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Leveraging the 24-hour movement paradigm to preserve cognitive function and prevent Alzheimer's disease: The Multi-Ethnic Study of Atherosclerosis (MESA) 24H-ACT Study

利用 24 小时运动模式保护认知功能并预防阿尔茨海默病：动脉粥样硬化多种族研究 (MESA) 24H-ACT 研究

基本信息

批准号：
10617247
负责人：
Keith M Diaz
金额：
$ 188.67万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-05-01 至 2025-04-30
项目状态：
未结题

项目摘要

ABSTRACT Alzheimer’s Disease and Related Dementias (ADRD) are an emerging epidemic in the United States (U.S.). Black and Hispanic men and women are particularly vulnerable to ADRD. Without effective prevention strategies to target and optimize resilience to ADRD, 14 million U.S. adults will be living with ADRD by 2060, with an associated financial burden of $511 billion by 2040. While physical activity has been consistently identified as a modifiable, protective factor to prevent cognitive decline and delay age of dementia onset, the majority of this evidence is based on reported estimates of leisure-time moderate to vigorous intensity physical activity (MVPA), which provides an incomplete characterization of this complex behavioral phenotype. Approximately 95% of waking hours are spent sedentary or in light intensity physical activity; however, there is limited research exploring the health impacts of these different intensity categories. Also, less than 10% of adults accumulate sufficient MVPA to meet recommendations, and this prevalence is even lower in minority groups. Studies have also demonstrated that sleep disturbances, particularly sleep duration and sleep- disordered breathing may increase risk of cognitive impairment. However, this body of evidence is still emerging. Further, Black and Hispanic adults have a higher prevalence of disordered sleep compared to Whites. Despite the potential importance of both waking and sleep behaviors to optimize cognitive resilience, their impacts are often studied in isolation. To address these critical research gaps, we propose the Multi- Ethnic Study of Atherosclerosis 24-Hour Activity Cycle Study (MESA 24H-ACT), a four-year ancillary study to MESA. The overall goal of the MESA 24H-ACT Study is to quantify the impact of physical activity and sleep via the 24-hour movement paradigm to preserve cognitive function and prevent Alzheimer’s disease. Participants who meet eligibility criteria and agree to participate (estimated n=2,125) will be included. As part of MESA 24H-ACT, we propose to augment MESA with a 7-day accelerometer and sleep actigraphy protocol to objectively measure the 24-hour activity cycle (sedentary behavior, light intensity physical activity, MVPA, and sleep). To accomplish these goals, this study will examine the associations of 24-hour activity cycle behaviors, ascertained via device-based measures, cross-sectionally with cognition; markers of cerebrovascular disease, neurodegeneration, and amyloid burden; and the prevalence of MCI and dementia (AIM 1); examine self- reported 24-hour activity cycle behaviors with prospective changes in global cognitive function, cerebrovascular disease and neurodegeneration (AIM 2); and elucidate the bidirectional relationship between impaired cognitive function and 24-hour activity cycles over 12 years. MESA 24H-ACT will address current evidence gaps and provide empirical evidence to accelerate a paradigm shift towards an integrated model that incorporates all 24-hour movement behaviors to optimize brain health across racially/ethnically diverse populations.

抽象的阿尔茨海默氏病和相关痴呆症 (ADRD) 是美国 (U.S.) 的一种新流行病。黑人和西班牙裔男性和女性特别容易受到 ADRD 的影响。如果没有有效的预防制定针对 ADRD 的目标和优化抵御能力的战略，到 2060 年将有 1400 万美国成年人患有 ADRD，到 2040 年，相关的财务负担将达到 5110 亿美元。被认为是一种可改变的保护性因素，可以防止认知能力下降并延缓痴呆症的发病年龄，大多数证据是基于报告的对闲暇时间中度至高强度体力活动的估计活性（MVPA），它提供了这种复杂行为表型的不完整表征。大约 95% 的醒着时间都花在久坐或轻度体力活动上；然而，有探索这些不同强度类别对健康影响的研究有限。而且，不到 10% 成年人积累了足够的 MVPA 来满足建议，而少数族裔的患病率甚至更低组。研究还表明，睡眠障碍，特别是睡眠持续时间和睡眠障碍呼吸紊乱可能会增加认知障碍的风险。然而，这些证据仍然正在出现。此外，与黑人和西班牙裔成年人相比，黑人和西班牙裔成年人睡眠障碍的患病率更高白人。尽管清醒和睡眠行为对于优化认知弹性具有潜在的重要性，它们的影响常常被孤立地研究。为了解决这些关键的研究差距，我们提出了多动脉粥样硬化 24 小时活动周期研究 (MESA 24H-ACT) 的种族研究，一项为期四年的辅助研究台面。 MESA 24H-ACT 研究的总体目标是通过以下方式量化体力活动和睡眠的影响 24 小时运动模式可保护认知功能并预防阿尔茨海默病。参加者符合资格标准并同意参与的人（估计 n=2,125）将被纳入其中。作为 MESA 的一部分 24H-ACT，我们建议通过 7 天的加速度计和睡眠体动记录仪协议来增强 MESA 客观测量 24 小时活动周期（久坐行为、低强度体力活动、MVPA 和睡觉）。为了实现这些目标，本研究将检查 24 小时活动周期行为的关联，通过基于设备的测量、横向认知来确定；脑血管疾病的标志物，神经退行性变和淀粉样蛋白负担；以及 MCI 和痴呆症的患病率（AIM 1）；检查自我报告了 24 小时活动周期行为以及整体认知功能的预期变化，脑血管疾病和神经变性（AIM 2）；并阐明两者之间的双向关系认知功能和 24 小时活动周期受损超过 12 年。 MESA 24H-ACT 将解决当前证据差距并提供经验证据，以加速向综合模型的范式转变纳入所有 24 小时运动行为，以优化不同种族/民族的大脑健康人口。