Dyadic Sleep, Biobehavioral Rhythms and Cognitive Function in Older Adults: Implications for Alzheimer’s Disease

老年人的二元睡眠、生物行为节律和认知功能：对阿尔茨海默病的影响

• 批准号: 10584241
• 负责人: Kelly Glazer Baron
• 金额: $ 99.05万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10584241
• 关键词: Address; Adult; Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Behavior; Biological; Cellular Phone; Cessation of life; Circadian Dysregulation; Circadian Rhythms; Cognition; Cognitive; Couples; Development; Elderly; Health; Health Care Costs; Health Expenditures; Health behavior; Impaired cognition; Impairment; Individual; Intervention; Life; Measures; Memory; Moods; Neuropsychology; Outcome; Patient Self-Report; Patients; Pattern; Personal Satisfaction; Physiology; Population; Premature Mortality; Process; Prospective Studies; Protocols documentation; Quality of life; Research; Rest; Risk; Risk Reduction; Role; Sampling; Sleep; Sleep disturbances; Spouses; Vulnerable Populations; Woman; Work; actigraphy; biobehavior; caregiving; circadian; cognitive function; cognitive testing; daily functioning; dementia risk; disability; executive function; experience; follow-up; functional disability; healthy aging; improvement on sleep; innovation; member; men; mild cognitive impairment; mortality; novel; poor sleep; processing speed; prospective; response; sex; sleep pattern; social; social culture

Abstract Individuals with mild cognitive impairment (MCI) demonstrate cognitive decline without major functional impairment but also experience a 7-fold increased risk for developing Alzheimer’s disease, a leading cause of poorer quality of life (QOL), premature mortality, and health care expenditures. Sleep and biobehavioral rhythm disturbances (disruptions in 24h oscillations in physiology and behavior, including rest-activity patterns and mealtimes) are more than twice as common among patients with MCI than cognitively intact older adults. Emerging evidence demonstrates a mechanistic role of sleep and biobehavioral rhythm disturbances in cognitive decline and the development and progression of Alzheimer’s disease. Importantly, the consequences of sleep and biobehavioral rhythm disruption in MCI extend beyond the patient, also affecting the spouse/partner, as sleep is a “shared” health behavior for most adults. However, sleep and biobehavioral rhythms are typically considered at the level of the individual. Building on our team’s pioneering work on sleep as a shared experience among couples, we propose to investigate sleep and biobehavioral rhythms as fundamental dyadic processes that contribute to the health and cognitive functioning of individuals with MCI or mild AD and their partners. We will evaluate the daily and longitudinal effects of two dyadic processes in sleep: interdependence (partners’ sleep patterns influence on each other) and concordance (i.e., the couples’ similarity in rest/activity and social rhythms such as meal timing). We will conduct a 14-day naturalistic study protocol in order to examine the mechanistic associations between sleep and biobehavioral rhythms and proximal indicators of daytime functioning, within a sample of 170 couples in which one partner evidences cognitive impairment (MCI to mild Alzheimer’s disease). During the naturalistic study protocol, we will capture sleep and biobehavioral rhythms via objective (actigraphy) measures of sleep and circadian rest-activity rhythms and daily social rhythms, respectively. Also, we will include daily assessments of mood and relationship quality, and we will use an innovative smartphone cognitive assessment that has been validated to measure cognitive function in daily life. In addition, we will conduct comprehensive neuropsychological assessments at baseline and again at two-year follow-up to examine how sleep and biobehavioral rhythm disruptions at baseline predict cognitive decline over 2 years in both partners. Results of study will advance the understanding of the daily and longitudinal relationships between the individual and couple-level processes in sleep and biobehavioral rhythms that influence the progression of cognitive decline in a population at increased risk for developing Alzheimer’s disease.

摘要 轻度认知障碍(MCI)的个体表现为认知功能减退，而不是主要的功能障碍 但患阿尔茨海默病的风险也增加了7倍，阿尔茨海默病是 较差的生活质量(QOL)、过早死亡率和医疗保健支出。睡眠与生物行为节律 干扰(24小时内的干扰生理和行为的振荡，包括休息-活动模式和 进食时间)在MCI患者中的发生率是认知正常老年人的两倍多。 新出现的证据表明，睡眠和生物行为节律紊乱在 认知功能衰退与阿尔茨海默病的发展和进展。重要的是，其后果 MCI患者的睡眠和生物行为节律紊乱的影响超出了患者的范围，也影响了 配偶/伴侣，因为对于大多数成年人来说，睡眠是一种“共同”的健康行为。然而，睡眠和生物行为 节奏通常是在个体层面上考虑的。以我们团队在睡眠方面的开创性工作为基础 作为夫妻之间的共同经历，我们建议研究睡眠和生物行为节律 基本的二元过程，有助于MCI或MCI患者的健康和认知功能 轻度AD和他们的伴侣。我们将评估睡眠中两个二元过程的日常和纵向影响： 相互依赖(伴侣的睡眠模式对彼此的影响)和和谐(即伴侣的睡眠模式 休息/活动和进餐时间等社会节律的相似性)。我们将进行为期14天的自然主义研究 协议，以检查睡眠和生物行为节律之间的机械联系，并 在170对夫妻中一方有证据的样本中，近端的日间功能指标 认知障碍(MCI到轻度阿尔茨海默病)。在自然主义研究方案中，我们将捕获 通过客观测量睡眠和昼夜休息活动的睡眠和生物行为节律 节奏和日常社交节奏。此外，我们还将包括每日情绪评估和 关系质量，我们将使用经过验证的创新智能手机认知评估 测量日常生活中的认知功能。此外，我们还将进行全面的神经心理学 在基线和两年随访时进行评估，以检查睡眠和生物行为节律 基线水平的中断预示着双方在两年内都会出现认知能力下降。研究结果将推动 理解个人和夫妻之间的日常关系和纵向关系 睡眠和生物行为节律影响认知功能减退进展的人群 罹患阿尔茨海默氏症的风险。