Aerobic Exercise for Optimizing Cognitive and Brain Health In Remitted Late-Life Depression

有氧运动可优化晚年抑郁症的认知和大脑健康

• 批准号: 10538569
• 负责人: Swathi Gujral
• 金额: $ 17.02万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-14 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538569
• 关键词: Acute; Aerobic Exercise; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Area; Attenuated; Award; Biological; Brain; Brain Pathology; Brain region; Clinical; Cognition; Cognitive; Cognitive deficits; Cognitive remediation; Data; Data Analytics; Dementia; Diagnosis; Disease remission; Elderly; Exclusion; Future; Goals; Health; Hippocampus; Home; Impaired cognition; Impairment; Individual; Intervention; Investigational Therapies; Knowledge; Laboratories; Late Effects; Learning; Life Style Modification; Literature; Medical; Memory; Mental Depression; Mental disorders; Methodology; Moods; National Institute of Mental Health; Nerve Degeneration; Neuropsychology; Occipital lobe; Outcome; Outcome Measure; Participant; Pharmacological Treatment; Pharmacotherapy; Physical activity; Population; Prefrontal Cortex; Prevalence; Process; Randomized; Randomized, Controlled Trials; Recording of previous events; Recovery; Research Personnel; Risk; Supervision; Thalamic structure; Training; Translating; Vascular Dementia; aging population; analytical method; behavioral health; brain abnormalities; brain health; burden of illness; clinical translation; cognitive benefits; cognitive change; cognitive enhancement; cognitive function; cognitive performance; cognitive process; dementia risk; depressive symptoms; disability; executive function; exercise intervention; exercise training; experience; geriatric depression; gray matter; high risk; improved; lifestyle factors; mild cognitive impairment; mortality; multiple chronic conditions; neural; neural circuit; neuroimaging; neuroimaging marker; neuromechanism; neurotoxic; non-demented; poor health outcome; post intervention; preservation; prevent; social engagement; translational scientist; trial comparing

ABSTRACT Late-life depression (LLD) increases risk for numerous poor health outcomes in aging, including medical multi-morbidities, disability, and mortality. Importantly, LLD also doubles the risk for dementia relative to the general aging population. Impairment in select cognitive domains (i.e., executive function) persists even after remission of depressive symptoms in LLD. Lifestyle modification is currently the most promising non- pharmacological approach for attenuating cognitive decline in aging and preventing dementia, yet has not been used to target cognitive impairment in remitted LLD (rLLD). Aerobic exercise (AE) is a lifestyle factor that enhances cognitive functioning, with pronounced benefits for executive functioning. AE also influences neuroimaging markers of brain health in regions and networks critical for executive and memory function (i.e., prefrontal cortex, hippocampus, default-mode network). Critically, AE targets cognitive domains and brain regions and networks showing the greatest and most persistent abnormalities in LLD. The goal of the proposed study is to conduct a methodologically rigorous AE trial using comprehensive neuroimaging and neuropsychological approaches to assess the potential of AE training to 1) target systemic brain abnormalities and 2) cognitive deficits; and 3) to explore the extent to which AE effects on neuroimaging markers of brain health relate to its cognitive benefits in those with rLLD. In accordance with the NIMH Experimental Therapeutics approach, this project proposes a 6-month randomized controlled trial comparing moderate-intensity AE to a social engagement (SE) comparison condition, to examine the extent to which AE training influences structural and functional systemic brain abnormalities observed in those with rLLD. The secondary study aim is to examine the direct effect of AE training on cognitive function in those with rLLD. I will also explore the relationship between AE-related brain changes and cognitive improvements to probe neural mechanisms of AE effects on cognition in those with rLLD. The training provided through this award will include 1) building expertise in conducting laboratory- and home-based explanatory exercise interventions in geriatric psychiatric populations; and learning 2) advanced 7T neuroimaging data analytic methods and 3) longitudinal statistical analytic methods. In summary, this K23 study is the first step toward exploring biological mechanisms of the cognitive remediating effects of AE in those with rLLD using an experimental therapeutics approach. The results of this study will provide the necessary preliminary data to support the PI in her efforts to become an independent clinical translational investigator in geriatric behavioral health.

摘要 晚年抑郁症（LLD）增加了衰老过程中许多不良健康结果的风险，包括医疗 多发病、残疾和死亡率。重要的是，LLD也使痴呆症的风险增加一倍， 人口老龄化。选择认知领域的损害（即，执行功能）即使在 缓解LLD的抑郁症状。改变生活方式是目前最有前途的非- 用于减弱衰老中的认知下降和预防痴呆的药理学方法， 用于治疗缓解型LLD（rLLD）的认知障碍。有氧运动（AE）是一种生活方式因素， 增强认知功能，对执行功能有明显的好处。AE也影响 对执行和记忆功能至关重要的区域和网络中的脑健康的神经成像标记（即， 前额叶皮层、海马、默认模式网络）。关键是，AE针对认知领域和大脑 区域和网络显示最大和最持久的异常LLD。 拟议研究的目标是使用全面的方法进行严格的AE试验。 神经影像学和神经心理学方法，以评估AE培训的潜力，以1）靶向全身 大脑异常和2）认知缺陷;和3）探索AE对神经影像学的影响程度 大脑健康的标志物与rLLD患者的认知益处有关。根据NIMH 实验治疗方法，该项目提出了一项为期6个月的随机对照试验， 中等强度AE与社会参与（SE）比较条件，以检查AE 在rLLD患者中观察到的训练影响结构和功能性系统性脑异常。的 次要研究目的是检查AE训练对rLLD患者认知功能的直接影响。我会 并探讨AE相关的脑变化与认知改善之间的关系，以探索神经 AE对rLLD患者认知功能影响的机制。通过该奖项提供的培训将包括 1)建立在老年人中进行实验室和家庭为基础的解释性练习干预的专门知识 学习2）先进的7 T神经影像学数据分析方法和3）纵向 统计分析方法。 总之，这项K23研究是探索认知障碍的生物学机制的第一步。 使用实验性治疗方法在患有rLLD的患者中治疗AE的效果。的结果 研究将提供必要的初步数据，以支持主要研究者努力成为一名独立研究者。 老年行为健康的临床转化研究者。