24-hour Activity Cycles to Optimize Cognitive Resilience to Alzheimer's Disease in African Americans: The Jackson Heart Study

24 小时活动周期可优化非裔美国人对阿尔茨海默病的认知能力：杰克逊心脏研究

• 批准号: 10410567
• 负责人: Kelley Pettee Gabriel
• 金额: $ 96万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10410567
• 关键词: Accelerometer; Activity Cycles; Address; Adult; African American population; Age; Alleles; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease related dementia; Ancillary Study; Atherosclerosis Risk in Communities; Behavior; Behavioral; Black Populations; Black race; Brain; Categories; Cerebrovascular Disorders; Characteristics; Circadian Rhythms; Clinical; Cognitive; Cohort Studies; Complement; Complex; Data; Dementia; Diagnosis; Education; Elderly; Epidemic; Epidemiology; Exclusion Criteria; Financial Hardship; Funding; Genetic Risk; Genotype; Goals; Health Benefit; Healthcare Systems; High Prevalence; Hippocampus (Brain); Hour; Impaired cognition; Instruction; Jackson Heart Study; Joints; Leisures; Light; MRI Scans; Magnetic Resonance; Measurement; Measures; Minority Groups; Nerve Degeneration; Onset of illness; Outcome; Participant; Persons; Pharmacological Treatment; Physical activity; Physicians; Prevalence; Prevention strategy; Public Health; Recommendation; Reporting; Research; Risk; Role; Sampling; Sleep; Sleep Apnea Syndromes; Sleep Disorders; Sleep Wake Cycle; Sleep disturbances; Socioeconomic Factors; Sum; Time; United States; White Matter Hyperintensity; Woman; actigraphy; age effect; aged; apolipoprotein E-4; base; behavioral phenotyping; black men; black women; brain health; brain magnetic resonance imaging; brain volume; burden of illness; cognitive function; cognitive performance; cohort; high risk; human old age (65+); innovation; light intensity; literacy; member; men; mild cognitive impairment; novel; personalized intervention; phenotypic data; pre-clinical; prevent; protective factors; research study; resilience; response; sedentary; sex; sleep behavior; vigorous intensity; white matter

ABSTRACT Alzheimer’s Disease and Related Dementias (ADRD) is an emerging epidemic in the United States; Black adults are particularly vulnerable. Without effective prevention strategies to target and optimize resilience to ADRD, 14 million U.S. adults will be living with ADRD by 2060, with an associated financial burden of $511 billion by 2040. While physical activity has been consistently identified as a modifiable, protective factor to prevent cognitive decline and delay age of dementia onset, the majority of this evidence is based on reported estimates of leisure-time moderate to vigorous intensity physical activity (MVPA), which provides an incomplete characterization of this complex behavioral phenotype. Adults spend approximately 95% of waking hours sedentary or in light intensity physical activity; however, there is limited research exploring the interrelations of these different intensity categories. Further, less than 10% of adults accumulate sufficient MVPA to meet recommendations, and this prevalence estimate is even lower in Black adults. Studies have also demonstrated that sleep disturbances, including short sleep duration, circadian rhythm disturbances, and sleep-disordered breathing may increase risk of cognitive impairment. However, this evidence is still emerging. Further, Black adults have a higher prevalence of disordered sleep compared to Whites. Despite the potential importance of both waking and sleep behaviors to optimize cognitive resilience, their impacts are often studied in isolation. To address these critical research gaps, we propose the Jackson Heart Study (JHS) 24-Hour Activity Cycle Study (Jackson 24H-ACT), a four-year ancillary study to the funded JHS Exam 4 (2020-22). The overall goal of the Jackson 24H-ACT Study is to quantify 24-hour activity cycle behaviors and estimate the independent and joint roles of waking (sedentary to vigorous intensity physical activity) and sleep (duration and quality characteristics) behaviors to optimize cognitive resilience. All participants attending Exam 4 and who are willing to concurrently wear an accelerometer and sleep actigraphy watch for seven consecutive days will be invited to participate. Exclusion criteria include: unable to ambulate or physician instruction not to be physically active. Jackson 24H-ACT ancillary study measures include: (1) accelerometry and (2) sleep actigraphy, which complement extant JHS data, and data that will be collected as part of Exam 4. To accomplish these goals, we propose to examine the independent and joint associations of 24-hour activity cycle behaviors with: (Aim 1) cognitive functioning; (Aim 2) subclinical markers of cerebrovascular disease (e.g. white matter hyperintensity volumes), white matter microstructural integrity, and neurodegeneration (e.g. hippocampal and total brain volumes) quantified from brain magnetic resonance (MRI) imaging; and (Aim 3) the prevalence of mild cognitive impairment (MCI) and dementia. Potential moderation by sex, age epoch (<65 versus ≥65 years), education/literacy, and APOE ɛ4 genotype will also be evaluated. Jackson 24H-ACT will provide novel information on the role of 24-hour activity cycles in promoting cognitive resilience in Black adults.

