A Novel Mobile Health Exercise Intervention in Aging: Brain Perfusion and Cognition

项目总结/摘要 专注于在衰老过程中保持大脑和认知健康的研究工作已成为公众关注的焦点。 考虑到65岁以上的人口将从2010年的4020万增加到8850万， 到2050年，美国的AD患病率预计为1380万。这对健康至关重要 专业人员开发行为干预措施，防止健康老年人的认知能力下降。 心血管危险因素与认知能力下降有关，脑血管变化非常重要。 在正常衰老中很常见，这表明针对心血管危险因素可能有助于维持 脑血管和认知健康。在有监督的环境中进行体育活动干预 （实验室和小组设置）与老年人一直显示改善心血管和 脑血管健康和改善认知功能。缺乏的是制定干预措施 发生在真实的世界环境中，利用新技术客观地帮助 跟踪真实的时间身体活动行为。真实的世界身体活动干预有可能达到 在干预期结束后加强维持。的 一个拟议的研究项目将开发一种新的，为期6个月的身体活动干预使用移动的健康 提高身体活动水平的技术可能会影响真实的世界中的脑血流和认知 在65-75岁的认知正常的老年人的环境。这种干预的目的是增加时间 花费在中度到剧烈的体力活动，以150分钟/周，这是由美国心脏建议 心血管益处协会。为此，将进行随机对照试验， 30名参与者被分配到移动的健康体力活动条件，另外30名参与者被分配到教育条件 对照组6个月。身体活动处方将针对每个人最大量的60-75% 心率基于健身测试，并将在真实的世界环境中独立进行。此外，委员会认为， 我们将研究这种新的干预是否有可能增加脑血流量， 先前在受控环境中的研究已经表明，认知。K23的五年应用程序是 旨在为申请人提供成为独立临床科学家所需的培训 专注于开发行为干预措施，以改善大脑和认知老化。该项目建立在 申请人以前在衰老认知神经科学、脑成像和神经心理学方面的经验， 实现以下培训目标：1）在开发和实施方面获得广泛的培训 使用移动的健康技术对老年人进行身体活动干预; 2）学习如何收集、处理 并分析脑血流和静息状态连接脑成像数据; 3）培养 设计和实施随机对照试验（包括高级统计学）;以及4）获得 有科学写作和语法的经验。完成本项目和相关培训目标 将确保申请人获得必要的技能和经验，过渡到一个角色， 他是一位独立的调查员，他将运动科学、真实的世界行为干预、 认知增强和老年人的脑成像。

PROJECT SUMMARY/ABSTRACT Research efforts focusing on maintaining brain and cognitive health in aging have become a critical public health concern given that the number of people over 65 will increase from 40.2 million in 2010 to 88.5 million by 2050 in the United States, with a forecasted AD prevalence of 13.8 million. It is crucial for health professionals to develop behavioral interventions that prevent cognitive decline in healthy older adults. Cardiovascular risk factors have been associated with cognitive decline, and cerebrovascular changes are very common in normal aging, suggesting that targeting cardiovascular risk factors could potentially help to maintain cerebrovascular and cognitive health. Physical activity interventions conducted in supervised settings (laboratories and group settings) with older adults have consistently shown improved cardiovascular and cerebrovascular health and improved cognitive function. What is lacking is the development of interventions that take place in real world environments and that take advantage of new technologies to help objectively track real time physical activity behaviors. Real world physical activity interventions have the potential to reach a larger segment of the population and to enhance maintenance after the intervention period ends. The proposed research project will develop a novel, 6-month physical activity intervention using mobile health technologies to promote physical activity levels likely to affect cerebral blood flow and cognition in real world environments in cognitively normal older adults aged 65-75. The goal of this intervention is to increase time spent in moderate to vigorous physical activity to 150 min/week, which is recommended by the American Heart Association for cardiovascular benefits. For this purpose, a randomized controlled trial will be conducted with 30 participants being assigned to the mobile health physical activity condition and another 30 to an education control condition for 6 months. Physical activity prescriptions will target 60-75% of each individual’s maximum heart rate based on fitness testing and will be conducted independently in real world environments. Moreover, we will investigate if this novel intervention has the potential to increase cerebral blood flow and improve cognition as has been shown by previous research in controlled environments. This five year K23 application is designed to provide the applicant with the necessary training to become an independent clinical scientist focusing on developing behavioral interventions to improve brain and cognitive aging. This project builds on the applicant’s previous experience with cognitive neuroscience of aging, brain imaging, and neuropsychology to achieve the following training goals: 1) Obtain extensive training in the development and implementation of physical activity interventions with older adults using mobile health technology; 2) learn how to collect, process and analyze cerebral blood flow and resting state connectivity brain imaging data ; 3) develop expertise in the design and implementation of randomized controlled trials (including advanced statistics); and 4) obtain experience with scientific writing and grantsmanship. Completion of this project and associated training goals will ensure the applicant obtains the necessary skills and experience to transition into the role of an independent investigator who integrates the fields of exercise science, real world behavioral interventions, cognitive enhancement, and brain imaging with older adult populations.