Administrative Supplement: Life-Space and Activity Digital Markers for Detection of Cognitive Decline in Community-Dwelling Older Adults: The RAMS Study

项目总结-RAMS研究的行政补充（R 01 AG 082251; MPI：Chung和 （萨金特） 本行政补充申请是对PA-20-272的答复。家长研究总结： 母研究（R 01 AG 082251），或“用于检测认知衰退的生活空间和活动数字标记 在社区居住的老年人：RAMS研究，”是一项研究，旨在发展敏感，实用， 和生态上可接受的生命空间移动性（LSM）数字指标，可用于临床相关 社区居住的老年人随后认知能力下降的标志。功能衰退的标志物 早在阿尔茨海默病和相关痴呆（ADRD）临床症状出现前开始年。有必要 尽早捕捉这些功能变化，在症状出现之前进行干预，以防止进一步的 恶化评估认知变化和检测轻度认知障碍进展的资源 (MCI)和ADRD在有健康差异的老年人中的作用有限。基于数字技术的 对认知复杂活动的评估，如LSM，有可能识别出那些有风险的人， 认知能力下降根据参与者的年龄，将其分为认知正常（CN; n=157）或MCI（n=157）。 在基线时进行神经心理成套测验，并将前瞻性随访3年，以收集7天RAMS 每6个月进行一次数据和神经心理学评估。具体目标是：（1）比较基线和 CN和MCI组之间RAMS测量的纵向轨迹，并确定社会影响 健康因素对RAMS指标和认知功能的影响;（2）确定将CN分类的RAMS指标， 基线时MCI组，并评估RAMS指标预测随后MCI发作的能力， （3）评估老年人对数字健康技术的态度， 监测认知能力下降的风险。行政补充摘要： 行政补充资金支持有针对性的机会，将基线ADRD生物标志物纳入 家长研究这笔资金将使我们的团队能够比较研究RAMS数字措施与现有的 ADRD标志物。添加ADRD生物标志物将加强研究预测模型，允许深入研究 表型，并验证RAMS数字预测模型与其他ADRD预测模型。这些发现 从基线ADRD生物标志物将推进科学知识，并加速翻译 将具有临床意义的数字化措施纳入临床实践，以支持早期识别和预防 MCI进展为ADRD。我们曾考虑将ADRD生物标志物措施纳入父母补助金 （R 01 AG 08225），但与堪萨斯大学（KU）没有建立工作关系 阿尔茨海默病研究中心（ADRC）生物标志物核心，直到赠款提交后。三k ADRC合作指导了方法并提供了进行生物标志物分析的材料 本行政补充规定。因此，行政补充为我们的团队提供了一个 有针对性地将先前不可用的ADRD生物标志物纳入母研究。

Project Summary - for Administrative Supplement to the RAMS Study (R01AG082251; MPIs: Chung and Sargent) This request for an administrative supplement is in response to PA-20-272. Summary of Parent Study: The parent study (R01AG082251), or the “Life-space and Activity Digital Markers for Detection of Cognitive Decline in Community-Dwelling Older Adults: The RAMS Study,” is a study that aims to develop sensitive, practical, and ecologically acceptable life-space mobility (LSM) digital indicators that could be used as clinically relevant markers of subsequent cognitive decline among community-dwelling older adults. Markers of functional decline begin years before clinical symptoms of Alzheimer’s disease and related dementias (ADRD). It is essential to capture these functional changes as early as possible to intervene before symptoms arise to prevent further deterioration. Resources to assess cognitive changes and detect the progression to mild cognitive impairment (MCI) and ADRD are limited among older adults with health disparities. The digital technology-based assessment of cognitively complex activities, such as LSM, has the potential to identify those at risk for cognitive decline. Participants are classified as cognitively normal (CN; n=157) or MCI (n=157) based on a neuropsychological battery at baseline and will be prospectively followed up for 3 years to collect 7-day RAMS data and neuropsychological evaluations every 6 months. The specific aims are to (1) Compare baseline and longitudinal trajectories of RAMS measures between CN and MCI groups and determine the impact of social health factors on RAMS indicators and cognitive function; (2) Determine RAMS indicators that classify CN and MCI groups at baseline and evaluate the ability of RAMS indicators to predict the subsequent onset of MCI and dementia over a 3-year period; and (3) Evaluate older adults’ attitudes towards digital health technology for monitoring risks of cognitive decline. Summary of Administrative Supplement: The request for the administrative supplement funding supports a targeted opportunity to include baseline ADRD biomarkers in the parent study. This funding will allow our team to compare the study RAMS digital measures with established ADRD markers. Adding the ADRD biomarkers will strengthen the study prediction model, allow for deep phenotyping, and validate the RAMS digital prediction model with other ADRD prediction models. The findings from the baseline ADRD biomarkers will advance the scientific knowledge and accelerate the translation of clinically meaningful digital measures into clinical practice to support early identification and prevention of the progression of MCI to ADRD. We had considered incorporating ADRD biomarker measures in the parent grant (R01AG08225) but did not have an established working relationship with the University of Kansas (KU) Alzheimer’s Disease Research Center (ADRC) Biomarker Core until after the grant was submitted. The KU ADRC collaboration has guided the methods and provided the materials to conduct the biomarker analysis proposed in this administrative supplement. Therefore, the administrative supplement provides our team with a targeted opportunity to include ADRD biomarkers in the parent study that were not previously available.