抽象的 阿尔茨海默病和相关痴呆症 (ADRD) 在美国是一种新出现的流行病；黑色的 成年人尤其容易受到伤害。如果没有有效的预防策略来瞄准和优化抵御能力 ADRD，到 2060 年，将有 1400 万美国成年人患有 ADRD，相关经济负担为 511 美元 到 2040 年，身体活动将持续被认为是一个可改变的保护因素 预防认知能力下降并延缓痴呆症发病年龄，大部分证据基于报道 休闲时间中度至高强度体力活动 (MVPA) 的估计，它提供了 这种复杂行为表型的不完整表征。成年人大约 95% 的时间都在醒着的时候度过 久坐或轻度体力活动的时间；然而，探索该问题的研究有限 这些不同强度类别的相互关系。此外，只有不到 10% 的成年人积累了足够的 MVPA 符合建议，而黑人成人中的患病率估计甚至更低。研究有 还表明，睡眠障碍，包括睡眠时间短、昼夜节律紊乱和 睡眠呼吸障碍可能会增加认知障碍的风险。然而，这一证据仍在不断涌现。 此外，与白人相比，黑人成年人睡眠障碍的患病率更高。尽管有潜力 清醒和睡眠行为对于优化认知弹性的重要性，人们经常研究它们的影响 隔离中。为了解决这些关键的研究空白，我们提出了杰克逊心脏研究 (JHS) 24 小时 活动周期研究 (Jackson 24H-ACT)，是资助的 JHS 考试 4 (2020-22) 的一项为期四年的辅助研究。这 Jackson 24H-ACT 研究的总体目标是量化 24 小时活动周期行为并估计 清醒（久坐到剧烈的体力活动）和睡眠（持续时间和睡眠时间）的独立和联合作用 质量特征）优化认知弹性的行为。所有参加考试 4 的参与者以及 愿意连续 7 天同时佩戴加速度计和睡眠体动记录仪 受邀参加。排除标准包括：无法行走或医生指示不要 身体活跃。 Jackson 24H-ACT 辅助研究措施包括：(1) 加速度测量和 (2) 睡眠 体动记录仪，补充现有的 JHS 数据以及将作为考试 4 的一部分收集的数据。 为了实现这些目标，我们建议审查24小时活动的独立协会和联合协会 循环行为具有：（目标 1）认知功能； （目标2）脑血管疾病的亚临床标志物 （例如白质高信号体积）、白质微观结构完整性和神经变性（例如神经退行性疾病） 通过脑磁共振 (MRI) 成像量化海马体和总脑体积；和（目标 3） 轻度认知障碍（MCI）和痴呆症的患病率。性别、年龄时期的潜在调节（<65 还将评估 ≥65 岁）、教育/识字率和 APOE ɛ4 基因型。杰克逊 24H-ACT 将 提供关于 24 小时活动周期在促进黑人成人认知弹性方面的作用的新信息。