MIND DIET AND DEMENTIA PREVENTION IN ISCHEMIC STROKE PATIENTS

缺血性中风患者的注意饮食和痴呆症预防

基本信息

批准号：
9887889
负责人：
NEELUM T. AGGARWAL
金额：
$ 308.71万
依托单位：
RUSH UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/9887889
关键词：
Activities of Daily Living Acute Advocate Affect Aging Alzheimer&apos s Disease Alzheimer&apos s disease pathology Amyloid beta-42 Amyloid beta-Protein Amyloid deposition Animals Berry Biochemical Markers Biological Biological Markers Blood Brain Brain-Derived Neurotrophic Factor Caring Cerebral Infarction Cerebrovascular system Characteristics Chicago Cognition Cognitive Consumption Counseling DASH diet Dementia Diet Diet Modification Dietary Component Dietary Intervention Disease Progression Elderly Episodic memory Family Food Funding Health Hippocampus (Brain)Home environment Hospitalization Human Hybrids Impaired cognition Incidence Individual Inflammation Intervention Ischemic Stroke Life Style Modification Magnetic Resonance Imaging Measures Mediation Mediator of activation protein Medical center Mediterranean Diet Memory Mental Depression Microvascular Dysfunction Mind Mission Modification Nerve Degeneration Nutrient Oxidative Stress Participant Patient Recruitments Patient Self-Report Patients Pattern Pharmacological Treatment Pharmacotherapy Phase Plants Plasma Prevention Prevention trial Primary Prevention Principal Investigator Public Health Randomized Controlled Trials Recommendation Research Semantic memory Senile Plaques Short-Term Memory Site Specific qualifier value Speed Stroke Structure Survivors Symptoms Testing Therapeutic Intervention Time Treatment Efficacy United States National Institutes of Health Universities Vascular Diseases Vegetables White Matter Hyperintensity aged base blood-brain barrier function brain health brain volume cardiovascular risk factor clinical research site cognitive change cognitive function cognitive testing cohort cost estimate delivered meals depressive symptoms design digital disability executive function experience functional disability functional status high risk population improved inflammatory marker neuron loss neuropathology nutrition overtreatment post stroke post stroke dementia preservation programs recruit retinal imaging saturated fat stroke patient stroke survivor symptom treatment treatment as usual treatment duration treatment group trial design

项目摘要

Program Director/Principal Investigator (Last, First, Middle): Morris, Martha Clare and Aggarwal, Neelum T This is a resubmission of R01 application AG062637 that is retitled to, “MIND Diet and Dementia Prevention in Ischemic Stroke Patients.” The application is a Phase III randomized-controlled trial designed to test the effects of a 3-year intervention of the MIND diet plus usual post-stroke care versus usual post-stroke care on cognitive decline, brain biomarkers of AD and vascular disease, and on functional disability and depression in 500 patients hospitalized for acute ischemic stroke, aged 60-80 years and without dementia who are discharged home following hospitalization. More than 795,000 people in the U.S. have a stroke every year, the majority of which (87%) are ischemic. The estimated cost is $34 billion each year. Stroke is the leading cause of serious long-term disability. It is estimated that about half of survivors will experience cognitive impairment and depression, and one third will develop post-stroke dementia. Dementia is a major and growing public health problem that is amplified by the lack of effective cures or therapies to ameliorate the disease progression and symptoms. Lifestyle modifications, including dietary interventions using the DASH and Mediterranean diets, have been demonstrated to preserve or improve cognitive function and depression in older adults at high cardiovascular risk, however, it is unknown whether diet is an effective therapeutic intervention in stroke survivors. Importantly, dietary recommendations are highly desired by stroke patients and their families. The MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) is a hybrid of the Mediterranean and DASH diets but with selected modifications based on foods and nutrients that are important to brain health. The MIND diet has the same basic components of the DASH and Mediterranean diets, such as emphasis on natural plant-based foods and limited animal and high saturated fat foods, but uniquely specifies green leafy vegetables and berries as well as food component servings that reflect the nutrition-dementia evidence. The trial will employ a parallel group design comparing the effects of the MIND intervention (3 months of delivered MIND meals followed by dietary counseling) versus usual post-stroke care (3 months of delivered self-selected meals followed by general stroke health counseling) on decline in cognitive function and functional abilities, and depressive symptoms. Biological effects of the MIND diet will be assessed by change in measures of retinal imaging-derived amyloid beta plaque accumulation, and MRI-derived brain macro- and micro-structural integrity in 300 randomly selected participants. Other biochemical markers will be assessed over the treatment period in the entire cohort of 500 participants, including: plasma Abeta 42/Abeta 40, brain-derived neurotrophic factor (BDNF) and plasma markers of oxidative stress and inflammation. In addition, the trial will examine potential effect mediators and modifiers by a number of cardiovascular risk factors, AD biomarkers, and biological mechanisms. The proposed study has three recruitment sites at comprehensive stroke centers in Chicago and one clinical site at Rush University. PHS 398/2590 (Rev. 06/09) Page Continuation Format Page

项目总监/首席调查员（最后，第一，中间）：莫里斯，玛莎·克莱尔和阿格加瓦尔，尼鲁姆T 这是R01申请AG062637的重新提交，该申请被重新命名为“心智饮食和痴呆症该应用是一项旨在测试影响的III期随机控制试验的应用三年的思维饮食干预加上常规后击后护理与常规的认知后护理衰落，AD和血管疾病的脑生物标志物以及500的功能障碍和抑郁症患者因急性缺血性中风住院，年龄60-80岁，没有痴呆症住院后的家。美国每年有795,000多人中风，大多数哪个（87％）是缺血性的。估计的成本为每年340亿美元。中风是严重的主要原因长期残疾。据估计，大约一半的生存会遭受认知障碍和痴呆症是一个主要的公共卫生缺乏有效治疗或疗法来改善疾病进展和症状。生活方式的改变，包括使用破折号和地中海饮食的饮食干预措施已被证明可以保留或改善高成年人的认知功能和抑郁症但是，心血管风险，尚不清楚饮食是否是中风的有效治疗干预措施幸存者。重要的是，饮食建议是中风患者及其家人高度期望的。心理饮食（用于神经退行性延迟的地中海 - 划线干预）是地中海的杂种和破折号饮食，但基于对大脑健康很重要的食物和营养的精选修饰。思维饮食具有仪表板和地中海饮食的基本组成部分，例如强调天然植物性食品和有限的动物和高饱和脂肪食品，但独特地指定了绿叶蔬菜和浆果以及反映营养止血证据的食物成分。试验将采用比较思维干预效果的平行组设计（交付的3个月饮食咨询之后的心灵餐）与平常的势后护理（3个月交付的自我选择餐点，然后进行一般卒中健康咨询）关于认知功能和功能能力的下降，和抑郁症状。思维饮食的生物学作用将通过测量的变化来评估视网膜成像衍生的淀粉样β斑块积累以及MRI衍生的大脑宏观结构 300名随机选择的参与者的完整性。其他生化标志物将在治疗中进行评估整个队列中的500名参与者的期间，包括：血浆Abeta 42/abeta 40，脑衍生的神经营养因子（BDNF）和血浆氧化应激和注射的等离子体标记。此外，审判将检查通过许多心血管危险因素，AD生物标志物和生物学机制。拟议的研究在综合中风中心有三个招聘站点芝加哥和拉什大学的一个临床站点。 PHS 398/2590（修订版06/09）页面延续格式页面