Physical activity, sedentary behavior, and sleep in the ACT cohort: The 24-hour activity cycle

老年人的体力活动(PA)、久坐行为(SB)和睡眠都会影响认知和身体健康。 到目前为止，大多数研究都集中在每种行为上的时间是如何单独影响健康的 结果。然而，PA、SB和SLEEP之间的相互作用可能是造成这种巨大异质性的部分原因 在与衰老相关的健康结果中，以及它们在支持健康老龄化的24小时内的最佳平衡 是未知的。这项建议充分利用了成人思维变化所提供的独特资源 (行动)U19项目，探索PA、SB、睡眠和认知纵向轨迹的相互关系 和身体健康。24小时活动周期范式作为确定纵向间隔期的模型 PA、SB和睡眠对健康结果的相关性是创新的，正如我们建议的设备集合- 以数据为基础，补充自我报告的结果。本项目拟采用多项创新技术 分析24小时活动周期和轨迹之间复杂关系的统计方法 认知和身体功能。科学严谨由24小时行为的客观监测提供支持 并以20多年来在特征良好的临床人群中的ACT数据为基础。衡量标准 认知和身体功能将包括认知能力筛查工具项目反应理论 分数、执行功能和语言流利性的专门测试、日常生活活动自我报告、步态 速度，从椅子上站起来，以及握力。对于目标1，我们将测试与认知相关的双向关联 和身体机能到24小时活动周期，使用设备评估的PA和SB测量，以及自我评估 报告说他睡着了。我们假设：(A)历史上较好的认知和身体功能将独立 与ACT参与者更高的PA水平，更低的SB和更好的睡眠有关，以及(B)更多的PA，更少的SB， 更好的睡眠将独立地与未来更好的认知和身体维持相关 功能。对于目标2，我们假设：(A)历史上较好的认知和身体功能 独立地与ACT参与者更好的设备评估睡眠质量和昼夜节律相关， 和(B)更好的设备评估睡眠质量和昼夜节律将独立地与 更好地维持未来的认知和身体功能。为了实现这两个目标，我们将建设24- 小时活动周期配置文件(基于PA、SB和睡眠的不同平衡)，并了解配置文件如何 与认知和身体功能的历史轨迹和未来变化相关的。协作 将提供有关生命历程和临床核心变量如何影响的新数据 以及关于24小时活动周期和小说之间关系的新信息 神经成像数据。最终，我们的结果将提供急需的证据来指导 促进老年人健康老龄化的指导方针和干预措施，可能包括降低 认知功能减退和老年痴呆，包括阿尔茨海默病。

Physical activity (PA), sedentary behavior (SB), and sleep all impact cognitive and physical health in aging. Most research to date has focused on how time spent in each of these behaviors individually impacts health outcomes. However, interactions of PA, SB, and sleep likely account in part for the tremendous heterogeneity in aging-related health outcomes, and their optimal balance across the 24-hour day in supporting healthy aging is not known. This proposal capitalizes upon unique resources available through the Adult Changes in Thought (ACT) U19 Program to explore the inter-relatedness of PA, SB, sleep, and longitudinal trajectories of cognitive and physical health. The 24-hour activity cycle paradigm as a model for determining longitudinal inter- relatedness of PA, SB, and sleep on health outcomes is innovative, as is our proposed collection of device- based data to complement self-reported outcomes. This project proposes to use a number of innovative statistical approaches to analyze the complex relationships between the 24-hour activity cycle and trajectories of cognition and physical functioning. Scientific rigor is supported by objective monitoring of 24-hour behaviors and builds upon more than two decades of ACT data in a well-characterized clinical population. Measures of cognitive and physical function will include Cognitive Abilities Screening Instrument item response theory scores, specialized tests of executive functioning and verbal fluency, self-reported activities of daily living, gait speed, rising from a chair, and grip strength. For Aim 1, we will test bidirectional associations relating cognitive and physical function to the 24-hour activity cycle using device-assessed measures of PA and SB, and self- reported sleep. We hypothesize that (a) historically better cognitive and physical function will be independently associated with higher levels of PA, lower SB, and better sleep in ACT participants, and (b) more PA, less SB, and better sleep will be independently associated with better future maintenance of cognitive and physical function. For Aim 2, we hypothesize that (a) historically better cognitive and physical function will be independently associated with better device-assessed sleep quality and circadian rhythms in ACT participants, and (b) better device-assessed sleep quality and circadian rhythms will be independently associated with better future maintenance of cognitive and physical function. For both Aims, we will construct combined 24- hour activity cycle profiles (based on different balances of PA, SB, and sleep) and explore how profiles are associated with historical trajectories of and future changes in cognitive and physical function. Collaboration with other Cores will provide new data about how Life Course and Clinical Core variables influence associations, as well as new information about relationships between the 24-hour activity cycle and novel neuroimaging data. Ultimately, our results will provide much needed evidence to inform the development of guidelines and interventions to promote healthy aging in older adults, potentially including reducing risk for cognitive decline and late life dementia including Alzheimer’s disease.