Physical Activity and Cognitive Decline in the Elderly

描述（由申请人提供）：本职业发展奖申请的主要目标是使申请人能够发展成为老年人认知能力下降流行病学研究专家所需的技能和专业知识，重点是体力活动的潜在保护作用。动物和人类研究都有令人信服的证据表明，体育活动可能会降低认知能力下降和痴呆症的风险，尽管有几个关键问题尚未解决。拟议的培训计划将为申请人提供解决这些问题所需的工具，并将包括荟萃分析，纵向数据分析，随机对照试验设计，老年人体力活动的测量，痴呆症的诊断和病理生理学以及研究的道德行为等领域的课程和重点指导。拟议的研究计划将利用学到的技术来解决有关身体活动和认知能力下降之间关联的几个关键问题。具体而言，我们将：1）基于纵向观察性研究的荟萃分析确定相关性的强度和一致性（目标1）; 2）在心血管健康研究的参与者中进行一系列研究，该研究是一项为期12年的纵向研究，涉及5，888名年龄在65岁或以上的白色和非洲裔美国人，以确定a）与认知下降的最低风险相关的体力活动的量和类型，B）该关联是否因性别或种族而不同，c）该关联的时间（即，鸡vs.蛋），以及d）该关联是否由血管疾病、炎症或磁共振成像上的脑结构变化介导（目的2和3）;以及3）进行初步研究，以评估在有认知能力下降风险的老年人中进行随机对照试验的可行性（目的4）。这种培训和研究的结合将使申请人能够发展成功过渡到独立所需的技能，并将大大推动物理领域的发展。 活动和认知能力下降。

DESCRIPTION (provided by applicant): The primary objective of this Career Development Award application is to enable the applicant to develop the skills and expertise necessary to become an expert in the epidemiologic study of cognitive decline in the elderly, with an emphasis on the potential protective effects of physical activity. There is compelling evidence from both animal and human studies that physical activity may lower the risk of cognitive decline and dementia, although several key issues remain unresolved. The proposed Training Plan will provide the applicant with the tools necessary to address these issues and will include coursework and focused mentoring in the areas of metaanalysis, longitudinal data analysis, randomized controlled trial design, measurement of physical activity in the elderly, diagnosis and pathophysiology of dementia, and ethical conduct of research. The proposed Research Plan will utilize the techniques learned to address several key questions about the association between physical activity and cognitive decline. Specifically, we will: 1) determine the strength and consistency of the association based on a meta-analysis of longitudinal, observational studies (Aim 1); 2) conduct a series of studies in participants in the Cardiovascular Health Study, which is a 12-year, longitudinal study of 5,888 white and African American adults age 65 years or older, to determine a) the amounts and types of physical activity associated with the lowest risks of cognitive decline, b) whether the association differs by gender or ethnicity, c) the timing of the association (i.e., chicken vs. egg), and d) whether the association is mediated by vascular disease, inflammation or structural brain changes on magnetic resonance imaging (Aims 2 and 3); and 3) conduct a pilot study to evaluate the feasibility of a randomized controlled trial in elders at risk of cognitive decline (Aim 4). This combination of training and research will enable the applicant to develop the skills necessary to transition successfully to independence and also will substantially advance the field on physical activity and cognitive decline.