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

项目摘要 阿尔茨海默病的患病率稳步上升，对公共卫生造成了毁灭性的影响。的 与白色美国人相比，非裔美国人中阿尔茨海默病的患病率更高， 构成了健康差距。轻度认知障碍（MCI）的个体患以下疾病的风险增加： 进展为痴呆，包括AD痴呆。预防阿尔茨海默病或改变阿尔茨海默病的干预措施 与阿尔茨海默病相关的认知能力下降的过程是必要的。大多数老年人没有达到 建议的身体活动水平，这包括非洲裔美国人。定期的身体活动有 被证明是一种安全有效的手段，以提高认知功能的老年人与MCI。所以我们的 这项研究的重点是促进身体活动，这是一种有效的方法，可以改变多种神经生物学 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运动益处， 他们的神经退化的自然过程，运动对 神经保护和神经变性，以及产生的临床表型可能不同。大量现有的 数据表明，运动可以改善心血管和脑血管功能， 增强淀粉样蛋白的血管周围清除和减少慢性脑组织缺血的潜力， 有益效果。与此同时，长期锻炼已被证明可以增加中枢神经系统的水平。 神经营养因子，反过来促进对阿尔茨海默病神经变性的保护 通过各种机制的途径。虽然身体活动干预已被证明具有积极的作用， 对这些因素以及由此产生的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，非洲裔美国人进入他们的老年人， 在不同寿命暴露于各种与神经保护相关的因素的背景下， 神经退化，包括心血管风险，运动，饮食和教育。此外，先前的数据 表明阿尔茨海默病（APOE）的关键遗传风险因素可能对阿尔茨海默病（APOE）有不同的后果。 非裔美国人中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身体活动对大脑的益处。我们将利用 随机临床试验来解决这些问题。参与者将被随机分配到一项体力活动中， 促进干预或积极控制组52周。我们将招募一群MCI患者。我们将 客观评估认知功能、脑结构和功能、循环激素、神经营养因子 测量身体活动、心肺健康、睡眠参数和端粒长度。我们的研究将 迈出第一步，了解运动对大脑的假设益处是否会延续下去 患有轻度认知障碍的非裔美国老人

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.