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)

基本信息

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
项目类别：
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&apos s Disease Alzheimer&apos 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

项目摘要

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氏病的患病率正在稳步增长，并产生了毁灭性的公共卫生影响。这与白人美国人相比，非裔美国人的阿尔茨海默氏病的患病率更高构成健康差异。轻度认知障碍（MCI）的个体有增加的风险发展为痴呆症，包括痴呆症。预防阿尔茨海默氏病或改变的干预措施需要与阿尔茨海默氏病有关的认知下降。大多数老年人无法实现建议的体育锻炼水平，其中包括非裔美国人。定期体育锻炼有被证明是增强MCI老年人认知功能的安全有效手段。因此，我们的研究的重点是促进体育锻炼，这是一种改变多种神经生物学的潜在方法在阿尔茨海默氏病中实施的途径。我们评估年龄较大的非洲裔美国人的运动益处，被理解的人以及在谁的自然神经变性过程中，运动对神经保护和神经退行性变化以及由此产生的临床表型可能有所不同。一大批现有数据表明，运动可以改善心血管和脑血管功能，因此具有增加淀粉样蛋白血管周清除并减少慢性脑组织缺血的潜力有益的效果。同时，已证明慢性运动可以增加中心水平神经营养因素又促进了针对阿尔茨海默氏病神经退行性的保护通过多种机制的途径。尽管已经证明身体活动干预措施具有阳性对这些因素以及对老年人的认知功能的影响，几乎所有干预措施都已经非洲裔美国人的代表微不足道。先前的数据表明，非洲裔美国人较早进入他们的在不同的寿命暴露于与神经保护相关的各种因素的背景下的几年神经变性，包括心血管风险，运动，饮食和教育。另外，先验数据表明阿尔茨海默氏病（APOE）的关键遗传危险因素可能对非洲裔美国人的阿尔茨海默氏病风险和其他遗传差异（即白细胞端粒长度）有可能影响该社区体育活动的大脑益处。我们将利用一个随机临床试验解决了这些问题。参与者将被随机分为体育锻炼促进干预或主动对照组52周。我们将与MCI招募人口。我们将评估认知功能，大脑结构和功能，循环激素，神经营养因素，客观地测量的体育锻炼，心肺适应性，睡眠参数和端粒长度。我们的研究愿意迈出第一步，了解锻炼对大脑的假设益处是否延续给MCI的非裔美国人。