Napping, Sleep, Cognitive Decline and Risk of Alzheimer's Disease

打盹、睡眠、认知能力下降和阿尔茨海默病风险

• 批准号: 10461715
• 负责人: Yue Leng
• 金额: $ 24.84万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10461715
• 关键词: Address; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Award; Behavior; Biochemical; Biological Markers; Caregivers; Circadian Rhythms; Clinical Research; Cognition; Cognitive; Cognitive Therapy; Cognitive aging; Communities; Complement; Data; Dementia; Development; Diabetes Mellitus; Diagnosis; Dimensions; Drowsiness; Early Diagnosis; Elderly; Epidemiologist; Epidemiology; Etiology; Fracture; Frequencies; Funding; Goals; Health; Hour; Impaired cognition; Impairment; Inflammation; Intention; Intervention; Intervention Studies; Investigation; Knowledge; Lead; Link; Measures; Mediating; Medicine; Mentorship; Metabolic; Napping; Nerve Degeneration; Neurology; Observational Study; Onset of illness; Outcome; Oxidative Stress; Pathway interactions; Patient Self-Report; Patients; Persons; Phase; Phototherapy; Pilot Projects; Polysomnography; Program Development; Prospective Studies; Psychiatry; Recording of previous events; Recovery; Research; Research Activity; Research Design; Research Personnel; Research Training; Resources; Risk; Risk Factors; Role; Serum; Sleep; Sleep Disorders; Sleep Wake Cycle; Sleep disturbances; Sleeplessness; Supervision; Testing; Time; Training; Work; actigraphy; cognitive testing; comorbidity; epidemiology study; experience; high risk; high risk population; improved; men; mild cognitive impairment; modifiable risk; mortality; multidisciplinary; novel; older women; osteoporosis with pathological fracture; pilot test; prevent; professor; programs; sleep behavior; sleep pattern; therapy development; treatment program; young adult

PROJECT SUMMARY Napping is highly prevalent in the elderly, particularly in patients with Alzheimer's disease, but the longitudinal effects of napping on neurodegeneration are poorly understood. While growing evidence suggests that sleep disturbances lead to increased risk of Alzheimer's disease, it is unclear whether napping, as a crucial part of the 24-h sleep-wake cycle, could be as important a risk factor as nocturnal sleep for Alzheimer's disease. This Pathway to Independence Award (K99/R00) application by Dr. Yue Leng intends to fill this knowledge gap by building on her prior epidemiologic research that suggests associations between self-reported napping and risk of various adverse health outcomes in the elderly, and will provide Dr. Leng with further focused trainings to facilitate her transition into an independent researcher in the field of napping, sleep and cognitive aging. The research aims during the K99 phase are to determine the independent and longitudinal effects of actigraphy- measured napping on cognitive decline and risk of incident mild cognitive impairment (MCI) and Alzheimer's disease, and to explore and elucidate potential mechanisms, including inflammation, oxidative stress, metabolic dysregulation and other comorbidities. Different dimensions of napping (i.e., intention, duration, frequency and timing) will also be explored and used to inform the development of a treatment program in R phase. This project will leverage data from two NIA-funded state-of-the-art prospective studies of aging, the Osteoporotic Fractures in Men (MrOS) Study and Study of Osteoporotic Fractures (SOF), both with 24-hour actigraphy recordings of napping and nocturnal sleep, widely used cognitive tests and serum biochemical measures. These research activities will be complemented by focused trainings in 1) etiology, diagnosis and management of Alzheimer's and other dementias; 2) interventional study design and conduct; and 3) aging- related sleep medicine. The training goals will be supervised by a multidisciplinary mentorship team, led by Dr. Kristine Yaffe, MD, Professor of Psychiatry, Neurology and Epidemiology. By the end of the training phase, Dr. Leng will develop expertise in sleep measurement and intervention to successfully transition into the R00 project, which aims to develop and pilot test a treatment program that incorporates bright light therapy and a modified cognitive behavioral therapy for insomnia (CBT-i) to improve 24-hour patterns of sleep in patients with MCI or mild Alzheimer's disease, with the ultimate aim of decreasing risk of Alzheimer's onset or progression. The combined 5-year research and training plan will allow Dr. Leng to establish an independent research program dedicated to the improvement of both sleep and aging outcomes. The current proposal will also specifically 1) advance knowledge about the effects of napping, an extremely common but understudied behavior in the elderly, on cognitive aging; 2) develop a novel sleep treatment program targeting patients with MCI; and 3) pilot a line of research on interventions of 24-h sleep patterns in order to improve cognitive outcomes and prevent Alzheimer's disease in high-risk population.

