IKE Kapuna (Elder Wisdom) Project

IKE Kapuna（长者智慧）项目

• 批准号: 10172085
• 负责人: Joseph Keawe'aimoku Kaholokula
• 金额: $ 54.43万
• 依托单位: WASHINGTON 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: 2021-08-01 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10172085
• 关键词: Address; Adherence; Adult; African American; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American Indians; Asian Americans; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cerebrovascular Disorders; Cognitive; Communities; Consent; Dancing; Data; Dementia; Detection; Diabetes Mellitus; Diagnosis; Dyslipidemias; Early Intervention; Education; Educational Curriculum; Effectiveness; Elderly; Epidemic; Ethnic group; Exercise; Functional disorder; Funding; Future; Genes; Genotype; Health; High Prevalence; Hyperglycemia; Hypertension; Impaired cognition; Incidence; Indigenous; Influentials; Intervention; Intervention Trial; Knowledge; Measurable; Measures; Mental Health; National Institute on Aging; Native Hawaiian; Neurobehavioral Manifestations; Obesity; Outcome; Pacific Island Americans; Participant; Persons; Physical Function; Physical activity; Population; Presenile Alzheimer Dementia; Prevalence; Prevention; Protocols documentation; Qualitative Methods; Race; Randomized; Randomized Controlled Trials; Research; Research Project Grants; Risk; Risk Factors; Sampling; Social support; Source; Testing; United States National Institutes of Health; Waiting Lists; aged; apolipoprotein E-4; base; blood pressure intervention; caucasian American; clinical care; clinical practice; cognitive change; cognitive function; cognitive performance; cohort; comorbidity; dementia risk; design; dietary; ethnic minority population; good diet; high risk; improved; indexing; lifestyle intervention; mild cognitive impairment; neuroimaging; novel; preservation; prevent; primary outcome; programs; racial minority; randomized trial; recruit; resilience; secondary outcome; social; social engagement; symposium; vascular risk factor; virtual

RESEARCH PROJECT 2: ABSTRACT The prevalence of Alzheimer’s disease and related dementias (ADRD) is rising in Hawai`i, where it is projected that 10% of people aged 65+ will be diagnosed with ADRD by 2025. Nationwide, Native Hawaiians and Pacific Islanders (NHPIs) are more likely to have early-onset ADRD than Whites, Asians, and African Americans. NHPIs have a higher prevalence of hypertension, obesity, diabetes, and dyslipidemia than other US racial and ethnic groups, which increase the likelihood of ADRD. ADRD is often preceded by subjective cognitive impairment and mild cognitive impairment, which offers an opportunity for early intervention to prevent or delay ADRD onset. Interventions that promote physical activity, healthy diet, and social and cognitive activities can prevent or slow cognitive decline. Notably, dancing can preserve or improve cognitive functioning and neuroimaging parameters, while reducing vascular risk factors. However, very few studies have tailored a dance program for ADRD prevention for racial or ethnic minorities, and none have included NHPIs. We completed a randomized controlled trial of an intervention featuring Hula in 277 NHPIs with uncontrolled hypertension. Over 6 months, the intervention lowered systolic (-5.4 mmHg, p = 0.02) and diastolic (-4.4 mmHg, p = 0.01) blood pressure compared to the control condition. We therefore will partner with 5 community-based organizations in Hawai‘i to adapt our existing Hula intervention and test its effectiveness for improving vascular health and maintaining or improving cognitive function in NHPI elders at high risk of ADRD. The ‘IKE Kupuna (Elder Wisdom) Project will use qualitative methods to revise our existing 12-month Hula curriculum for hypertension with culturally informed dietary education, cognitive exercises, and social engagement strategies. We will then conduct a pragmatic group-randomized trial with 208 NHPIs aged 50-75 years with at least 1 of 4 modifiable vascular risk factors for ADRD (hypertension, hyperglycemia, obesity, or dyslipidemia) and either SCI or MCI using a wait-list control design. The primary outcomes will be vascular risk factors for ADRD and subjective cognitive complaints. Secondary outcomes will include measures of cognitive performance, physical function, and mental health. We will also collect biospecimens from all participants to evaluate the cross-sectional association between APOE genotype, vascular risk factors, and cognitive complaints and function. Our Specific Aims are to: 1) Adapt our existing Hula-based intervention to target vascular risk factors for dementia, improve cognitive symptoms or function, and optimize salience, implementation, and adherence in NHPIs with subjective cognitive impairment or mild cognitive impairment; 2) Conduct a group randomized trial to test the effect of ‘IKE Kupuna on vascular risk factors for ADRD and cognitive complaints and function over 12 months; and 3) Evaluate the cross-sectional association of vascular risk factors and APOE genotype with cognitive complaints and function. The NHPI elder population is increasing and their needs are escalating. This will be the first study to test a novel intervention to address ADRD in NHPIs and to assess the association APOE-ε4 genotype with cognitive function in this group.

