, IL-1ß, TNF-α) and C-reactive protein, and whether these biomarkers relate to changes in physical activity, sleep, and cognitive function. Upon completion, this proposal will provide important insights on the optimal features of physical activity and napping for cognitive function. The proposed intervention may provide a novel way for older adults to optimize wellness and achieve active, healthy lives while aging, a key theme of the National Institute of Nursing Research in its mission to enhance public health. It will also build a strong foundation for my future career as an independent researcher.

项目概要/摘要 该项目旨在确定白天小睡和体力活动对于认知​​的最佳特征 老年人 (K99) 并检查创新的、个性化的行为干预对 促进久坐老年人的身体活动、健康的午睡、睡眠和认知功能（R00）。在 K99阶段，保证R00项目的顺利完成，促进我的目标的实现 职业发展目标，我将遵循强化培训计划，包括课程、实验室培训、 指导和结构化活动。此外，还将利用两个大型 美国老年人的纵向队列研究白天体力活动的关联 夜间睡眠会伴随认知能力下降，持续 4-6 年。 K99 研究将检查：1) 基线关联 午睡特征、体力活动和夜间睡眠持续时间与认知的关系； 2）是否基线 午睡、体力活动和夜间睡眠持续时间可预测 4-6 年随访时认知能力的下降；和 3) 身体活动和夜间睡眠时间的变化与认知变化之间的关系 后续功能。以 K99 为基础，在 R00 阶段，将在 具有久坐生活方式和夜间睡眠抱怨的老年人（无痴呆症），以检查 使用智能手表技术实施的 24 周个性化行为干预的有效性 与对照组相比，促进身体活动、夜间睡眠和认知；我们有 在一项试点研究中成功地测试了这一点。将评估血清炎症生物标志物以探索 研究结果之间关联的假设机制。为了优化结果 学科层面，将根据个人特点计算个性化的身体活动计划， 基线时的个人昼夜节律，以及午睡和身体活动的最佳特征 在K99阶段被鉴定。 R00 研究将检查：1）干预是否增加 参与者非午睡期间的体力活动，优化午睡时间，增强夜间睡眠； 2） 干预措施是否改善参与者的整体认知表现； 3）是否有关系 研究干预和认知表现之间的关系是由体力活动的变化介导的，健康 午睡持续时间和夜间睡眠持续时间； 4)（探索性目标）如果提议的干预措施发生变化 血清炎症生物标志物，包括细胞因子（IL-6、IL-1ß、TNF-α）和 C 反应蛋白，以及是否 这些生物标志物与身体活动、睡眠和认知功能的变化有关。完成后，这 该提案将为认知活动和小睡的最佳特征提供重要见解 功能。拟议的干预措施可能为老年人提供一种优化健康并实现目标的新方法 在老龄化过程中保持积极、健康的生活，这是国家护理研究所的一个关键主题，其使命是 加强公共卫生。它还将为我未来作为一名独立研究员的职业生涯打下坚实的基础。

项目成果

An mHealth-Facilitated Personalized Intervention for Physical Activity and Sleep in Community-Dwelling Older Adults.

移动健康促进的针对社区老年人身体活动和睡眠的个性化干预。

• DOI: 10.1123/japa.2020-0463
• 发表时间: 2022
• 期刊: Journal of aging and physical activity
• 影响因子: 1.5
• 作者: Li,Junxin;Szanton,SarahL;McPhillips,MirandaV;Lukkahatai,Nada;Pien,GraceW;Chen,KerCheng;Hladek,MelissaD;Hodgson,Nancy;Gooneratne,NalakaS
• 通讯作者: Gooneratne,NalakaS

Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States.

美国华裔移民妇女的宫颈癌筛查经验。

• DOI: 10.1016/j.jogn.2017.10.003
• 发表时间: 2018
• 期刊: Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
• 作者: Seo,JinYoung;Li,Junxin;Li,Kun
• 通讯作者: Li,Kun

Higher vitamin D intake could improve sleep and cognitive outcomes in older adults with heart failure.

较高的维生素 D 摄入量可以改善患有心力衰竭的老年人的睡眠和认知结果。

• DOI: 10.1136/eb-2018-102947
• 发表时间: 2018
• 期刊: Evidence-based nursing
• 作者: Li,Junxin

Afternoon Napping and Cognition in Chinese Older Adults: Findings from the China Health and Retirement Longitudinal Study Baseline Assessment.

中国老年人的下午小睡和认知：来自中国健康和退休纵向研究基线评估的结果。

• DOI: 10.1111/jgs.14368
• 发表时间: 2017-03
• 期刊: Journal of the American Geriatrics Society
• 影响因子: 6.3
• 作者: Li J;Cacchione PZ;Hodgson N;Riegel B;Keenan BT;Scharf MT;Richards KC;Gooneratne NS
• 通讯作者: Gooneratne NS

Recruiting Persons with Dementia and Caregivers in a Clinical Trial: Dyads Perceptions.

• DOI: 10.1177/01939459211008563
• 发表时间: 2022-06
• 期刊: Western journal of nursing research
• 影响因子: 1.8
• 作者: McPhillips MV;Petrovsky DV;Brewster GS;Li J;Gooneratne NS;Hodgson NA;Sefcik JS
• 通讯作者: Sefcik JS