Novel application of Digital signals of movement, sleep and heart rhythms for detection of Alzheimer's Disease and Related Dementias

项目总结 早期发现认知和功能衰退是NIA对抗阿尔茨海默氏症的主要目标 疾病及相关痴呆(ADRD)。与ADRD相关的身体、生理和认知变化 可能出现在临床症状之前数年，因此迫切需要新颖、经济、 非侵入性、可扩展的工具，可改进ADRD风险检测。患有认知障碍的老年人经常 表现出运动、睡眠和心率的变化，提示可能有共同的血管或 神经退行性变的途径。我们团队和其他人的新研究将运动产生的数字信号联系起来， 睡眠、心跳节律与大脑和认知健康；然而，知识差距仍然存在 在这些信号中，大脑和认知健康贯穿认知光谱。回应NOT-AG-20- 017，该应用程序将使用现有的和正在进行的/新的数据收集直接解决这些差距 可穿戴技术(7天加速测量和14天动态心电图)，认知 评估(神经心理成套测验、已判定的认知诊断)和神经成像(氟倍他匹PET 对于β淀粉样蛋白(Aβ)，3T脑核磁共振用于神经退行性变和白质疾病)来自≥1000老年人 参与社区动脉粥样硬化风险(ARIC)神经认知研究。我们将使用新的分析 综合运动、睡眠和心率特征并评估其个体和关节的方法 与大脑和认知健康的关系。我们的首要目标是识别与临床相关的数字 结合运动、睡眠和心率信号的生物标志物，作为认知功能的敏感指标， 认知轨迹、ADRD病理学和认知诊断。为此，这项研究将为未来提供信息 可穿戴设备在大规模研究中的使用，为ADRD的筛查和早期检测提供了新的靶点 在干预和治疗更有可能有效的疾病阶段，并帮助确定 预防试验的高危参与者。

PROJECT SUMMARY Early detection of cognitive and functional decline is a major goal of the NIA in its fight against Alzheimer's Disease and Related Dementias (ADRD). Physical, physiological, and cognitive changes associated with ADRD may emerge years prior to clinical manifestations, thus there is an urgent need for novel, cost-effective, noninvasive, and scalable tools to improve detection of ADRD risk. Older adults with cognitive impairment often exhibit changes in movement, sleep, and heart rhythms, suggesting possible shared vascular or neurodegenerative pathways. Emerging research from our group and others links digital signals from movement, sleep, and heart rhythms with brain and cognitive health; however, knowledge gaps remain in the associations among these signals and brain and cognitive health across the cognitive spectrum. In response to NOT-AG-20- 017, this application will directly address these gaps using existing and ongoing/new data collection from wearable technology (7-day accelerometry and 14-day ambulatory electrocardiogram (ECG)), cognitive assessments (neuropsychological battery, adjudicated cognitive diagnosis), and neuroimaging (florbetapir PET for beta amyloid (Aβ), 3T brain MRI for neurodegeneration and white matter disease) from ≥1000 older adults participating in the Atherosclerosis Risk in Communities (ARIC) Neurocognitive Study. We will use novel analytic approaches to integrate movement, sleep, and heart rhythm features and assess their individual and joint associations with brain and cognitive health. Our overarching goal is to identify clinically relevant digital biomarkers that combine movement, sleep, and heart rhythm signals as sensitive indicators of cognitive function, cognitive trajectories, ADRD pathology, and cognitive diagnosis. To this end, this research will inform the future use of wearable devices in large-scale studies, provide novel targets for screening and early detection of ADRD in disease stages during which intervention and treatment are more likely to be effective, and aid in identifying high-risk participants for prevention trials.