Long-term Effects of a Community-based Volunteer Trial on Lifestyle Activity and Risk for Alzheimer's Disease

摘要 阿尔茨海默病的风险是美国十大死亡原因中唯一无法预防的， 治愈或甚至减缓使用药物，是最昂贵的慢性疾病。2006年， 巴尔的摩经验团试验（BECT）是最大的随机对照试验（N = 702）检查 多模式的社交、认知和身体参与是否增强了神经认知功能， 认知完好的老年人。BECT在干预试验中是新颖的，因为它在经济上吸引了 处于不利地位的成年人患阿尔茨海默病的风险增加。该试验随机选择了老年人， 小学志愿者的生产性社会参与增加了生活方式活动和生成性 在两年的暴露中，阿尔茨海默病的认知和大脑生物标志物得到了改善。我们 现在需要评估是否在相对健康的老年人中两年的短期影响 总体而言，这些风险与10-12年后的长期健康益处有关， 人们进入他们的80和90岁的生活。我们将确定是否增加社会 在2006-2012年期间参与体验团导致了阿尔茨海默病的长期风险降低， 减少医疗保健支出，保持功能和财务独立，提高质量 生活和社会网络的稳定性，以及较低的死亡率。为了实现这些目标，我们将利用广泛的 关联数据，包括Medicare和Medicaid索赔、马里兰州CRISP医疗保健数据、国家死亡指数 (NDI)，财务记录，以及低成本的10-12年随访电话访谈，以评估认知， 功能、健康、生活方式和社会联系。这项研究将使我们能够研究长期的 社会参与计划对阿尔茨海默病风险相关关键结果的影响， 痴呆风险、功能和经济独立性、生活质量和死亡率。

Abstract Risk for Alzheimer’s disease is the only cause of death among the top 10 in the US that cannot be prevented, cured or even slowed using medications and is the most expensive chronic disease. Initiated in 2006, the Baltimore Experience Corps Trial (BECT) is the largest randomized controlled trial (N = 702) to examine whether multi-modal social, cognitive, and physical engagement enhanced neurocognitive functions in cognitively intact older adults. The BECT was novel among intervention trials in its appeal to economically disadvantaged adults at elevated risk for Alzheimer’s disease. The trial randomized older adults to show that productive social engagement as volunteers in elementary schools increased lifestyle activity and generative purpose and improved cognition and brain biomarkers for Alzheimer’s disease over two years of exposure. We now need to evaluate whether the two-year short-term effects in relatively healthy aging adults collectively were associated with longer-term health benefits 10-12 years later as these at-risk individuals enter their 80th and 90th decades of life. We will determine whether increased social engagement in Experience Corps between 2006-2012 led to long-term lower risk for Alzheimer’s disease, reductions in Medical Care expenditures, maintained functional and financial independence, improved quality of life and social network stability, and lower mortality. To achieve these goals, we will leverage a wide range of linked data, including Medicare and Medicaid Claims, Maryland CRISP healthcare data, National Death Index (NDI), financial records, and a low-cost 10-12-year follow-up telephone interview to assess cognition, function, health, lifestyle and social connectivity. This study will allow us to examine the long-term impact of a social engagement program on key outcomes related to risk for Alzheimer’s disease and dementia risk, functional and financial independence, quality of life, and mortality.