PROJECT SUMMARY/ABSTRACT
The prevalence of Alzheimer’s disease and related dementias (ADRD) is projected to double over the next 20
years. Ethnic and racial minorities will bear a disproportionate burden of disease with the most staggering
increase of nearly six-fold anticipated among Mexican Americans and other Hispanic groups. Nonetheless, there
is marked variability in cognitive trajectories, and approximately two-thirds of Mexican Americans surviving into
their 80’s will remain dementia-free. The variability in outcomes highlights the influence of risk and resilience
factors, which may alter neurodegenerative disease course. Recent studies have suggested that upwards of
40% of all dementia cases may be attributable to potentially modifiable risk factors. Among these, the data
supporting the protective benefits of lifestyle factors, such as physical, cognitive, and social activity engagement,
are so compelling that the nation’s leading health organizations have adopted these findings as
recommendations for attenuating ADRD risk. However, the protective effects of lifestyle factors in Mexican
Americans, which may interact with socioeconomic factors, comorbid disease burden, genetic loading, and
cultural factors, warrants further investigation. Assessment of activity engagement has typically relied on self-
report, which is prone to inaccuracies due to the fallibility of memory, social desirability biases, and the limited
frequency of evaluation, negating more nuanced understanding of behavioral change in response to common
fluctuations in environmental and individual factors. Our team at Oregon Health & Science University has
validated the Collaborative Aging Research using Technology (CART) platform, which is comprised of an
integrated network of in-home monitoring devices that capture high-density multi-modal data and are coupled
with algorithms to derive activity patterns that predict cognitive decline. Through a partnership with The University
of Texas Health Science Center at San Antonio, we have extended the technology to the homes of 5 Mexican
American older adults. We now propose to expand upon this line of research and leverage the CART platform
to continuously monitor real-world physical, cognitive, and social activity patterns across a three-year period in
a cohort of 120 older Mexican Americans adults (Aim 1a). We will further evaluate the modifying effects of
socioeconomic status, acculturation, sex, depression, cardiovascular burden, and apolipoprotein e4 status (Aim
1b). Next, we will explore the associations between activity engagement and traditional and novel neuroimaging
indices of brain aging and ADRD (Aim 2). Finally, we will examine the inflammatory profile associated with
activity engagement, as well as their associations with cognitive decline and neuroimaging outcomes (Aim 3).
Leveraging the innovative CART technology platform, we will identify the activity engagement patterns that
promote risk and resilience of cognitive decline in a high-risk, understudied ethnic group. Results of the study
will identify multidimensional health determinants and inflammatory pathways that shape cognitive trajectories,
providing insights into targeted ADRD prevention and treatment strategies within this growing population.
