Physical Activity and Cognitive Decline in the Elderly

描述(由申请者提供)：本职业发展奖申请的主要目标是使申请者能够发展成为老年人认知衰退流行病学研究的专家所需的技能和专业知识，重点是体力活动的潜在保护作用。来自动物和人类的研究都有令人信服的证据表明，体育锻炼可能会降低认知能力下降和痴呆症的风险，尽管仍有几个关键问题尚未解决。拟议的培训计划将为申请者提供解决这些问题所需的工具，并将包括元分析、纵向数据分析、随机对照试验设计、老年人体力活动的测量、痴呆症的诊断和病理生理学以及研究的伦理行为等领域的课程作业和重点指导。拟议的研究计划将利用所学的技术来解决有关体力活动和认知能力下降之间的关联的几个关键问题。具体地说，我们将：1)基于对纵向观察性研究(目标1)的荟萃分析，确定这种联系的强度和一致性；2)对心血管健康研究的参与者进行一系列研究，这是一项为期12年的纵向研究，涉及5888名65岁或以上的白人和非裔美国成年人，以确定a)与认知能力下降风险最低相关的体力活动的数量和类型，b)这种关联是否因性别或种族而异，c)关联的时间(即鸡肉和鸡蛋)，以及d)这种关联是否由血管疾病、炎症或磁共振成像上的大脑结构性变化所调节(目标2和3)；以及3)开展一项先导性研究，以评估在有认知衰退风险的老年人中进行随机对照试验的可行性(目标4)。这种培训和研究的结合将使申请者能够发展成功过渡到独立所需的技能，并将极大地促进体能领域的发展 活动和认知能力下降。

DESCRIPTION (provided by applicant): The primary objective of this Career Development Award application is to enable the applicant to develop the skills and expertise necessary to become an expert in the epidemiologic study of cognitive decline in the elderly, with an emphasis on the potential protective effects of physical activity. There is compelling evidence from both animal and human studies that physical activity may lower the risk of cognitive decline and dementia, although several key issues remain unresolved. The proposed Training Plan will provide the applicant with the tools necessary to address these issues and will include coursework and focused mentoring in the areas of metaanalysis, longitudinal data analysis, randomized controlled trial design, measurement of physical activity in the elderly, diagnosis and pathophysiology of dementia, and ethical conduct of research. The proposed Research Plan will utilize the techniques learned to address several key questions about the association between physical activity and cognitive decline. Specifically, we will: 1) determine the strength and consistency of the association based on a meta-analysis of longitudinal, observational studies (Aim 1); 2) conduct a series of studies in participants in the Cardiovascular Health Study, which is a 12-year, longitudinal study of 5,888 white and African American adults age 65 years or older, to determine a) the amounts and types of physical activity associated with the lowest risks of cognitive decline, b) whether the association differs by gender or ethnicity, c) the timing of the association (i.e., chicken vs. egg), and d) whether the association is mediated by vascular disease, inflammation or structural brain changes on magnetic resonance imaging (Aims 2 and 3); and 3) conduct a pilot study to evaluate the feasibility of a randomized controlled trial in elders at risk of cognitive decline (Aim 4). This combination of training and research will enable the applicant to develop the skills necessary to transition successfully to independence and also will substantially advance the field on physical activity and cognitive decline.