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

 描述（由申请人提供）：鉴于美国65岁以上的人数将从2010年的4020万增加到2050年的8850万，预测AD患病率为1380万，因此专注于在老龄化中保持大脑和认知健康的研究工作已成为关键的公共卫生问题。对于健康专业人员来说，制定预防健康老年人认知能力下降的行为干预措施至关重要。心血管风险因素与认知能力下降有关，脑血管变化在正常衰老中非常常见，这表明针对心血管风险因素可能有助于维持脑血管和认知健康。在监督环境（实验室和小组环境）中对老年人进行的身体活动干预一直显示出改善的心血管和脑血管健康以及改善的认知功能。缺乏的是在真实的世界环境中进行干预的发展，并利用新技术来帮助客观地跟踪真实的时间身体活动行为。真实的世界体力活动干预措施有潜力达到更大的人群，并在干预期结束后加强维持。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，使用移动的健康技术，以促进身体活动水平可能会影响脑血流和认知在真实的世界环境中的年龄在65-75岁的认知正常的老年人。这种干预的目标是将中等强度到剧烈体力活动的时间增加到150分钟/周，这是美国心脏协会推荐的心血管益处。为此，将进行一项随机对照试验，其中30名参与者被分配到移动的健康体力活动条件下，另外30名参与者被分配到教育对照条件下，为期6个月。身体活动处方将根据健身测试针对每个人最大心率的60-75%，并将在真实的世界环境中独立进行。此外，我们将研究这种新的干预是否有可能增加脑血流量和改善认知，正如先前在受控环境中的研究所显示的那样。K23申请为期五年，旨在为申请人提供必要的培训，使其成为一名独立的临床科学家，专注于开发行为干预措施，以改善大脑和认知老化。本项目建立在申请人之前在衰老认知神经科学、脑成像和神经心理学方面的经验基础上，以实现以下培训目标：1）获得使用移动的健康技术开发和实施老年人身体活动干预的广泛培训; 2）学习如何收集、处理和分析脑血流和静息状态连接脑成像数据; 3）发展随机对照试验（包括高级统计学）的设计和实施方面的专业知识; 4）获得科学写作和语法的经验。完成本项目和相关的培训目标将确保申请人获得必要的技能和经验，过渡到一个独立的调查员谁整合运动科学，真实的世界行为干预，认知增强领域的作用，并与老年人的大脑成像。

 DESCRIPTION (provided by applicant): 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 potentia 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.