Impact of Physical Activity on Stroke and Cognitive Function in Older Adults

体力活动对老年人中风和认知功能的影响

• 批准号: 7591504
• 负责人: STEVEN PAUL HOOKER
• 金额: $ 59.81万
• 依托单位: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7591504
• 关键词: Adult; Affect; African American; Age; Age-Years; Aging; Alabama; American; Ancillary Study; Appendix; Area; Atrial Fibrillation; Blood Pressure; Body mass index; Brain; C-reactive protein; Cardiovascular Diseases; Clinical; Cognition; Communities; Coronary; Coronary heart disease; Data; Data Collection; Dimensions; Disease; Dose; Elderly; Electronics; End Point; Energy Metabolism; Enrollment; Epidemiology; Event; Expenditure; Family health status; Foundations; Frequencies; Funding; Gender; Geographic Locations; Glucose; Health; Hypertension; Impaired cognition; Incidence; Institutes; Investments; Knowledge; Life; Link; Lipids; Longitudinal Studies; Measurement; Measures; Mediating; Medical Records; Medical Surveillance; Myocardial Infarction; Outcome; Parents; Pattern; Personal Satisfaction; Physical activity; Plasma; Platelet Count measurement; Population; Population Group; Population Heterogeneity; Positioning Attribute; Prevention; Prevention strategy; Prospective Studies; Public Health; Publishing; Race; Recommendation; Recording of previous events; Recruitment Activity; Research Personnel; Risk; Risk Factors; Role; Sampling; Socioeconomic Status; Stroke; Stroke prevention; Subgroup; United States National Institutes of Health; Universities; Variant; Woman; aging population; base; cardiovascular disorder risk; cognitive change; cognitive function; cohort; design; follow-up; geographic difference; improved; insight; men; mortality; nervous system disorder; racial difference; response; sex

DESCRIPTION (provided by applicant): None of the published studies that have related physical activity (PA) exposures with stroke outcomes have included a representative population sample, none have used objective measures of PA, and none have been specifically designed to examine racial or geographical variations in PA patterns and stroke incidence. In this application we propose an ancillary study to examine PA patterns and stroke risk in a racially and geographically diverse population sample of nearly 22,000 free-living women and men enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. REGARDS, managed by investigators at the University of Alabama at Birmingham, is a recently initiated prospective study funded by National Institute of Neurological Disorders and Stroke. The focus of the proposed ancillary study (i.e., REGARDS-PA) will be to quantify usual ambulatory PA patterns in terms of frequency, duration and intensity, and thus, the total dose of activity-related minutes and energy expenditure (EE). PA exposures will be related with the occurrence of stroke events and the degree to which these associations are confounded or modified by sex, race, geographical location, and conventional CVD risk factors. Strengths of the study will be the large population sample of racially and geographically diverse adults broadly representative of the overall U.S. population 45 years of age and older, use of objectively-measured PA from an electronic accelerometer, access to extensive baseline data on personal and family health histories, CVD risk predictors including plasma markers and selected physical measurements, 5-year surveillance for stroke events at 6-month intervals, and confirmation of incident stroke events and other study endpoints by medical record review. Findings from this study will provide empirical evidence of the role that variation in PA levels has on differences in stroke occurrence among population subgroups as defined by race and geographic region, which could have important clinical and public health implications for enhancing health-related PA recommendations and for improving population based stroke prevention strategies. REGARDS is also uniquely positioned to provide insights to the first national data on predictors of cognitive change. Because cognitive function, which in many instances is directly impacted by stroke, also will be recorded regularly during the follow-up period, the opportunity exists to expand on the primary analyses to investigate whether any variations in this clinical outcome are explained by variations in PA. Additionally, the dose-response relationship between PA and cognitive function will be explored with greater accuracy than any other previous longitudinal study due to the objective measurement of PA. Such data will be critical in developing effective PA recommendations to maintain optimal cognitive function during aging. This is much needed considering the overall aging of the U.S. population and strong importance American adults place on maintaining brain health as they age. PUBLIC HEALTH RELEVANCE Findings from this study will provide empirical evidence of the role that variation in physical activity (PA) levels has on differences in stroke and cognitive impairment occurrence among population subgroups as defined by age, gender, race, and geographic region. Such findings could have important clinical and public health implications for enhancing health-related PA recommendations and for improving population-based stroke and cognitive decline prevention strategies. This is much needed considering the overall aging of the U.S. population and strong importance American adults place on maintaining health and function as they age.

描述（由申请人提供）：没有一项具有相关体育锻炼（PA）风险与中风结局的已发表的研究包括代表性的人群样本，没有一项使用PA的客观度量，并且没有专门设计用于检查PA模式和中风发生率的种族或地理变化。在此应用中，我们提出了一项辅助研究，以检查近22,000名自由生活的男女的种族和地理不同人口样本中的PA模式和中风风险。在阿拉巴马大学伯明翰大学的调查人员管理的情况下，是一项由国家神经系统疾病和中风研究所资助的最近发起的前瞻性研究。拟议的辅助研究的重点（即PARD-PA）将根据频率，持续时间和强度来量化常规的非卧床PA模式，因此，与活动相关的分钟和能量消耗（EE）的总剂量（EE）。 PA暴露将与中风事件的发生以及这些关联被性别，种族，地理位置和常规CVD风险因素混淆或修改的程度有关。 Strengths of the study will be the large population sample of racially and geographically diverse adults broadly representative of the overall U.S. population 45 years of age and older, use of objectively-measured PA from an electronic accelerometer, access to extensive baseline data on personal and family health histories, CVD risk predictors including plasma markers and selected physical measurements, 5-year surveillance for stroke events at 6-month intervals, and confirmation of incident stroke events and other研究终点通过病历审查。这项研究的结果将提供经验证据表明，PA水平的变化对种族和地理区域定义的人群亚组的中风发生差异具有的作用，这可能对增强与健康相关的PA建议并改善基于人群的研究具有重要的临床和公共卫生影响。 预防策略。也有唯一的定位，可以为第一个提供见解 关于认知变化预测指标的国家数据。因为认知功能，在许多情况下是 直接受到中风的影响，也将在随访期间定期记录，存在扩展主要分析的机会，以研究该临床结果的任何变化是否通过PA的变化来解释。此外，由于PA的客观测量，PA和认知功能之间的剂量反应关系将比其他任何以前的纵向研究更高。此类数据对于制定有效的PA建议至关重要，以在衰老期间保持最佳认知功能。考虑到美国人口的整体老龄化以及美国成年人在维持大脑健康上的重要性，这是非常需要的。这项研究的公共卫生相关性结果将提供经验证据表明，体育活动（PA）水平的变化在人口亚组中的中风和认知障碍差异的差异在年龄，性别，种族和种族和认知障碍之间存在差异。 地理区域。这样的发现可能对增强与健康相关的PA建议以及改善基于人群的中风和认知能力下降的预防策略具有重要的临床和公共卫生影响。考虑到美国人口的整体老龄化以及美国成年人在保持健康和功能随着年龄的增长方面的重要性，这是非常需要的。