Characterizing Older Mexican (American) Participation in Activity Digitally, Reliably, and Ecologically with the CART Platform (COMPADRE CART): Implications for Cognition and ADRD

使用 CART 平台 (COMPADRE CART) 以数字化、可靠且生态的方式描述墨西哥（美国人）老年人对活动的参与：对认知和 ADRD 的影响

• 批准号: 10447342
• 负责人: Zachary Beattie
• 金额: $ 78.31万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10447342
• 关键词: Acculturation; Adopted; Adult; Age; Aging; Algorithms; Alzheimer' s disease related dementia; Apolipoproteins; Atrophic; Attenuated; Behavioral; Biological; Blood; C-reactive protein; Cardiovascular system; Cellular Phone; Chitinase; Cognition; Cognitive; Collection; Computers; Coupled; Data; Dementia; Development; Devices; Diabetes Mellitus; Elderly; Enrollment; Ethnic group; Evaluation; Frequencies; Funding; Genetic; Genetic Load; Glial Fibrillary Acidic Protein; Health; Health Sciences; Hispanic Populations; Home; Impaired cognition; Individual; Inflammation; Inflammatory; Injury; Interleukin-6; Investigation; Length; Machine Learning; Measurement; Measures; Memory; Mental Depression; Mexican Americans; Monitor; Neurodegenerative Disorders; Not Hispanic or Latino; Obesity; Oregon; Outcome; Pathway interactions; Patient Self-Report; Pattern; Peripheral; Population; Population Study; Prevalence; Prevention; Prevention strategy; Proteins; Questionnaires; Recommendation; Research; Risk; Risk Factors; Shapes; Social Desirability; Socioeconomic Factors; Socioeconomic Status; TNF gene; Tablets; Technology; Texas; Time; Travel; Underrepresented Populations; United States; United States National Institutes of Health; Universities; Ursidae Family; Weather; White Matter Hyperintensity; affective disturbance; aging brain; base; burden of illness; cognitive benefits; cohort; comorbidity; dementia risk; density; digital; ethnic minority; fitness; follow-up; health organization; high risk; hippocampal atrophy; indexing; innovation; insight; lifestyle factors; low socioeconomic status; modifiable risk; monitoring device; motion sensor; multimodal data; neuroimaging; neuroinflammation; novel; prevent; protective effect; racial minority; resilience; response; sex; social; social culture; social engagement; socioeconomics; treatment strategy

PROJECT SUMMARY/ABSTRACT The prevalence of Alzheimer’s disease and related dementias (ADRD) is projected to double over the next 20 years. Ethnic and racial minorities will bear a disproportionate burden of disease with the most staggering increase of nearly six-fold anticipated among Mexican Americans and other Hispanic groups. Nonetheless, there is marked variability in cognitive trajectories, and approximately two-thirds of Mexican Americans surviving into their 80’s will remain dementia-free. The variability in outcomes highlights the influence of risk and resilience factors, which may alter neurodegenerative disease course. Recent studies have suggested that upwards of 40% of all dementia cases may be attributable to potentially modifiable risk factors. Among these, the data supporting the protective benefits of lifestyle factors, such as physical, cognitive, and social activity engagement, are so compelling that the nation’s leading health organizations have adopted these findings as recommendations for attenuating ADRD risk. However, the protective effects of lifestyle factors in Mexican Americans, which may interact with socioeconomic factors, comorbid disease burden, genetic loading, and cultural factors, warrants further investigation. Assessment of activity engagement has typically relied on self- report, which is prone to inaccuracies due to the fallibility of memory, social desirability biases, and the limited frequency of evaluation, negating more nuanced understanding of behavioral change in response to common fluctuations in environmental and individual factors. Our team at Oregon Health & Science University has validated the Collaborative Aging Research using Technology (CART) platform, which is comprised of an integrated network of in-home monitoring devices that capture high-density multi-modal data and are coupled with algorithms to derive activity patterns that predict cognitive decline. Through a partnership with The University of Texas Health Science Center at San Antonio, we have extended the technology to the homes of 5 Mexican American older adults. We now propose to expand upon this line of research and leverage the CART platform to continuously monitor real-world physical, cognitive, and social activity patterns across a three-year period in a cohort of 120 older Mexican Americans adults (Aim 1a). We will further evaluate the modifying effects of socioeconomic status, acculturation, sex, depression, cardiovascular burden, and apolipoprotein ε4 status (Aim 1b). Next, we will explore the associations between activity engagement and traditional and novel neuroimaging indices of brain aging and ADRD (Aim 2). Finally, we will examine the inflammatory profile associated with activity engagement, as well as their associations with cognitive decline and neuroimaging outcomes (Aim 3). Leveraging the innovative CART technology platform, we will identify the activity engagement patterns that promote risk and resilience of cognitive decline in a high-risk, understudied ethnic group. Results of the study will identify multidimensional health determinants and inflammatory pathways that shape cognitive trajectories, providing insights into targeted ADRD prevention and treatment strategies within this growing population.

项目总结/摘要 阿尔茨海默病和相关痴呆症（ADRD）的患病率预计将在未来20年内翻一番。 年少数民族和种族将承受不成比例的疾病负担， 预计墨西哥裔美国人和其他西班牙裔群体的人数将增加近六倍。尽管如此， 在认知轨迹上有显著的变化，大约三分之二的墨西哥裔美国人幸存下来， 他们80多岁的时候就不会得痴呆症结果的可变性突出了风险和复原力的影响 这些因素可能会改变神经退行性疾病的进程。最近的研究表明， 40%的痴呆症病例可能归因于潜在的可改变的风险因素。其中，数据 支持生活方式因素的保护性益处，如身体、认知和社会活动参与， 是如此令人信服，全国领先的健康组织已经采用这些发现， 降低ADRD风险的建议。然而，墨西哥人生活方式因素的保护作用 美国人，这可能与社会经济因素，共病疾病负担，遗传负荷， 文化因素，值得进一步研究。对活动参与度的评估通常依赖于自我- 报告，这是容易不准确，由于记忆的易错性，社会期望偏见，和有限的 评估的频率，否定了对行为变化的更细致的理解， 环境和个人因素的波动。我们在俄勒冈州健康与科学大学的团队已经 验证了使用技术的协同老龄化研究（CART）平台，该平台由一个 家庭监控设备的集成网络，这些设备捕获高密度多模式数据， 用算法来推导出预测认知能力下降的活动模式。通过与大学的合作， 在位于圣安东尼奥的德克萨斯健康科学中心，我们已经将这项技术推广到了5个墨西哥人的家中。 美国老年人我们现在建议扩大这一研究领域，并利用CART平台 在三年的时间里，持续监测现实世界的身体、认知和社交活动模式， 一组120名墨西哥裔美国老年人（Aim 1a）。我们将进一步评估 社会经济地位、文化适应、性别、抑郁症、心血管负担和载脂蛋白ε4状态（Aim 1 b）。接下来，我们将探讨活动参与与传统和新型神经影像学之间的关联 脑老化和ADRD指标（目的2）。最后，我们将研究与炎症相关的炎症特征。 活动参与，以及它们与认知下降和神经影像学结果的相关性（目标3）。 利用创新的CART技术平台，我们将确定活动参与模式， 在高风险、未充分研究的种族群体中提高认知能力下降的风险和恢复力。研究结果 将确定塑造认知轨迹的多维健康决定因素和炎症途径， 为这一不断增长的人群提供针对性ADRD预防和治疗策略的见解。