mHealth-Facilitated Physical Activity Toward Health (mPATH) for Cognitive Function and Sleep in Low-Income Older Adults

项目摘要/摘要 低收入老年人(LIOA)是患阿尔茨海默病和相关疾病的高危人群 痴呆症(ADRD)和睡眠障碍。尽管经验研究表明，体力活动 一般情况下，干预有利于老年人的认知和睡眠，体力活动的可能好处是 在LIOA留学。LIOA中的现有证据表明，LIOA经历了独特的障碍 身体活动，更普遍的身体不活动和久坐行为。由于缺乏身体活动和 久坐行为是对认知功能有协同有害影响的独立危险因素 在LIOA中，同时解决这两个问题以促进认知和睡眠健康是至关重要的。这个 不断增长的可穿戴设备和移动健康(MHealth)提供了一种创新的方法来单独提供 量身定制的家庭体育活动干预措施，灵活的时间表，以克服身体活动的障碍 在LIOA。此外，有限的研究考察了体育活动干预是否会影响个人的 淀粉样蛋白/牛磺酸/神经变性(ATN)阿尔茨海默病的生物学状态以及体力活动是否可能 通过影响睡眠和AD病理来促进认知。这项随机对照试验旨在 检查由移动健康促进的身体活动对健康的直接和持续的效果 (MPATH)对LIOA患者认知功能和睡眠的干预。MPATH是一种个性化的身体活动 干预，包括个性化的身体活动计划和训练课程，在家中锻炼 在可穿戴设备的支持下，关注个性化的运动视频，并在24周内每两周进行一次电话培训 支持设备的移动健康战略。将使用移动健康战略和锻炼视频来支持 参与者在6-12个月期间的体力活动情况。在拟议的研究中，我们将随机选择176个社区 有失眠症状和无痴呆的LIOA与mPATH组或对照组的比例为1：1。 随机化将根据年龄、性别和认知状况进行分层。具体地说，我们将(1)测试即时(6- 与对照组相比，mPATH对LIOA患者认知功能的影响是持续的(12个月)； (2)与对照组比较，检测mPATH对睡眠的即刻(6个月)和持续(12个月)影响； (3)探讨mPATH对ATN生物标志物的影响及睡眠和ATN的潜在调节作用 MPATH对情景记忆影响的生物标志物。

PROJECT SUMMARY/ABSTRACT Low-income older adults (LIOA) are a population at higher risk to develop Alzheimer's disease and related dementias (ADRD) and sleep disturbances. Although empirical research suggests that physical activity interventions benefit cognition and sleep in older adults in general, the possible benefit of physical activity is understudied in LIOA. The available evidence in LIOA suggests that LIOA experience unique barriers to physical activity, more prevalent physical inactivity and sedentary behaviors. Since physical inactivity and sedentary behaviors are independent risk factors that have synergistic harmful effects for cognitive function and sleep, it is crucial to address them simultaneously to promote cognitive and sleep health in LIOA. The growing wearable device and mobile Health (mHealth) provide an innovative approach to deliver individually tailored physical activity interventions at home with flexible schedules to overcome barriers to physical activity in LIOA. In addition, limited research has examined if physical activity interventions impact the individual’s Amyloid/Tau/ Neurodegeneration (ATN) Alzheimer's disease biological state and whether physical activity may promote cognition through impacting sleep and AD pathology. This randomized controlled trial is designed to examine the immediate and sustaining efficacy of an mHealth-facilitated Physical Activity Toward Health (mPATH) intervention on cognitive function and sleep in LIOA. mPATH is a personalized physical activity intervention that includes personalized physical activity plans and training sessions, exercise at home by following personalized exercise videos, and biweekly phone coaching over 24 weeks, supported by wearable devices-enabled mHealth strategies. mHealth strategies and exercise videos will be used to support participant’s physical activity during 6-12months. In the proposed study, we will randomize 176 community dwelling LIOA with insomnia symptoms and without dementia to the mPATH or control group on a 1:1 ratio. Randomization will be stratified by age, sex, and cognitive status. Specifically, we will (1) test the immediate (6- month) and sustaining (12-month) effects of mPATH on cognitive function among LIOA, compared to control; (2) test the immediate (6-month) and sustaining (12-month) effects of mPATH on sleep, compared to control; and (3) explore the effect of mPATH on ATN biomarkers and potential mediating roles of sleep and ATN biomarkers in mPATH’s effect on episodic memory.