研究项目 2：摘要 夏威夷阿尔茨海默病和相关痴呆症 (ADRD) 的患病率正在上升，预计 到 2025 年，10% 65 岁以上的人将被诊断出患有 ADRD。全国范围、夏威夷原住民和太平洋地区 岛民 (NHPI) 比白人、亚洲人和非裔美国人更容易患早发 ADRD。 NHPI 与美国其他种族和民族相比，高血压、肥胖、糖尿病和血脂异常的患病率更高 组，这会增加 ADRD 的可能性。 ADRD 之前通常会出现主观认知障碍 轻度认知障碍，这提供了早期干预以预防或延迟 ADRD 发作的机会。 促进身体活动、健康饮食以及社交和认知活动的干预措施可以预防或减缓 认知能力下降。值得注意的是，跳舞可以保持或改善认知功能和神经影像参数， 同时减少血管危险因素。然而，很少有研究为 ADRD 量身定制舞蹈计划 少数种族或族裔的预防措施，但没有一项包括 NHPI。我们完成了一项随机对照 对 277 名高血压未受控制的 NHPI 进行草裙舞干预试验。 6个多月以来， 干预降低了收缩压（-5.4 mmHg，p = 0.02）和舒张压（-4.4 mmHg，p = 0.01） 与控制条件相比。因此，我们将与夏威夷的 5 个社区组织合作， 调整我们现有的草裙舞干预措施并测试其改善血管健康和维持或维持的有效性 改善 ADRD 高风险 NHPI 老年人的认知功能。 ‘IKE Kupuna（长者智慧）项目将 使用定性方法修订我们现有的 12 个月高血压草裙舞课程，并融入文化知识 饮食教育、认知练习和社会参与策略。接下来我们将进行一次务实的 对 208 名年龄在 50-75 岁的 NHPI 进行的分组随机试验，他们至少具有 4 个可改变的血管危险因素中的 1 个 ADRD（高血压、高血糖、肥胖或血脂异常）和 SCI 或 MCI（使用等待名单对照） 设计。主要结果是 ADRD 的血管危险因素和主观认知抱怨。 次要结果将包括认知表现、身体功能和心理健康的测量。我们 还将收集所有参与者的生物样本，以评估 APOE 之间的横截面关联 基因型、血管危险因素以及认知症状和功能。我们的具体目标是： 1) 调整我们的 现有的基于草裙舞的干预措施旨在针对痴呆症的血管危险因素，改善认知症状或 功能，并优化具有主观认知障碍的 NHPI 的显着性、实施和依从性 或轻度认知障碍； 2) 进行一组随机试验，测试“IKE Kupuna”对血管的影响 ADRD 的风险因素以及 12 个月内的认知障碍和功能； 3) 评估横截面 血管危险因素和 APOE 基因型与认知症状和功能的关联。 NHPI长老 人口不断增加，他们的需求不断增加。这将是第一项测试新颖干预措施的研究 解决 NHPI 中的 ADRD 问题，并评估 APOE-ε4 基因型与该组认知功能的关联。