Reducing African Americans' Alzheimer's Disease Risk Through Exercise-MCI Cohort (RAATE-MCI)

通过运动降低非裔美国人阿尔茨海默病风险 - MCI 队列 (RAATE-MCI)

• 批准号: 10196930
• 负责人: OWEN T. CARMICHAEL
• 金额: $ 93.46万
• 依托单位: LSU PENNINGTON BIOMEDICAL RESEARCH CTR
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10196930
• 关键词: Address; Adult; African American; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Amyloid; Anti-Inflammatory Agents; Biological; Biological Assay; Biological Markers; Blood; Brain; Brain-Derived Neurotrophic Factor; Cardiovascular system; Cerebrovascular Circulation; Cerebrum; Characteristics; Chromosomes; Chronic; Clinical; Cognitive; Communities; Control Groups; Data; Dementia; Development; Diagnosis; Effectiveness; Elderly; Episodic memory; Ethnic group; Evaluation; Exercise; Exposure to; Functional Magnetic Resonance Imaging; Genotype; Hormones; Impaired cognition; Impairment; Individual; Insulin-Like Growth Factor I; Intervention; Ischemia; Knowledge; Lead; Length; Longevity; Magnetic Resonance Imaging; Measurement; Measures; Mediating; Memory; Memory Loss; Mental Depression; Nerve Degeneration; Neurobiology; Not Hispanic or Latino; Older Population; Other Genetics; Outcome; Participant; Pathway interactions; Patients; Perfusion; Phenotype; Physical activity; Physiological; Population; Positron-Emission Tomography; Prevalence; Public Health; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Research; Risk; Risk Factors; Sample Size; Sleep; Structure; Time; Underserved Population; White Matter Hyperintensity; active control; base; brain tissue; cardiorespiratory fitness; cardiovascular risk factor; caucasian American; cerebrovascular; clinical phenotype; cognitive benefits; cognitive enhancement; cognitive function; cohort; depressive symptoms; evidence base; executive function; exercise intervention; experience; fitness; functional disability; genetic risk factor; gray matter; health disparity; improved; insight; mild cognitive impairment; neuroimaging; neuromechanism; neuroprotection; neuropsychiatry; neurotrophic factor; nutrition education; preservation; prevent; programs; recruit; response; sex; symptomatology; telomere; trial design; β-amyloid burden

Project Summary Alzheimer’s disease is steadily increasing in prevalence, with a devastating public health impact. The prevalence of Alzheimer’s Disease is higher in African Americans compared to white Americans, thereby constituting a health disparity. Individuals with mild cognitive impairment (MCI) are at increased risk for progressing to dementia, including AD dementia. Interventions that prevent Alzheimer’s disease or change the course of cognitive decline associated with Alzheimer’s disease are needed. Most older adults do not achieve recommended levels of physical activity, and this includes African Americans. Regular physical activity has proven to be a safe and effective means to enhance cognitive function in older adults with MCI. Therefore, our study is focused on physical activity promotion, a potent approach to modifying multiple neurobiological pathways implicated in Alzheimer’s Disease. We evaluate exercise benefits among elderly African Americans, who are understudied and in whom the natural course of neurodegeneration, exercise effects on neuroprotection and neurodegeneration, and resulting clinical phenotypes may differ. A large body of existing data suggests that exercise improves cardiovascular and cerebrovascular functioning, and thus has the potential to enhance perivascular clearance of amyloid and reduce chronic brain tissue ischemia, among other beneficial effects. At the same time, chronic exercise has been shown to increase central levels of neurotrophic factors, which in turn promote protection against Alzheimer’s Disease neurodegeneration pathways via a variety of mechanisms. While physical activity interventions have been shown to have positive effects on these factors and on resultant cognitive functioning in older adults, nearly all interventions have had a negligible representation of African Americans. Prior data suggests that African Americans enter their elderly years against a backdrop of different lifespan exposures to a variety of factors relevant to neuroprotection and neurodegeneration, including cardiovascular risk, exercise, diet, and education. In addition, prior data suggests that the key genetic risk factor for Alzheimer’s Disease (APOE) may have differing consequences for Alzheimer’s Disease risk among African Americans, and other genetic differences (i.e. leucocyte telomere length) have the potential to influence the brain benefits of physical activity in this community. We will utilize a randomized clinical trial to addresses these questions. Participants will be randomized into a physical activity promotion intervention or an active control group for 52 weeks. We will recruit a population with MCI. We will assess cognitive function, brain structure and function, circulating hormones, neurotrophic factors, objectively measured physical activity, cardiorespiratory fitness, sleep parameters, and telomere length. Our study will take the first step toward understanding whether the hypothesized benefits of exercise for the brain carry over to elderly African Americans with MCI.

项目摘要 阿尔茨海默病的患病率正在稳步上升，对公共健康造成了毁灭性的影响。这个 与美国白人相比，非裔美国人患阿尔茨海默氏症的比例更高，因此 构成了健康差距。轻度认知障碍(MCI)的个体患上 进展为痴呆症，包括阿尔茨海默病。预防阿尔茨海默病或改变 与阿尔茨海默病相关的认知衰退的病程是必要的。大多数老年人没有达到 推荐的体力活动水平，这包括非裔美国人。有规律的体力活动有 经证实，这是一种安全有效的方法来提高老年MCI患者的认知功能。因此，我们的 研究的重点是促进身体活动，这是一种改变多种神经生物学的有效方法 与阿尔茨海默病有关的通路。我们评估了老年非裔美国人的锻炼益处， 谁是研究不足的人，在谁的神经退化的自然过程中，运动对 神经保护和神经变性，以及由此产生的临床表型可能不同。一大堆现存的 数据表明，运动可以改善心血管和脑血管功能，因此具有 增强血管周围淀粉样蛋白清除和减少慢性脑组织缺血的潜力等 有益的影响。与此同时，长期锻炼已被证明可以提高中枢激素水平。 神经营养因子，进而促进对阿尔茨海默病神经退行性变的保护 通过各种机制的途径。虽然体力活动干预已被证明有积极的作用 对这些因素和老年人认知功能的影响，几乎所有的干预措施都有 非洲裔美国人的代表性微不足道。先前的数据表明，非裔美国人进入了他们的老年人 多年来，在不同的寿命背景下暴露于与神经保护和 神经退化，包括心血管风险、运动、饮食和教育。此外，之前的数据 提示阿尔茨海默病(APOE)的关键遗传风险因素可能对 非裔美国人患阿尔茨海默病的风险以及其他遗传差异(即白细胞端粒 长度)有可能影响这个社区中体力活动对大脑的好处。我们将利用一个 旨在解决这些问题的随机临床试验。参与者将被随机分为体力活动组 推广干预组或积极对照组，为期52周。我们将招募一批MCI患者。我们会 客观评估认知功能、大脑结构和功能、循环激素、神经营养因子 测量体力活动、心肺功能、睡眠参数和端粒长度。我们的研究将 迈出了解运动对大脑的假定益处是否会延续的第一步 给患有MCI的老年非裔美国人。