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

项目摘要 早期发现认知和功能下降是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 可能在临床表现前数年出现，因此迫切需要一种新颖的，成本有效的， 非侵入性和可扩展的工具，以提高ADRD风险的检测。患有认知障碍的老年人通常 表现出运动、睡眠和心律的变化，表明可能有共同的血管或 神经退行性通路我们团队和其他人的新兴研究将数字信号与运动联系起来， 睡眠和心脏节律与大脑和认知健康;然而， 在这些信号中，大脑和认知健康在整个认知范围内。根据NOT-AG-20- 017，该应用程序将使用现有和正在进行的/新的数据收集直接解决这些差距， 可穿戴技术（7天加速度计和14天动态心电图（ECG）），认知 评估（神经心理成套测试、判定认知诊断）和神经影像学（florbetapir PET β淀粉样蛋白（Aβ）、神经变性和白色疾病的3 T脑MRI） 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 整合运动、睡眠和心律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。我们的首要目标是确定临床相关的数字 结合联合收割机运动、睡眠和心律信号作为认知功能的敏感指标的生物标志物， 认知轨迹、ADRD病理学和认知诊断。为此，这项研究将告知未来 在大规模研究中使用可穿戴设备，为ADRD的筛查和早期检测提供了新的靶点 在干预和治疗更可能有效的疾病阶段， 高风险参与者进行预防试验。

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.