Einstein Aging Study

ABSTRACT The etiology of Alzheimer’s disease and related dementias (ADRD) is multifactorial and given the current lack of disease-modifying treatments, there is a growing need to better understand the roles of modifiable risk factors. The overarching goal of this Einstein Aging Study Program Project (EAS P01) renewal is to elucidate pathways linking behavioral, social/emotional and metabolic health, as well as environmental factors to cognitive decline prior to onset of ADRD. The EAS cohort is a diverse community-based sample from Bronx County, NY, and provides the opportunity to examine social factors related to racial/ethnic disparities in cognitive health. In the current funding period, we developed and applied ecological momentary assessment (EMA) methods and aligned them with robust clinic-based measures of cognitive performance to identify early cognitive changes and modifiable risk factors for cognitive decline. We will expand upon this experience by utilizing mobile devices that capture the dynamic time-varying nature of risk factors and cognitive performance as participants engage in their usual daily activities. Our experience with ambulatory assessment paired with our expertise in conventional methods and strong statistical expertise are major strengths of the proposal. The robust conventional cognitive battery provides domain specific measures of cognitive status and decline, supports the diagnosis of mild cognitive impairment (MCI) and facilitates comparison with other studies. We propose four thematically connected projects, to measure exposures in relation to the primary cognitive outcomes: cognitive performance, cognitive decline, mild cognitive impairment, and blood-based AD biomarkers. Project 1 will assess combined effects of sleep health, physical activity and sedentary behavior. Project 2 will investigate the independent, and joint effects of social/emotional health, inflammation and markers of biological aging. Project 3 will measure person-specific exposure to air pollution to investigate the effects of particulate matter exposure. Project 4 utilize continuous glucose monitoring in Type 2 diabetics to examine effects of glucose regulation. The resources and expertise within these integrated projects, will be supported by six closely linked cores. These combined resources will enhance our ability to examine biological mechanisms that may underlie associations of exposures with cognitive outcomes including inflammation, vascular processes, markers of neurodegeneration. Information will inform future targeted interventions to prevent of delay ADRD onset. EAS researchers will continue to mentor junior investigators to train the next generation of cognitive aging scientists in innovative approaches to clinical research. Through oongoing national and international collaborations the EAS will continue as a valuable resource for the ADRD research community.