POINTER-zzz: Sleep Ancillary to U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk of Alzheimer's Disease

POINTER-zzz：美国研究通过睡眠辅助通过生活方式干预降低阿尔茨海默病风险来保护大脑健康

• 批准号: 10645111
• 负责人: Laura D. Baker
• 金额: $ 58.22万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10645111
• 关键词: Accountability; Adherence; Adult; Age; Alzheimer disease prevention; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Ancillary Study; Blood Tests; Brain; Cardiovascular system; Characteristics; Chronic; Clinical Trials; Cognition; Cognitive; Dementia; Development; Diabetes prevention; Diet; Disease; Education; Elderly; Event; Exercise; Family history of; Fingers; Genetic Risk; Genotype; Geography; Group Meetings; Health; Heart Rate; Hippocampus; Home; Hypoxemia; Impaired cognition; Impairment; Intervention; Intervention Studies; Intervention Trial; Life Style Modification; Link; Measurement; Measures; Mediterranean Diet; Memory impairment; Outcome; Outcome Assessment; Oxygen; Oxygen saturation measurement; Parents; Participant; Pharmacological Treatment; Physical Function; Physiologic pulse; Prevention; Prevention strategy; Prevention trial; Pulse Oximetry; Quality of life; Randomized; Randomized, Controlled Trials; Resources; Rest; Risk; Risk Management; Risk Reduction; Site; Sleep; Sleep Apnea Syndromes; Sleep Fragmentations; Sleep disturbances; Structure; Subgroup; Testing; Unhealthy Diet; actigraphy; adjudication; arm; brain health; cardiometabolic risk; cardiometabolism; cardiovascular disorder prevention; cardiovascular health; cardiovascular risk factor; cerebrovascular health; cognitive benefits; cognitive disability; cognitive function; cohort; evidence base; exercise program; falls; health care service utilization; improved; improvement on sleep; intervention effect; lifestyle intervention; mild cognitive impairment; modifiable risk; multi-component intervention; participant enrollment; prevent; racial diversity; sedentary lifestyle; sex; sleep abnormalities; tonometry; treatment arm; treatment as usual; wrist worn device; β-amyloid burden

PROJECT SUMMARY No pharmacologic treatments have been identified to prevent or treat Alzheimer’s disease. To date, non- pharmacological approaches that target modifiable risks through lifestyle interventions provide the most promising evidence for disease delay. The impact of highly prevalent and chronic cardiometabolic conditions in older Americans places an important spotlight on the long prodromal period that precedes the development of Alzheimer’s and other dementias – for prevention. The U.S. study to PrOtect brain health through lifestyle INTErvention to Reduce risk (U.S. POINTER) uses a multi-domain intervention approach that has proven successful for cardiovascular disease and diabetes prevention, and for cognitive function in a Finnish cohort of older adults. U.S. POINTER launches in Fall 2018 to investigate whether random assignment to one of two lifestyle interventions that differ in structure, intensity, and accountability influences cognitive trajectory over 2 years in 2000 cognitively normal older adults (age 60-79 yrs) who are at increased risk for cognitive decline, Alzheimer’s disease and other dementias. The ancillary study, POINTER-zzz, will add in-home objective sleep assessments for 700 parent trial participants to examine the effects of lifestyle modification and cardiovascular risk management on sleep disturbances that have been linked to cognitive decline and Alzheimer’s disease. In older adults, chronic sleep disturbances marked by sleep-disordered breathing and sleep fragmentation are associated with impaired hippocampal functioning, greater brain beta-amyloid burden, and increased risk for Alzheimer’s disease. These and other sleep abnormalities are also associated with reduced cardiovascular and cerebrovascular health. Although there is some evidence to suggest that diet, exercise, and cardiometabolic risk reduction can improve sleep and that improved sleep benefits cognitive function in older adults, these effects have not been confirmed in a large-scale rigorous clinical trial with comprehensive and objective measures of sleep. POINTER-zzz provides an unprecedented opportunity to leverage extensive resources provided by a multi-site randomized controlled prevention trial in a well-characterized cohort of cognitively normal but Alzheimer-vulnerable adults to test the effects of a 2-year intensive lifestyle intervention on sleep-disordered breathing using oximetry and on sleep fragmentation using actigraphy. POINTER-zzz will also examine whether changes in sleep predict changes in global and domain-specific cognitive function and other parent trial outcomes. POINTER-zzz results may identify an effective strategy for improving sleep that could have important consequences for the prevention of Alzheimer’s disease and related dementias.

项目总结