Targeting Cognitive Control to Improve Physical Activity Adherence in Midlife for Alzheimer's Risk Reduction

以认知控制为目标，提高中年体力活动的坚持，从而降低阿尔茨海默病的风险

• 批准号: 10488462
• 负责人: MICHELLE WEBB VOSS
• 金额: $ 34.84万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10488462
• 关键词: Accounting; Adherence; Adopted; Adoption; Adult; Affect; Affective; Age; Age-associated memory impairment; Aging; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease risk; American; Attention; Behavior; Benchmarking; Boston; Brain; Cities; Cognitive; Cognitive aging; Control Groups; Coupled; E-learning; Effectiveness; Effectiveness of Interventions; Emotional; Environment; Exercise; Experimental Designs; Exposure to; Face; Feedback; Feeling; Fright; Future; Goals; Habits; Health; Heart; Impaired cognition; Informal Social Control; Intention; Intervention; Iowa; Life; Literature; Longevity; Maintenance; Mind; Modeling; Motivation; Nerve Degeneration; Pathology; Performance; Persons; Phase; Physical Exercise; Physical activity; Plant Roots; Prevention; Public Health; Randomized Controlled Trials; Reporting; Research; Research Support; Risk Reduction; Role; Rural; Sampling; Self Efficacy; Severities; Short-Term Memory; Site; Stimulus; Structure; Testing; Training; Training Programs; Treatment Efficacy; active lifestyle; aging brain; base; behavior change; cognitive capacity; cognitive control; cognitive training; computerized; cost; critical period; design; efficacy testing; environmental change; exercise intervention; experience; flexibility; high risk; improved; insight; intervention program; mange; middle age; moderate-to-vigorous physical activity; negative affect; physical conditioning; prevent; programs; psychosocial; racial and ethnic; resilience; sedentary; success; theories; vigorous intensity; young adult

Although evidence in favor of physical activity (PA) for reducing age-related cognitive decline and associated Alzheimer’s risk continues to grow, critical issues are persistently low PA adoption and adherence during critical periods for Alzheimer’s prevention. Because PA starts declining at middle-age and neurodegenerative pathologies increasing Alzheimer’s risk start decades before cognitive impairment, there is a pressing need to understand how and why middle-age adults can more successfully adopt and sustain PA. Self-regulatory capacities have been identified as critical for acting on our intentions and plans to be more physically active, however causal evidence testing whether and how strongly self-regulatory capacities affect PA behavior change is absent from the literature. Therefore, our objective is to test the causal role of the self-regulation construct, cognitive control, in PA behavior change among inactive middle-aged adults. Based on the Temporal Self-Regulation Theory (TST), we hypothesize cognitive training designed to improve cognitive control will increase the success of a PA behavior change program, and training cognitive control with emotionally valenced stimuli will further increase moderate-to-vigorous PA adherence. Our predictions are based on research showing the importance of cognitive control in PA adherence and maintenance, evidence that negative affective experiences of PA are common and detrimental to future PA, and the modifiability of cognitive control with adaptive cognitive training. We test our overall hypothesis with three aims, including an R61 phase (Aim 1) to develop and refine a computerized training program targeting aspects of motivation, planning, and cognitive control theorized to promote PA behavior change, followed by an implementation R33 phase (Aim 2) with a lab-based, randomized controlled trial (RCT) to determine the extent that cognitive control for emotionally valenced information is a target mechanism for PA behavior change in inactive middle-age adults at moderate-to-high risk for Alzheimer’s. The RCT implemented in Aim 2 will be tested across rural and urban sites to increase diversity and generalizability of our sample, which forms the basis for (Aim 3) determining moderators of intervention efficacy for improving PA behavior change. We predict those with poor cognitive control and high negative affective experiences to moderate intensity PA will benefit most from cognitive control training targeted to an affective domain for PA behavior change. Our results will be significant by determining the causal role of cognitive control and affect in sustainable PA behavior change in midlife, a critical prevention period for Alzheimer’s. Success will culminate in a scalable training program to boost PA adherence, setting the stage for personalized and accessible strategies for midlife adults to change their course towards a more physically active lifestyle and a virtuous cycle of sustained cognitive and physical health.

尽管支持体力活动(PA)以减少与年龄相关的认知衰退和相关的阿尔茨海默病风险的证据继续增加，但关键问题是在阿尔茨海默氏症预防的关键时期，体力活动(PA)的采用率和依从性一直较低。由于PA在中年就开始下降，而增加阿尔茨海默氏症风险的神经退行性病理在认知障碍的几十年前就开始了，因此迫切需要了解中年人如何以及为什么能够更成功地采用并维持PA。自我调节能力已被认为是根据我们的意图和计划进行更多身体活动的关键，然而，文献中没有因果证据来测试自我调节能力是否以及如何强烈地影响PA的行为改变。因此，我们的目标是测试自我调节结构，认知控制，在不活跃的中年人的PA行为改变中的因果作用。基于时间自我调节理论(TST)，我们假设，旨在提高认知控制的认知训练将增加PA行为改变计划的成功率，而使用情绪效价刺激训练认知控制将进一步增加适度到剧烈的PA依从性。我们的预测是基于研究表明认知控制在PA坚持和维持中的重要性，有证据表明PA的负面情感体验是常见的并对未来的PA有害，以及认知控制通过适应性认知训练的可调性。我们用三个目标来检验我们的总体假设，包括R61阶段(目标1)，以开发和完善计算机化的培训计划，目标是从理论上促进PA行为改变的动机、计划和认知控制方面；其次是实施R33阶段(Aim 2)，通过基于实验室的随机对照试验(RCT)来确定对情感配价信息的认知控制在多大程度上是阿尔茨海默氏症风险中高风险的不活跃的中年成年人PA行为变化的目标机制。目标2中实施的RCT将在农村和城市地点进行测试，以增加样本的多样性和普适性。这构成了(目标3)确定改善PA行为改变的干预效果的调节因素的基础。我们预测，那些认知控制能力差、负性情绪体验高至中等强度的PA将从针对PA行为改变的情感领域的认知控制训练中受益最大。通过确定认知控制和影响在中年可持续的PA行为变化中的因果作用，我们的结果将具有重要意义。中年是阿尔茨海默氏症的关键防御期。成功的最终结果将是一个可扩展的培训计划，以提高PA的忠诚度，为中年成年人改变路线，走向更积极的生活方式和持续认知和身体健康的良性循环奠定基础。