Longitudinal Characterization of Nutritional Behavior Using Unobtrusive Digital Technology in Aging, Alzheimer's and Related Disorders

项目摘要 饮食行为的改变和体重减轻与营养不良和痴呆症的发病有关; 然而，目前的评估工具并没有被设计成检测行为中的细微前驱变化， 发生在症状出现前六年。据估计，全球有1.07亿痴呆症病例， 到2050年，迫切需要客观的评估工具来确定与食品相关的行为的变化， 相关的功能，可以预测阿尔茨海默病和相关疾病（ADRD）。整体 该项目的目标是通过拟议的研究和指导培训， 申请人。生命实验室评估平台（Life Lab）是研究生命周期的范式转变， 使用家庭，不引人注目，客观和生态有效的个人之间的变化和模式 真实的测量（普适计算、传感器和其他技术）。该平台是 俄勒冈州老龄化和技术中心的指导下，博士凯（拟议的主要导师）谁是 目前，该平台正在老年人的家中部署，其中一部分人患有轻度认知障碍 (MCI)和早期痴呆症拟议的研究将生命实验室带入一个新的研究空间， 选择饮食行为的客观衡量标准。该提案的科学目标是确定可行的数字化方法， 纵向饮食行为谈话测量，比较自动化的、基于家庭的系统结果测量， 当前常规结局指标，并检测复合客观功能结局指标和ob- 营养不良患者的客观行为功能特征。密集的纵向数据（每日、每周和 季度评估，长达18个月），来自80名参与者（轻度认知障碍、早期AD和年龄- 匹配的同龄人），目前参加了生命实验室项目将被用来表征纵向身体质量通量- tuations，并确定可行的数字措施的食物寻求行为和持续的膳食补充剂摄入量 为将来的试验提供活动和行为的基线。申请人将获得一套 技能，以便进行拟议的研究，并通过培训为独立的研究生涯做好准备（1） 临床老年医学，老年学和衰老生物学，（2）数据丰富的研究应用程序的设计和统计分析， 使用数字技术进行研究，以及（3）使用技术从老年人那里获取营养数据。亲- 每一位导师都提供一个或多个领域的专业知识，并致力于合作， 为申请人的培训提供便利。详细的培训计划包含多模式学习（例如， 课程、研讨会和讲习班;应用型培训;以及国家和国际科学 会议）。申请人将这些新技能应用于拟议的研究项目，并获得R 01/R61 sup- 港口进行纵向研究，使用数字生物标志物，以确定饮食行为的前驱变化 制定有效的单一和多领域生活方式和非药物干预措施， 功能独立和改善认知的老年人或有风险的ADRD。

PROJECT SUMMARY Changes in dietary behavior and weight loss have been linked to malnutrition and to the onset of dementia; however, current assessment tools are not designed to detect subtle prodromal changes in behavior that can occur up to six years prior to symptom onset. With an estimated global burden of 107 million dementia cases by 2050, there is a critical need for objective assessment tools to identify changes in food-related behavior and associated function that could be predictive of Alzheimer’s disease and related disorders (ADRD). The overall goal of this project is to address this critical need through the proposed research and mentored training of the applicant. The Life Laboratory Assessment Platform (Life Lab) is a paradigm shift towards studying the behav- iors and patterns of change among individuals using in-home, unobtrusive, objective, and ecologically-valid measurements in real time (pervasive computing, sensors, and other technologies). The platform is part of the Oregon Center for Aging and Technology under the direction of Dr. Kaye (proposed primary mentor) who is currently deploying the platform in homes of older adults, a portion of whom have mild cognitive impairment (MCI) and early-stage dementia. The proposed research takes the Life Lab into a novel research space by col- lecting objective measures of dietary behavior. The scientific goals of this proposal are to identify feasible digi- tal measures of longitudinal dietary behavior, compare automated, home-based system outcome measures to current conventional outcome measures, and detect composite objective functional outcome metrics and ob- jective behavioral-functional signatures of malnourished patients. Intensive longitudinal data (daily, weekly and quarterly assessments for up to 18 months) from 80 participants (mild cognitive impairment, early AD, and age- matched peers) currently enrolled in Life Lab projects will be used to characterize longitudinal body mass fluc- tuations, and identify viable digital measures of food seeking behavior and sustained dietary supplement intake providing a baseline of activities and behaviors to contrast for future trials. The applicant will gain a new set of skills in order to conduct the proposed study and prepare for an independent research career by training in (1) clinical geriatrics, gerontology and aging biology, (2) design and statistical analysis of data-rich research ap- proaches using digital technology, and (3) acquiring nutrition data from older adults using technology. The pro- posed team of mentors each provide expertise in one or more of these areas and are committed to collabora- tively facilitating the applicant’s training. The detailed training plan contains multi-modal learning (e.g. formal coursework, seminars, and workshops; application-based training; and national and international scientific meetings). The applicant will apply these new skills to the proposed research project and obtain R01/R61 sup- port to conduct longitudinal studies using digital biomarkers to identify prodromal changes in dietary behavior and to develop effective single and multi-domain lifestyle and non-pharmaceutical interventions for maintaining functional independence and improving cognition in older adults with or at risk for ADRD.