Targeting Cognitive Control to Improve Physical Activity Adherence in Midlife for Alzheimer's Risk Reduction

虽然支持体力活动（PA）减少与年龄相关的认知能力下降和相关的阿尔茨海默病风险的证据继续增加，但关键问题是在阿尔茨海默病预防的关键时期PA采用率和依从性持续较低。由于PA在中年开始下降，而神经退行性病变增加阿尔茨海默氏症的风险在认知障碍之前几十年就开始了，因此迫切需要了解中年人如何以及为什么能够更成功地采用和维持PA。自我调节能力已被确定为对我们的意图和计划采取行动的关键是更积极的身体活动，然而因果证据测试是否以及如何强烈的自我调节能力影响PA行为变化是缺乏文献。因此，我们的目标是测试的因果关系的自我调节结构，认知控制，在PA的行为变化不活跃的中年人。基于时间自我调节理论（TST），我们假设旨在改善认知控制的认知训练将增加PA行为改变计划的成功率，并且用情绪化刺激训练认知控制将进一步增加中度到剧烈的PA依从性。我们的预测是基于研究显示的重要性，认知控制PA的坚持和维护，证据表明，PA的负面情感体验是常见的和有害的未来PA，和可修改的认知控制与自适应认知训练。我们用三个目标来测试我们的总体假设，包括R61阶段（目标1），以开发和完善针对动机，计划和认知控制理论方面的计算机化培训计划，以促进PA行为改变，然后是实施R33阶段（目标2），随机对照试验（RCT），以确定对情绪化信息的认知控制在多大程度上是中度不活跃中年人PA行为改变的目标机制。老年痴呆症的高风险目标2中实施的随机对照试验将在农村和城市地区进行测试，以增加样本的多样性和普遍性，这构成了（目标3）确定改善PA行为变化的干预有效性调节剂的基础。我们预测那些认知控制能力差和高负性情感体验的人将从针对情感领域的认知控制训练中受益最多。我们的研究结果将是显着的，通过确定的因果关系的作用，认知控制和影响可持续的PA行为变化在中年，一个关键的预防期阿尔茨海默氏症。成功将在一个可扩展的培训计划中达到高潮，以提高PA的依从性，为中年人的个性化和可访问的策略奠定基础，以改变他们的课程，走向更积极的生活方式和持续的认知和身体健康的良性循环。

Although evidence in favor of physical activity (PA) for reducing age-related cognitive decline and associated Alzheimer’s risk continues to grow, critical issues are persistently low PA adoption and adherence during critical periods for Alzheimer’s prevention. Because PA starts declining at middle-age and neurodegenerative pathologies increasing Alzheimer’s risk start decades before cognitive impairment, there is a pressing need to understand how and why middle-age adults can more successfully adopt and sustain PA. Self-regulatory capacities have been identified as critical for acting on our intentions and plans to be more physically active, however causal evidence testing whether and how strongly self-regulatory capacities affect PA behavior change is absent from the literature. Therefore, our objective is to test the causal role of the self-regulation construct, cognitive control, in PA behavior change among inactive middle-aged adults. Based on the Temporal Self-Regulation Theory (TST), we hypothesize cognitive training designed to improve cognitive control will increase the success of a PA behavior change program, and training cognitive control with emotionally valenced stimuli will further increase moderate-to-vigorous PA adherence. Our predictions are based on research showing the importance of cognitive control in PA adherence and maintenance, evidence that negative affective experiences of PA are common and detrimental to future PA, and the modifiability of cognitive control with adaptive cognitive training. We test our overall hypothesis with three aims, including an R61 phase (Aim 1) to develop and refine a computerized training program targeting aspects of motivation, planning, and cognitive control theorized to promote PA behavior change, followed by an implementation R33 phase (Aim 2) with a lab-based, randomized controlled trial (RCT) to determine the extent that cognitive control for emotionally valenced information is a target mechanism for PA behavior change in inactive middle-age adults at moderate-to-high risk for Alzheimer’s. The RCT implemented in Aim 2 will be tested across rural and urban sites to increase diversity and generalizability of our sample, which forms the basis for (Aim 3) determining moderators of intervention efficacy for improving PA behavior change. We predict those with poor cognitive control and high negative affective experiences to moderate intensity PA will benefit most from cognitive control training targeted to an affective domain for PA behavior change. Our results will be significant by determining the causal role of cognitive control and affect in sustainable PA behavior change in midlife, a critical prevention period for Alzheimer’s. Success will culminate in a scalable training program to boost PA adherence, setting the stage for personalized and accessible strategies for midlife adults to change their course towards a more physically active lifestyle and a virtuous cycle of sustained cognitive and physical health.