Characterizing Older Mexican (American) Participation in Activity Digitally, Reliably, and Ecologically with the CART Platform (COMPADRE CART): Implications for Cognition and ADRD

项目摘要/摘要 阿尔茨海默病和相关痴呆症(ADRD)的患病率预计将在未来20年翻一番 好几年了。少数族裔和少数族裔将承担不成比例的疾病负担，其中最令人震惊的是 在墨西哥裔美国人和其他拉美裔群体中，预计增加了近六倍。尽管如此，在那里 认知轨迹的显著变异性，大约三分之二的墨西哥裔美国人存活到 他们80岁的S将保持无痴呆症。结果的可变性突出了风险和韧性的影响 可能改变神经退行性疾病病程的因素。最近的研究表明，超过 40%的痴呆症病例可能归因于潜在的可改变的危险因素。其中，数据 支持生活方式因素的保护性益处，如身体、认知和社会活动参与， 是如此令人信服，以至于国家领先的卫生组织采用了这些发现作为 降低ADRD风险的建议。然而，在墨西哥，生活方式因素的保护作用 美国人，这可能与社会经济因素相互作用，共病的疾病负担，基因负荷，以及 文化因素，值得进一步研究。对活动投入的评估通常依赖于自我 由于记忆的易错误性、社会期望的偏差和有限的 评估的频率，否定了对响应共同的行为变化的更细微的理解 环境和个人因素的波动。我们俄勒冈健康与科学大学的团队已经 验证了协作老龄化技术研究(CART)平台，该平台由 家庭监控设备的集成网络，捕获高密度多模式数据并耦合 通过算法得出预测认知衰退的活动模式。通过与大学的合作伙伴关系 在圣安东尼奥的德克萨斯健康科学中心，我们已经将这项技术扩展到5个墨西哥人的家庭 美国老年人。我们现在建议扩展这一研究领域，并利用购物车平台 在三年的时间内持续监控真实世界的身体、认知和社会活动模式 一个由120名墨西哥裔美国老年人组成的队列(目标1a)。我们将进一步评估其修改效果。 社会经济地位、文化适应、性别、抑郁、心血管负担和载脂蛋白ε4状态(目的 1B)。接下来，我们将探索活动参与与传统的和新的神经成像之间的联系 脑老化指数和ADRD(目标2)。最后，我们将检查与以下内容相关的炎症概况 活动投入及其与认知衰退和神经成像结果的关系(目标3)。 利用创新的购物车技术平台，我们将确定符合以下要求的活动参与模式 在高危、研究不足的种族群体中促进认知能力下降的风险和韧性。研究结果 将确定塑造认知轨迹的多维健康决定因素和炎症途径， 提供对不断增长的人口中有针对性的ADRD预防和治疗策略的见解。

PROJECT SUMMARY/ABSTRACT The prevalence of Alzheimer’s disease and related dementias (ADRD) is projected to double over the next 20 years. Ethnic and racial minorities will bear a disproportionate burden of disease with the most staggering increase of nearly six-fold anticipated among Mexican Americans and other Hispanic groups. Nonetheless, there is marked variability in cognitive trajectories, and approximately two-thirds of Mexican Americans surviving into their 80’s will remain dementia-free. The variability in outcomes highlights the influence of risk and resilience factors, which may alter neurodegenerative disease course. Recent studies have suggested that upwards of 40% of all dementia cases may be attributable to potentially modifiable risk factors. Among these, the data supporting the protective benefits of lifestyle factors, such as physical, cognitive, and social activity engagement, are so compelling that the nation’s leading health organizations have adopted these findings as recommendations for attenuating ADRD risk. However, the protective effects of lifestyle factors in Mexican Americans, which may interact with socioeconomic factors, comorbid disease burden, genetic loading, and cultural factors, warrants further investigation. Assessment of activity engagement has typically relied on self- report, which is prone to inaccuracies due to the fallibility of memory, social desirability biases, and the limited frequency of evaluation, negating more nuanced understanding of behavioral change in response to common fluctuations in environmental and individual factors. Our team at Oregon Health & Science University has validated the Collaborative Aging Research using Technology (CART) platform, which is comprised of an integrated network of in-home monitoring devices that capture high-density multi-modal data and are coupled with algorithms to derive activity patterns that predict cognitive decline. Through a partnership with The University of Texas Health Science Center at San Antonio, we have extended the technology to the homes of 5 Mexican American older adults. We now propose to expand upon this line of research and leverage the CART platform to continuously monitor real-world physical, cognitive, and social activity patterns across a three-year period in a cohort of 120 older Mexican Americans adults (Aim 1a). We will further evaluate the modifying effects of socioeconomic status, acculturation, sex, depression, cardiovascular burden, and apolipoprotein ε4 status (Aim 1b). Next, we will explore the associations between activity engagement and traditional and novel neuroimaging indices of brain aging and ADRD (Aim 2). Finally, we will examine the inflammatory profile associated with activity engagement, as well as their associations with cognitive decline and neuroimaging outcomes (Aim 3). Leveraging the innovative CART technology platform, we will identify the activity engagement patterns that promote risk and resilience of cognitive decline in a high-risk, understudied ethnic group. Results of the study will identify multidimensional health determinants and inflammatory pathways that shape cognitive trajectories, providing insights into targeted ADRD prevention and treatment strategies within this growing population.