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

项目摘要/摘要 专注于在衰老过程中保持大脑和认知健康的研究努力已经成为一个关键的公众 考虑到65岁以上人口的数量将从2010年的4020万增加到8850万，人们对健康感到担忧 到2050年，美国的AD患病率预计为1380万。这对健康至关重要。 专业人士开发行为干预措施，以防止健康老年人的认知能力下降。 心血管危险因素与认知能力下降有关，而脑血管的变化 在正常衰老中很常见，这表明针对心血管危险因素可能有助于保持 脑血管和认知健康。在监督环境中进行的体力活动干预 (实验室和小组设置)与老年人的合作一直显示出心血管和 脑血管健康和认知功能的改善。缺乏的是干预措施的发展 它们发生在现实世界环境中，并利用新技术客观地帮助 跟踪实时体力活动行为。现实世界的体育活动干预措施有可能达到 更大部分的人口，并在干预期结束后加强维护。这个 拟议的研究项目将利用移动健康开发一种新的、为期6个月的体育活动干预 提高身体活动水平的技术可能会影响现实世界中的脑血流和认知 65-75岁认知正常老年人的环境。这种干预的目的是为了增加时间 每周进行中等到剧烈的体力活动150分钟，这是美国心脏协会推荐的 心血管福利协会。为此，将进行一项随机对照试验， 30名参与者被分配到流动健康体力活动条件下，另外30名参与者被分配到接受教育 控制条件6个月。体力活动处方的目标是每个人最大运动量的60%-75% 心率基于健康测试，并将在现实世界环境中独立进行。此外， 我们将研究这种新的干预措施是否有可能增加脑血流并改善 受控环境中先前的研究已经证明了认知能力。这份为期五年的K23申请是 旨在为申请者提供成为独立临床科学家所需的培训 专注于开发行为干预措施，以改善大脑和认知老化。该项目建立在 申请人以前在认知神经科学的衰老、脑成像和神经心理学方面的经验 实现以下培训目标：1)在制定和实施 使用移动健康技术对老年人进行体力活动干预；2)学习如何收集、处理 并分析脑血流和静息状态连通性脑成像数据；3)在 设计和实施随机对照试验(包括高级统计学)；以及4)获得 具有科学写作和文艺方面的经验。完成本项目和相关的培训目标 将确保申请者获得必要的技能和经验以过渡到 一位独立的调查者，他综合了运动科学、现实世界行为干预、 认知增强，以及老年人群的脑成像。

PROJECT SUMMARY/ABSTRACT 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 potential 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.