项目摘要 午睡在老年人中非常普遍，特别是在阿尔茨海默病患者中，但纵向研究表明， 午睡对神经退化的影响还知之甚少。越来越多的证据表明睡眠 虽然睡眠紊乱会导致老年痴呆症的风险增加，但目前还不清楚午睡作为老年痴呆症的重要组成部分， 24小时睡眠-觉醒周期可能是与夜间睡眠一样重要的阿尔茨海默病风险因素。这 岭余博士的独立之路奖（K99/R 00）申请旨在填补这一知识空白， 她之前的流行病学研究表明，自我报告的午睡与风险之间存在关联， 的各种不利的健康后果，并将为冷博士提供进一步的重点培训， 帮助她成为午睡、睡眠和认知老化领域的独立研究人员。的 K99阶段的研究目标是确定体动记录仪的独立和纵向效应- 测量午睡对认知能力下降和轻度认知障碍（MCI）和阿尔茨海默氏症的风险 疾病，并探索和阐明潜在的机制，包括炎症，氧化应激， 代谢失调和其他合并症。不同的起绒尺寸（即，意图、持续时间 频率和时间）也将被探索和用于告知R治疗计划的发展 相位该项目将利用来自两个国家的国家的最先进的老龄化前瞻性研究， 男性骨质疏松性骨折（MrOS）研究和骨质疏松性骨折（SOF）研究，均为24小时 活动记录仪记录午睡和夜间睡眠，广泛使用的认知测试和血清生化 措施这些研究活动将得到以下方面的重点培训的补充：1）病因学，诊断和 阿尔茨海默氏症和其他痴呆症的管理; 2）干预性研究设计和实施;以及3）衰老- 与睡眠有关的药物培训目标将由一个多学科的导师团队监督，由博士领导。 Kristine Yaffe，医学博士，精神病学，神经病学和流行病学教授。在培训结束后，博士。 Leng将发展睡眠测量和干预方面的专业知识，以成功过渡到R 00 该项目旨在开发和试点测试一种治疗方案，该方案将明亮的光疗法和 失眠症的改良认知行为疗法（CBT-i），以改善患者的24小时睡眠模式， MCI或轻度阿尔茨海默病，最终目的是降低阿尔茨海默病发作或进展的风险。 结合5年的研究和培训计划将允许冷博士建立一个独立的研究 致力于改善睡眠和衰老结果的计划。目前的提案还将 具体来说，1）关于午睡影响的先进知识，一个非常普遍但研究不足的问题， 行为在老年人中，认知老化; 2）开发一种新的睡眠治疗方案，针对患者 MCI;以及3）对24小时睡眠模式的干预进行一系列研究，以改善认知功能。 结果和预防高危人群中的阿尔茨海默病。

项目成果

Interventions involving a major dietary component improve cognitive function in cognitively healthy adults: a systematic review and meta-analysis.

涉及主要饮食成分的干预措施可改善认知健康成年人的认知功能：系统评价和荟萃分析。

• DOI: 10.1016/j.nutres.2019.02.008
• 发表时间: 2019
• 期刊: Nutrition research (New York, N.Y.)
• 作者: McEvoy,ClaireT;Leng,Yue;Peeters,GeeskeMee;Kaup,AllisonR;Allen,IsabelE;Yaffe,Kristine
• 通讯作者: Yaffe,Kristine

Sleep Timing and Risk of Dementia Among the Chinese Elderly in an Urban Community: The Shanghai Aging Study.

• DOI: 10.3389/fneur.2021.629507
• 发表时间: 2021
• 期刊: Frontiers in neurology
• 影响因子: 3.4
• 作者: Li X;Ding D;Zhao Q;Wu W;Xiao Z;Luo J;Yaffe K;Leng Y
• 通讯作者: Leng Y

Associations of 24-Hour Light Exposure and Activity Patterns and Risk of Cognitive Impairment and Decline in Older Men: The MrOS Sleep Study.

24 小时光照和活动模式与老年男性认知障碍和衰退风险的关联：MrOS 睡眠研究。

• DOI: 10.1093/gerona/glac187
• 发表时间: 2023
• 期刊: The journals of gerontology. Series A, Biological sciences and medical sciences
• 作者: Blackwell,TerriL;Figueiro,MarianaG;Tranah,GregoryJ;Zeitzer,JamieM;Yaffe,Kristine;Ancoli-Israel,Sonia;Kado,DeborahM;Ensrud,KristineE;Lane,NancyE;Leng,Yue;Stone,KatieL;OsteoporoticFracturesinMen(MrOS)StudyGroup
• 通讯作者: OsteoporoticFracturesinMen(MrOS)StudyGroup

Race Differences in the Association Between Sleep Medication Use and Risk of Dementia.

• DOI: 10.3233/jad-221006
• 发表时间: 2023
• 期刊: Journal of Alzheimer's disease : JAD
• 作者: Leng Y;Stone KL;Yaffe K
• 通讯作者: Yaffe K

Current Alzheimer disease research highlights: evidence for novel risk factors.

• DOI: 10.1097/cm9.0000000000001706
• 发表时间: 2021-09-09
• 期刊: Chinese medical journal
• 影响因子: 6.1
• 作者: Brenowitz WD;Xiang Y;McEvoy CT;Yang C;Yaffe K;Le WD;Leng Y
• 通讯作者: Leng Y