Light Physical Activity for Brain Health in Older Adult Breast Cancer Survivors

轻度体力活动有利于老年乳腺癌幸存者的大脑健康

• 批准号: 10689020
• 负责人: Brett Ryan Gordon
• 金额: $ 7.4万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689020
• 关键词: Address; Advisory Committees; Aftercare; Alcohol consumption; Alcohols; Alzheimer' s disease risk; American; American Cancer Society; Anxiety; Biometry; Breast Cancer Treatment; Breast Cancer survivor; Cancer Survivor; Carcinogens; Cessation of life; Clinical Trials; Consensus; Consumption; Data; Dementia; Diagnosis; Dose; Ecological momentary assessment; Elderly; Exercise; Face; Fellowship; General Population; Grant; Guidelines; Health; Health behavior; Human; Impaired cognition; Individual; Inflammatory; International; Intervention; Knowledge; Late Effects; Learning; Light; Mental Health; Mentors; Obesity; Obesity Epidemic; Oncology; Outcome; Participant; Patient Self-Report; Physical activity; Population Study; Postdoctoral Fellow; Process; Randomized; Randomized, Controlled Trials; Recurrence; Reporting; Research; Research Personnel; Risk; Risk Reduction; Role; Series; Sports Medicine; Survival Rate; Survivors; Symptoms; Training; United States; United States National Institutes of Health; Work; aged; anxiety reduction; anxiety symptoms; arm; brain health; cancer diagnosis; cognitive function; college; drinking; efficacy evaluation; efficacy trial; exercise intervention; experience; health care settings; improved; light effects; light intensity; malignant breast neoplasm; meetings; modifiable behavior; mortality; multidisciplinary; novel; obese person; physical conditioning; primary outcome; psychological symptom; randomized trial; response; treatment as usual; treatment effect; vigorous intensity

Project Summary/Abstract Although breast cancer is the most frequently diagnosed cancer in the world, recently, the survival rate has greatly improved. With this improved survival rate, there is a growing population of obese, older adult breast cancer survivors facing unique challenges and late effects on brain health. Breast cancer survivors suffer cognitive impairments before, during, and post- treatment; more than one third experience persistent cognitive impairment lasting decades. Anxiety is the most common psychological symptom among cancer survivors, and frequently unrecognized and undertreated in health care settings. These survivors are also at increased risk of Alzheimer’s disease or dementia. There is unanimous consensus that physical activity and alcohol consumption are key modifiable behaviors to improve the physical and mental health of cancer survivors. Further, the American Cancer Society promotes increasing physical activity, and avoiding alcohol to manage treatment-related cognitive impairment. Although the benefits of physical activity for cancer survivors are well-established, the evidence is predominantly derived from guidelines-based, moderate-to-vigorous-intensity physical activity. However, survivors often do not meet guidelines for moderate-to-vigorous-intensity physical activity, do not adhere to physical activity interventions set at this intensity, and enjoy and prefer lighter-intensity activities. Much less is known about the effects of light-intensity physical activity on cognitive function and anxiety symptoms, and the 2018 United States Physical Activity Guidelines Advisory Committee Scientific Report identified the need to determine the role and contribution of light-intensity activity to diverse health outcomes as an overarching research need. Additionally, less is known about the effects of physical activity interventions on changes in alcohol consumption. Recent findings indicate physical activity may unintentionally increase alcohol consumption among cancer survivors. Increasing alcohol consumption places survivors at increased risk of recurrence, and may confound the positive effects of physical activity. Therefore, in the process of evaluating the effects of light-intensity physical activity on brain health outcomes among obese, older adult breast cancer survivors, the effects on alcohol consumption should be evaluated as well, to avoid unintended consequences. The light- intensity physical activity-breast cancer survivors (LIPA-BCS) trial addresses multiple knowledge gaps, with a primary and secondary focus on improving cognitive function and anxiety symptoms. The proposed work builds on this existing randomized controlled trial that randomizes obese, older adult breast cancer survivors 1-10 years post-breast cancer treatment, to either 15 weeks of light-intensity physical activity, or usual care. I will take advantage of this existing clinical trial to quantify and describe the effects on cognitive function, anxiety symptoms, and observe associated changes in alcohol consumption. To achieve this aim, we will assess cognitive function, anxiety symptoms, and alcohol consumption both pre- post, and utilizing ecological momentary assessments in 14-day bursts throughout the 15 week intervention. Through this research experience, and proposed post-doctoral fellowship, I will learn about the conduct of high quality human clinical trials among obese, older adult cancer survivors, and receive mentored training in ecological momentary assessments, biostatistics, and becoming an independent investigator in exercise oncology.

项目摘要/摘要 虽然乳腺癌是世界上诊断最多的癌症，但近年来，存活率有了很大提高。 随着存活率的提高，越来越多的肥胖、老年乳腺癌幸存者面临着独特的 对大脑健康的挑战和后遗症。乳腺癌幸存者在治疗前、治疗中和治疗后均出现认知障碍。 治疗；超过三分之一的人经历持续数十年的持续性认知障碍。焦虑是最常见的 癌症幸存者的心理症状，在卫生保健环境中经常得不到承认和治疗不足。 这些幸存者患阿尔茨海默病或痴呆症的风险也增加了。人们一致认为，身体上的 运动和饮酒是改善癌症患者身心健康的关键可改变行为 幸存者。此外，美国癌症协会提倡增加体力活动，避免饮酒 与治疗相关的认知障碍。尽管体力活动对癌症幸存者的益处是众所周知的， 证据主要来自于以指南为基础的、中等到剧烈强度的体力活动。然而， 幸存者经常不符合中等到剧烈强度的体力活动指南，不坚持体力活动 活动干预设置在这种强度，并享受和喜欢较轻强度的活动。人们对此知之甚少 光强度体力活动对认知功能和焦虑症状的影响，以及2018年美国体检 活动准则咨询委员会科学报告确定有必要确定下列活动的作用和贡献 将光强度活动对不同健康结果的影响作为首要研究需要。此外，人们还不太了解 体力活动干预对饮酒变化的影响。最近的发现表明，体力活动可能会 无意中增加了癌症幸存者的饮酒量。酒精消费的增加使幸存者处于 增加复发的风险，并可能混淆体力活动的积极影响。因此，在这个过程中， 评价光强度体力活动对肥胖老年乳腺癌患者脑健康结局的影响 对于幸存者来说，也应该评估对酒精消费的影响，以避免意想不到的后果。光-- 强度体力活动-乳腺癌幸存者(LIPA-BCS)试验解决了多个知识差距，初级和 其次注重改善认知功能和焦虑症状。拟议的工作建立在现有的基础上 一项随机对照试验，随机选择乳腺癌后1-10年肥胖的老年乳腺癌幸存者 治疗，要么是15周的光强度体力活动，要么是常规护理。我会利用这个现有的诊所 尝试量化和描述对认知功能、焦虑症状的影响，并观察酒精的相关变化 消费。为了实现这一目标，我们将评估认知功能、焦虑症状和饮酒前 在整个15周的干预过程中，在14天的突发事件中利用生态学瞬时评估。通过这件事 有研究经验，并建议博士后奖学金，我将学习高质量的人类临床行为 在肥胖的老年癌症幸存者中进行试验，并接受生态瞬时评估方面的指导培训， 生物统计学，并成为运动肿瘤学的独立研究员。