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.

摘要 阿尔茨海默病和相关痴呆症(ADRD)是美国第六大死亡原因， 在大约600万美国成年人中流行。如果没有有效的预防战略，ADRD的流行预计将 到2060年翻两番。临床ADRD缺乏成功的药物治疗，有必要呼吁采取行动 确定保护认知功能和预防ADRD的可改变因素。中等强度-剧烈强度 体力活动(MVPA)已被确定为一种关键策略，可能具有最大的非药理学意义 对预计的ADRD疫情的影响。然而，MVPA只相当于24小时一天中的一小部分 (~2%)。24小时内其余约98%的运动行为，包括久坐不动 行为(SB)、轻度体力活动(LPA)和睡眠是额外的可修改的考虑因素。生长 有证据表明，这些运动行为的综合影响可能比它们各自的影响更大 效果。因此，专注于单一因素(例如MVPA)会限制疗效。适当水平的MVPA，LPA， 可能需要同时获得睡眠(例如，“健康的24小时”)，以获得最佳的弹性 不良的认知结果。然而，几乎没有工作表征24小时活动周期的作用以保持 认识和预防ADRD。为了解决这一关键的研究差距，我们建议对 中风中地理和种族差异的持续原因研究(CONTS)。这个项目的总体目标是 项目是描述24小时活动周期和不利因素之间的时间、双向关系。 认知结果。具体地说，我们将测试：1)24小时活动周期的组成是否预示着变化 认知功能和事件发生轻度认知损害(MCI)或痴呆，2)认知功能和 流行的MCI/痴呆症预测24小时活动周期成分的变化，以及3) 24小时活动周期的组成与认知功能的变化和认知功能的转变有关 减值状态。我们还将确定与以下相关的最有益的24小时活动周期组成 较低的认知障碍风险。为了实现我们的目标，我们将利用 方面，包括每年和两年一次的认知功能评估，算法 MCI和痴呆症的分类，并收集24个清醒部分的客观测量- H 2009-2013年活动周期。在这项辅助研究中，我们建议增加7天的问候期 加速计和睡眠活动描记协议，以客观测量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 认知功能和识别有益的24小时活动周期成分，该项目将解决现有的 证据差距并提供经验证据，以加速向综合模型的范式转变 整合了所有24小时运动行为，以优化认知健康。