The role of 24-hour activity cycles in preserving cognitive function and preventing Alzheimer's disease and related dementias

24 小时活动周期在保护认知功能和预防阿尔茨海默病及相关痴呆方面的作用

• 批准号: 10455800
• 负责人: Keith M Diaz
• 金额: $ 545.03万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10455800
• 关键词: Accelerometer; Activity Cycles; Address; Adult; African American population; Age; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Ancillary Study; Attenuated; Behavior; Behavioral; Biological Factors; Cause of Death; Clinical Treatment; Cognition; Cognitive; Collection; Data; Dementia; Dependence; Diabetes Mellitus; Elderly; Enrollment; Epidemic; Financial Hardship; Future; Goals; Guidelines; Health; Health behavior; Healthcare Systems; Hour; Hyperlipidemia; Hypertension; Impaired cognition; Individual; Intervention; Lead; Light; Link; Longitudinal Studies; Measures; Mediating; Modeling; Movement; Outcome; Participant; Pathway interactions; Pharmacological Treatment; Physical activity; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Procedures; Protocols documentation; Public Health; Race; Research; Resources; Risk; Role; Sleep; Strenuous Exercise; Stroke; Testing; Time; Work; actigraphy; base; biracial; brain health; classification algorithm; cognitive function; cost; disability; geographic disparity; mild cognitive impairment; modifiable behavior; preservation; prevent; prospective; racial disparity; resilience; response; sedentary lifestyle; sex; sleep behavior; vascular risk factor; vigorous intensity

ABSTRACT Alzheimer’s disease and related dementias (ADRD) are the 6th leading cause of death in the U.S and is prevalent in ~6 million U.S. adults. Without effective prevention strategies, ADRD prevalence is expected to triple by 2060. The lack of successful pharmacologic treatments for clinical ADRD necessitates a call-for-action to identify modifiable factors that preserve cognitive function and prevent ADRD. Moderate-vigorous intensity physical activity (MVPA) has been identified as a key strategy that could have the greatest non-pharmacologic impact on the projected ADRD epidemic. However, MVPA corresponds to only a small portion of the 24-h day (~2%). The other movement behaviors that comprise the remaining ~98% of the 24-h day, including sedentary behavior (SB), light physical activity (LPA), and sleep, constitute additional modifiable considerations. Growing evidence suggests that the combined effects of these movement behaviors may be greater than their individual effects. Thus, focusing efforts on a single factor (e.g. MVPA) limits efficacy. Appropriate levels of MVPA, LPA, SB, and sleep may need to be achieved simultaneously (e.g. a “healthy 24-hours”) for optimal resilience to adverse cognitive outcomes. Yet little work has characterized the role of the 24-h activity cycle to preserve cognition and prevent ADRD. To address this critical research gap, we propose an ancillary study to the ongoing REasons for Geographic And Racial Disparities in Stroke (REGARDS) study. The overall goal of this project is to characterize the temporal, bidirectional relationship between the 24-h activity cycle and adverse cognitive outcomes. Specifically, we will test whether: 1) composition of the 24-h activity cycle predicts change in cognitive function and incident mild cognitive impairment (MCI) or dementia, 2) cognitive function and prevalent MCI/dementia predict change in composition of the 24-h activity cycle, and 3) change in the composition of the 24-h activity cycle is associated with change in cognitive function and transitions in cognitive impairment status. We will also determine the most beneficial 24-h activity cycle compositions associated with a lower risk of cognitive impairment. To address our aims, we will leverage the exceptional resources of REGARDS, including assessment of cognitive function at annual and biennial intervals, algorithmic classifications of MCI and dementia, and collection of objective measures of the waking components of the 24- h activity cycle from 2009-2013. In this ancillary study, we propose to augment REGARDS with a 7-day accelerometer and sleep actigraphy protocol to objectively measure the 24-hour activity cycle (SB, LPA, MVPA, and sleep). By elucidating the temporal, bidirectional relationship between the 24-h activity cycle and cognitive function and identifying beneficial 24-h activity cycle compositions, this project will address existing evidence gaps and provide empirical evidence to accelerate a paradigm shift towards an integrated model that incorporates all 24-hour movement behaviors to optimize cognitive health.

抽象的 阿尔茨海默氏病和相关痴呆症（ADRD）是美国第六个主要原因，是 在约600万美国成年人中流行。没有有效的预防策略，预计ADRD的流行率将 到2060年三倍。缺乏成功的临床药物治疗方法 确定可修改的因素来保留认知功能并防止ADRD。中等强度 体育活动（MVPA）已被确定为可能具有最大非药物的关键策略 对预计的ADRD流行病的影响。但是，MVPA仅对应于24小时的一小部分 （〜2％）。其他的运动行为占24小时的剩余约98％，包括久坐 行为（SB），轻体活动（LPA）和睡眠构成了其他可修改的考虑因素。生长 有证据表明，这些运动行为的综合效应可能大于其个人 效果。这将努力集中在一个因素（例如MVPA）上限制了有效性。适当水平的MVPA LPA， SB和睡眠可能需要简单地实现（例如，“健康的24小时”），以实现最佳的弹性 不利的认知结果。然而，很少的工作表征了24小时活动周期的作用 认知并防止ADRD。为了解决这个关键的研究差距，我们提出了一项辅助研究 持续的中风研究中地理和种族差异的原因（有关）研究。总体目标 项目是为了表征24小时活动周期和不利的临时双向关系 认知结果。具体而言，我们将测试是否：1）24小时活动周期预测的组成变化 在认知功能和事件中，轻度认知障碍（MCI）或痴呆症，2）认知功能和 普遍的MCI/痴呆症预测24小时活性周期组成的变化，3）变化 24小时活性周期的组成与认知功能的变化和认知过渡有关 损伤状况。我们还将确定与 认知障碍的风险较低。为了解决我们的目标，我们将利用 关于每年和两年一次的认知功能的评估，包括算法 MCI和痴呆症的分类，以及24--的唤醒成分的客观度量的收集 H 2009- 2013年的H活性周期。在这项辅助研究中，我们建议以7天 加速度计和睡眠行动摄影协议可以客观地测量24小时活动周期（SB，LPA， MVPA和睡眠）。通过阐明24小时活动周期和 认知功能并确定有益的24小时活动周期组成，该项目将解决现有 证据差距并提供经验证据，以加速向综合模型的范式转变 结合所有24小时运动行为，以优化认知健康。