Light Physical Activity for Brain Health in Older Adult Breast Cancer Survivors

轻度体力活动有利于老年乳腺癌幸存者的大脑健康

• 批准号: 10464004
• 负责人: Brett Ryan Gordon
• 金额: $ 6.86万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10464004
• 关键词: Address; Advisory Committees; Aftercare; Alcohol consumption; Alcohols; Alzheimer' s Disease; Alzheimer' s disease risk; American; American Cancer Society; Anxiety; Biometry; Breast Cancer Treatment; Breast Cancer survivor; Cancer Survivor; Carcinogens; Cessation of life; Clinical Trials; Consensus; Consumption; Data; Dementia; Diagnosis; Dose; Ecological momentary assessment; Elderly; Exercise; Face; Fellowship; General Population; Grant; Guidelines; Health; Health behavior; Human; Impaired cognition; Individual; Inflammatory; International; Intervention; Knowledge; Late Effects; Learning; Light; Mental Health; Mentors; Obesity; Obesity Epidemic; Oncology; Outcome; Participant; Patient Self-Report; Physical activity; Population Study; Postdoctoral Fellow; Process; Randomized; Randomized Controlled Trials; Recurrence; Reporting; Research; Research Personnel; Risk; Role; Series; Sports Medicine; Survival Rate; Survivors; Symptoms; Training; United States; United States National Institutes of Health; Work; aged; anxiety symptoms; arm; base; brain health; cancer diagnosis; cognitive function; college; drinking; efficacy trial; exercise intervention; experience; health care settings; improved; light effects; light intensity; malignant breast neoplasm; meetings; modifiable behavior; mortality; multidisciplinary; novel; obese person; physical conditioning; primary outcome; psychological symptom; randomized trial; response; treatment as usual; treatment effect; vigorous intensity

Project Summary/Abstract Although breast cancer is the most frequently diagnosed cancer in the world, recently, the survival rate has greatly improved. With this improved survival rate, there is a growing population of obese, older adult breast cancer survivors facing unique challenges and late effects on brain health. Breast cancer survivors suffer cognitive impairments before, during, and post- treatment; more than one third experience persistent cognitive impairment lasting decades. Anxiety is the most common psychological symptom among cancer survivors, and frequently unrecognized and undertreated in health care settings. These survivors are also at increased risk of Alzheimer’s disease or dementia. There is unanimous consensus that physical activity and alcohol consumption are key modifiable behaviors to improve the physical and mental health of cancer survivors. Further, the American Cancer Society promotes increasing physical activity, and avoiding alcohol to manage treatment-related cognitive impairment. Although the benefits of physical activity for cancer survivors are well-established, the evidence is predominantly derived from guidelines-based, moderate-to-vigorous-intensity physical activity. However, survivors often do not meet guidelines for moderate-to-vigorous-intensity physical activity, do not adhere to physical activity interventions set at this intensity, and enjoy and prefer lighter-intensity activities. Much less is known about the effects of light-intensity physical activity on cognitive function and anxiety symptoms, and the 2018 United States Physical Activity Guidelines Advisory Committee Scientific Report identified the need to determine the role and contribution of light-intensity activity to diverse health outcomes as an overarching research need. Additionally, less is known about the effects of physical activity interventions on changes in alcohol consumption. Recent findings indicate physical activity may unintentionally increase alcohol consumption among cancer survivors. Increasing alcohol consumption places survivors at increased risk of recurrence, and may confound the positive effects of physical activity. Therefore, in the process of evaluating the effects of light-intensity physical activity on brain health outcomes among obese, older adult breast cancer survivors, the effects on alcohol consumption should be evaluated as well, to avoid unintended consequences. The light- intensity physical activity-breast cancer survivors (LIPA-BCS) trial addresses multiple knowledge gaps, with a primary and secondary focus on improving cognitive function and anxiety symptoms. The proposed work builds on this existing randomized controlled trial that randomizes obese, older adult breast cancer survivors 1-10 years post-breast cancer treatment, to either 15 weeks of light-intensity physical activity, or usual care. I will take advantage of this existing clinical trial to quantify and describe the effects on cognitive function, anxiety symptoms, and observe associated changes in alcohol consumption. To achieve this aim, we will assess cognitive function, anxiety symptoms, and alcohol consumption both pre- post, and utilizing ecological momentary assessments in 14-day bursts throughout the 15 week intervention. Through this research experience, and proposed post-doctoral fellowship, I will learn about the conduct of high quality human clinical trials among obese, older adult cancer survivors, and receive mentored training in ecological momentary assessments, biostatistics, and becoming an independent investigator in exercise oncology.

项目总结/摘要 虽然乳腺癌是世界上最常见的癌症，但最近，生存率大大提高。 随着生存率的提高，越来越多的肥胖、老年乳腺癌幸存者面临着独特的 对大脑健康的挑战和后期影响。乳腺癌幸存者在治疗前、治疗中和治疗后都会出现认知障碍。 治疗;超过三分之一的人经历持续数十年的持续认知障碍。焦虑是最常见的 癌症幸存者的心理症状，在卫生保健机构中经常被忽视和治疗不足。 这些幸存者患阿尔茨海默病或痴呆症的风险也会增加。大家一致认为， 活动和饮酒是改善癌症患者身心健康的关键可改变行为。 幸存者此外，美国癌症协会提倡增加身体活动，避免饮酒，以控制癌症。 治疗相关的认知障碍虽然身体活动对癌症幸存者的好处是众所周知的， 证据主要来自基于指南的中等至剧烈强度的体力活动。然而，在这方面， 幸存者往往不符合中到高强度体力活动的指导方针，不坚持体力活动， 活动干预设置在这个强度，并享受和更喜欢轻强度的活动。关于这一点，我们所知甚少。 轻强度体力活动对认知功能和焦虑症状的影响，以及2018年美国物理学 活动指导方针咨询委员会的科学报告指出，需要确定 光强度活动对不同的健康结果作为一个总体的研究需要。此外，对 身体活动干预对酒精消费变化的影响。最近的研究结果表明，体力活动可能 无意中增加了癌症幸存者的酒精消费。增加酒精消费使幸存者 复发的风险增加，并可能混淆身体活动的积极影响。因此，在 评估轻度体力活动对肥胖、老年乳腺癌患者大脑健康结果的影响 此外，还应评估酒精消费对幸存者的影响，以避免意想不到的后果。光- 强度体力活动-乳腺癌幸存者（LIPA-BCS）试验解决了多个知识缺口，主要 其次注重改善认知功能和焦虑症状。拟议的工作建立在现有的 一项随机对照试验，对乳腺癌术后1-10年的肥胖老年乳腺癌幸存者进行随机分组 治疗，无论是15周的轻强度体力活动，或常规护理。我将利用现有的临床 一项量化和描述对认知功能、焦虑症状的影响，并观察酒精相关变化的试验 消费为了实现这一目标，我们将评估认知功能，焦虑症状和饮酒量， 在15周的干预期间，在14天的突发事件中使用生态瞬时评估。通过这个 研究经验，并提出博士后奖学金，我将了解高质量的人类临床进行 在肥胖的老年癌症幸存者中进行试验，并接受生态瞬时评估的指导培训， 生物统计学，并成为运动肿瘤学的独立研究者。