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

摘要 阿尔茨海默氏症的风险是美国前十名中唯一无法预防的死亡原因。 使用药物可以治愈甚至减缓病情，是最昂贵的慢性病。发起于2006年， 巴尔的摩体验团试验(BECT)是要检查的最大随机对照试验(N=702) 多模式社交、认知和身体参与是否增强了患者的神经认知功能 认知完好的老年人。BECT在干预试验中是新奇的，因为它在经济上的吸引力 罹患阿尔茨海默氏症风险增加的弱势成年人。这项试验随机选择了老年人，以表明 作为小学志愿者的生产性社会参与增加了生活方式的活动和生殖力 目的和改善阿尔茨海默病的认知和脑生物标记物超过两年的暴露。我们 现在需要评估两年的短期效果是否对相对健康的老年成年人 总体来说，10-12年后与长期健康益处相关，因为这些高危人群 个人步入80岁和90岁。我们将确定是否增加了社交网络 2006-2012年间参加体验团的人患阿尔茨海默病的风险长期较低， 减少医疗支出，保持职能和财务独立，提高质量 生活和社交网络的稳定性，以及更低的死亡率。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申领、马里兰州CRISP医疗数据、国家死亡指数 (NDI)，财务记录，以及低成本的10-12年跟踪电话采访，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检查长期的 社会参与计划对与阿尔茨海默病风险相关的关键结果的影响 痴呆症风险、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.