Mechanisms of Adherence to Light Intensity Physical Activity to Prevent Alzheimer's Disease and Related Dementias

项目总结 将阿尔茨海默病和相关痴呆症(ADRD)的发病推迟几年可能会积累 个人和家庭的生活质量、独立生活和医疗费用的大幅提高 专门的医疗保健。年进行的体力活动干预相关的积极认知结果 中老年人增加了对ADRD可能实现初级预防的承诺 通过改变生活方式。坚持健康促进行为可能需要几年到几十年的时间才能实现 在认知健康跨度方面取得了显著的进步。关键的是，虽然生活方式干预对行为是支持的 短期和长期维持认知健康促进行为的变化(即继续 在干预完成6个多月后实施这些行为)已被证明很难实现。 目前的项目将利用一种使用商业可用技术(SMART)的mHealth方法 手机、戴在手腕上的活动监测器)，以促进长期维持光强度体力活动 (LIPA)患ADRD(成人肥胖)风险增加的中年成年人。在健康教育之后 与经过认证的运动生理学家会谈后，我们的方法将提供其他干预组件： 自适应每日目标设定(双臂)、自我监控(双臂)和临时目标设定每2-3次 在参与者的日常生活过程中，在学习智能手机上进行数小时(仅限手臂治疗)。我们的目标是 证明对干预的临时目标设定操纵可以带来更大的长期 在干预的每一天，通过保持LIPA目标活跃在焦点注意力中来维持LIPA 通过定期实现目标来提高LIPA自我效能感。目标维护(由自我指示 监控频率)将通过参与者与定制集成的Fitbit手腕佩戴的互动进行量化 活动监控器和认知变化移动监控器(M2C2)部分 移动工具箱。Fitbit将配置一个定制设计的钟面，显示累积步长 当按下“检查我的步数”按钮时进行计数。日志记录和时间戳这些交互将允许 自我监测频率的量化。我们建议发展这些促进坚持的措施 机制(目标保持和自我效能)可以作为自我调节的脚手架，长期 可以实现健康促进收益。当前项目将：1)展示中期目标的能力 设置以执行我们提议的坚持促进目标(目标1)；2)测试临时目标的有效性 通过目标设置操作以增加干预后LIPA的短期和长期维护 维持和提高自我效能感(目标2)；3)检查认知变化如何影响 参与目标维护的干预(目标3)；4)探索长期有益的影响 对认知(ADRD风险的变化)和身体健康(体重变化，V02-max；目标4)的干预。

PROJECT SUMMARY Delaying the onset of Alzheimer’s disease and related dementias (ADRD) by even a few years could amass substantial improvements in quality of life for individuals and families, independent living, and the cost of specialized healthcare. Positive cognitive outcomes associated with physical activity interventions conducted in middle-aged and older adults have increased the promise that primary prevention of ADRD may be achievable via lifestyle change. It may take years to decades of adherence to health promoting behaviors to realize appreciable gains in cognitive health span. Critically, while lifestyle interventions are supportive of behavior change in the short-term, longer-term maintenance of cognitive health promoting behaviors (i.e. continued enactment of these behaviors 6+ months after completion of the intervention) has proven difficult to achieve. The current project will leverage an mHealth approach using commercially-available technology (smart phones, wrist-worn activity monitors) to promote long-term maintenance of light intensity physical activity (LIPA) in middle-aged adults at increased risk for ADRD (adults with obesity). Following a health education session with a certified exercise physiologist, our approach will deliver the other intervention components: adaptive daily step goal setting (both arms), self-monitoring (both arms), and interim goal setting every 2-3 hours (treatment arm-only), on study smart phones, over the course of participants daily lives. We aim to demonstrate that the interim goal setting manipulation to the intervention can lead to greater long-term maintenance of LIPA by keeping LIPA goals active in the focus attention during each day of the intervention period and increasing LIPA self-efficacy through regular goal attainment. Goal maintenance (indicated by self- monitoring frequency) will be quantified via participant interactions with custom-integrated Fitbit wrist-worn activity monitors and the Mobile Monitoring of Cognitive Change (M2C2) component of the forthcoming NIH Mobile Toolbox. Fitbits will be configured with a custom-designed clockface that displays accumulated step counts when a ‘check my steps’ button is pressed. Logging and timestamping these interactions will allow for quantification of self-monitoring frequency. We propose that development of these adherence-promoting mechanisms (goal maintenance and self-efficacy) can act as a self-regulatory scaffold from which long-term health promotion gains can be realized. The current project will: 1) demonstrate the ability of interim goal setting to engage our proposed adherence-promoting targets (Aim 1); 2) test the efficacy of the interim goal setting manipulation to increase short- and long-term LIPA maintenance following the intervention through goal maintenance and increased self-efficacy (Aim 2); 3) examine how variation in cognition influences the ability of the intervention to engage goal maintenance (Aim 3); 4) explore the long-term salutary effects of the intervention on cognitive (change in ADRD risk) and physical health (change in weight, V02-max; Aim 4).