Cognitive/Brain Effects of Adding Weight Loss to Exercise in Obese Older Adults

肥胖老年人在锻炼中加入减肥对认知/大脑的影响

• 批准号: 9281609
• 负责人: CHRISTINA E HUGENSCHMIDT
• 金额: $ 12.17万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9281609
• 关键词: Activities of Daily Living; Address; Adult; Aerobic Exercise; Affect; Aging; Attenuated; Behavioral; Body Composition; Body Weight; Body Weight decreased; Brain; Budgets; Caloric Restriction; Cardiovascular system; Cerebrovascular Circulation; Cerebrum; Clinical; Clinical Trials; Clinical Trials Network; Cognition; Cognitive; Complement; Conduct Clinical Trials; Data; Dementia; Education; Educational Intervention; Elderly; Energy Intake; Energy Metabolism; Ensure; Epidemic; Exercise; Fatty acid glycerol esters; Functional Magnetic Resonance Imaging; Functional disorder; Funding; Goals; Health; Healthcare; Healthcare Activity; Hypertension; Image Analysis; Impaired cognition; Individual; Inflammation; Institutionalization; Insulin Resistance; Intervention; Intervention Studies; Intervention Trial; Knowledge; Lead; Life Style; Link; Magnetic Resonance Imaging; Measures; Mentored Research Scientist Development Award; Mentors; Metabolic; Metabolic Diseases; National Research Service Awards; Neurosciences; Obesity; Overweight; Parents; Participant; Perfusion; Pericardial body location; Phenotype; Physical Function; Physiological; Population; Public Health; Randomized; Randomized Clinical Trials; Recording of previous events; Regimen; Research; Research Personnel; Rest; Risk; Risk Factors; Secure; Structure; Syndrome; Techniques; Time; Training; Treatment Efficacy; United Nations; Walking; Weight; Woman; Work; World Health Organization; abdominal fat; blood glucose regulation; brain volume; career; cerebral atrophy; cognitive enhancement; cognitive function; cognitive testing; cost; design; executive function; exercise intervention; experience; graph theory; improved; inflammatory marker; insulin sensitivity; men; modifiable risk; neuroimaging; neuronal growth; novel; post intervention; public health relevance; relating to nervous system; remediation; sedentary; theories; therapy design; translational scientist; treadmill; weight loss intervention; white matter

DESCRIPTION (provided by applicant): The population in the US and worldwide is aging rapidly~ the United Nations estimates that by 2050, for the first time in history, the population f older people will exceed the population of younger people. At the same time, obesity is rapidly reaching epidemic proportions. The World Health Organization states that worldwide, obesity has doubled since 1980, and in 2008, 1.5 billion adults were obese. The combination of an aging, overweight population has serious implications for cognitive health, as aging and obesity are both associated with cognitive decline, as are risk factors that are increased by both aging and obesity, such as insulin resistance and hypertension. Poor cognitive function is a significant public health concern, particularly in older adults, because it can reduce an individual's ability o perform activities of daily living or follow prescribed health care activities, leads to increased institutionalization and loss of independence. There is good evidence that aerobic exercise benefits cognitive function in older adults. Exercise also improves glucose regulation and insulin sensitivity, and may lower inflammation, all potential mechanisms for exercise-induced improvement in cognition. Intentional weight loss through reduced caloric intake improves metabolic risk factors for cognitive decline more than exercise alone, suggesting that weight and fat loss may enhance the cognitive benefits of exercise. However, whether weight loss is safe and healthy for older adults is a matter of controversy, and some studies actually show that higher body weight is associated with better cognition in older adults. Thus, it is unknown whether adding caloric restriction to an aerobic exercise intervention provides an additive benefit on cognition, and brain structure and function, beyond exercise alone in obese older adults. The proposed study addresses concerns of national and worldwide health significance by investigating the effects of adding weight loss to exercise in obese older adults as a potential avenue for remediation of obesity-related cognitive decline in older adults. This study also provides an excellent avenue for training for the candidate, whose overall career goal is to become an independent clinical and translational researcher. Her strong background in cognitive neuroimaging of aging will be augmented by training in clinical trial research and behavioral weight loss interventions~ new analysis techniques~ and knowledge of obesity, dementia, and other geriatric syndromes. This training will allow her to design new trials that further investigate the relationships between modifiable risk factors for metabolic disease and the brain and cognition.

描述（由申请人提供）：美国和世界范围内的人口正在迅速老龄化，联合国估计，到2050年，历史上第一次，老年人口将超过年轻人口。与此同时，肥胖正迅速达到流行病的程度。世界卫生组织表示，自1980年以来，全球肥胖人数翻了一番，2008年，有15亿成年人肥胖。老龄化和超重人口的结合对认知健康有严重影响，因为老龄化和肥胖都与认知能力下降有关，胰岛素抵抗和高血压等因老龄化和肥胖而增加的风险因素也与认知能力下降有关。认知功能低下是一个重大的公共卫生问题，特别是对老年人而言，因为它会降低个人进行日常生活活动或遵循规定的保健活动的能力，导致更多的机构化和丧失独立性。有充分的证据表明，有氧运动有益于老年人的认知功能。运动还可以改善葡萄糖调节和胰岛素敏感性，并可能降低炎症，这些都是运动引起的认知改善的潜在机制。通过减少热量摄入来有意识地减肥比单独运动更能改善认知能力下降的代谢风险因素，这表明减肥可能会增强运动对认知能力的益处。然而，对于老年人来说，减肥是否安全健康是一个有争议的问题，一些研究实际上表明，老年人体重增加与更好的认知能力有关。因此，对于肥胖的老年人来说，在有氧运动干预中增加热量限制是否能在认知、大脑结构和功能方面提供额外的益处，而不仅仅是运动。拟议的研究通过调查在运动中增加减肥对肥胖老年人的潜在影响，解决了对国家和全球健康意义的关注