Longitudinal Impact of Health and Lifestyle Behaviors on Cognition in Individuals with Multiple Sclerosis

健康和生活方式行为对多发性硬化症患者认知的纵向影响

• 批准号: 10708744
• 负责人: Michelle H Chen
• 金额: $ 11.65万
• 依托单位: RUTGERS BIOMEDICAL AND HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-22 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10708744
• 关键词: Accounting; Adherence; Affect; Aging; Behavior; Behavioral; Biometry; Blood Vessels; Clinical; Clinical Investigator; Clinical Trials Design; Cognition; Cognitive; Community Participation; Conduct Clinical Trials; Data; Dementia; Diet; Disease; Double-Blind Method; Elderly; Epidemiology; Equipment and supply inventories; Exercise; Funding; Goals; Grant; Health; Health behavior; Impaired cognition; Individual; Intervention; Interview; Investigation; Laboratories; Learning; Life Style; Link; Literature; Long-Term Effects; Longitudinal, observational study; Manuscripts; Measures; Medical center; Mentors; Mentorship; Mission; Monitor; Multiple Sclerosis; Neuropsychology; Participant; Patient Self-Report; Performance; Persons; Pharmaceutical Preparations; Population; Qualitative Research; Randomized, Controlled Trials; Recommendation; Rehabilitation therapy; Research; Research Design; Research Personnel; Risk; Risk Factors; Role; Secondary Prevention; Sleep; Smoking; Social support; Standardization; Structure; Surveys; Symptoms; Techniques; Time; Training; United States National Institutes of Health; Work; Writing; career; cognitive change; cognitive rehabilitation; cognitive testing; cognitive training; cohort; comorbidity; design; follow-up; good diet; health belief; health care availability; improved; instrumental activity of daily living; interest; lifestyle factors; lifestyle intervention; modifiable risk; multidisciplinary; multiple sclerosis patient; neuroimaging marker; neuroprotection; pharmacologic; population based; prospective; psychosocial; rehabilitation research; skill acquisition; skills; social; social health determinants; standard care; substance use; symptom management; systematic review

Project Summary/Abstract This CDA proposal seeks to investigate the long-term impact of modifiable health-related behaviors (e.g., smoking, exercise) on cognitive decline over time among persons with multiple sclerosis (MS; Specific Aim 1). This is important given the detrimental impact of cognitive impairment in MS, affecting symptom management, instrumental activities of daily living, and independence. Since there are no proven treatments for cognitive impairment, it is imperative to identify modifiable risk factors – specifically health-related behaviors – that can serve as potential treatment targets. Moreover, in order to modify these behaviors, this proposal will explore disease (MS)-related, person-specific, and environmental facilitators and barriers to engaging in health-related behaviors (Specific Aim 2). Such aims are consistent with the mission of the National Center for Medical Rehabilitation Research (NCMRR) to “determine the impact of modifiable lifestyle and health-related behaviors on prevention of secondary conditions, psychosocial functioning, and community participation,” as outlined in the 2016 NIH Research Plan on Rehabilitation. The Specific Aims will be accomplished via two longitudinal, observational studies among persons with MS. Cognitive trajectories will be established by standardized neuropsychological assessments. Health- related behaviors will be evaluated using self-report inventories. Facilitators/barriers to engaging in health-related behaviors will be determined by quantitative inventories and qualitative semi-structured interviews. Data from this investigation will serve as pilot data for a R01 grant in which a multicomponent lifestyle intervention to improve cognition among persons with MS will be proposed. Such intervention has been recently conducted in older adults at-risk of developing dementia, with ongoing replications around the world. Information from this project will help adapt this type of intervention to individuals with MS by accounting for MS-specific facilitators and barriers to engaging in health behaviors. I have assembled a multidisciplinary mentoring team, with expertise in clinical neuropsychology, cognitive rehabilitation, epidemiology, advanced biostatistics, and clinical trial design. By completing the proposed training and research plans, I will be able to achieve my training goals, including: (1) applying population-based survey research design to the role of the social determinants of health on lifestyle behaviors; (2) learning qualitative research design and advanced statistical techniques; (3) learning how to conduct clinical trials; and (4) honing my professional development skills, such as manuscript writing, grantsmanship, laboratory management, and mentorship. Achieving these goals will help me transition into an independent clinical investigator, with a long career of grant-funded research.

项目概要/摘要 该 CDA 提案旨在调查可改变的健康相关行为（例如， 吸烟、运动）对多发性硬化症患者（MS；特定 目标1）。鉴于多发性硬化症认知障碍的不利影响，这一点很重要，会影响 症状管理、日常生活的工具性活动和独立性。由于没有 认知障碍的有效治疗方法，必须确定可改变的风险因素 - 特别是与健康相关的行为——可以作为潜在的治疗目标。此外，为了 改变这些行为，该提案将探讨与疾病（MS）相关的、针对个人的和 参与健康相关行为的环境促进因素和障碍（具体目标 2）。这样的 目标与国家医疗康复研究中心的使命一致 （NCMRR）“确定可改变的生活方式和健康相关行为对 预防继发性疾病、心理社会功能和社区参与”， 2016 年 NIH 康复研究计划中概述了这一点。 具体目标将通过两项针对患有以下疾病的人的纵向观察性研究来实现 多发性硬化症。认知轨迹将通过标准化的神经心理学评估来建立。健康- 相关行为将使用自我报告清单进行评估。参与的促进因素/障碍 与健康相关的行为将通过定量清单和定性半结构化来确定 采访。此次调查的数据将作为 R01 拨款的试点数据，其中 将提出多组分生活方式干预以改善多发性硬化症患者的认知。 最近对有患痴呆症风险的老年人进行了此类干预，其中 世界各地正在进行复制。该项目的信息将有助于适应这种类型 通过考虑多发性硬化症特定的促进因素和参与障碍来对多发性硬化症患者进行干预 健康行为。 我组建了一支多学科指导团队，拥有临床神经心理学方面的专业知识， 认知康复、流行病学、高级生物统计学和临床​​试验设计。通过完成 提出培训和研究计划，我将能够实现我的培训目标，包括：（1）申请 基于人口的调查研究设计健康的社会决定因素对生活方式的作用 行为； （2）学习定性研究设计和先进的统计技术； (3) 学习如何 进行临床试验； (4) 磨练我的专业发展技能，例如稿件写作， 资助、实验室管理和指导。实现这些目标将帮助我过渡 成为一名独立的临床研究者，拥有长期的资助研究生涯。