The proposed project aims to identify the optimal features of daytime napping and physical activity for cognition in older adults (K99) and examine the effects of an innovative, personalized behavioral intervention on promoting physical activity, healthy napping, sleep and cognitive function in sedentary older adults (R00). In the K99 phase, to ensure the successful completion of the R00 project and facilitate the achievement of my career development goals, I will follow an intensive training plan that incorporates courses, laboratory training, mentoring, and structured activities. In addition, a retrospective study will be conducted using two large longitudinal cohorts of older adults in the United States to examine the associations of daytime physical activity and nocturnal sleep with cognitive decline over 4-6 years. The K99 study will examine: 1) baseline associations of napping characteristics, physical activity and nocturnal sleep duration with cognition; 2) whether baseline napping, physical activity and nocturnal sleep duration predict cognitive decline at the 4-6 year follow-up; and 3) relationships between changes in physical activity and nocturnal sleep duration and changes in cognitive function at follow-up. Building off the K99, in the R00 phase, a randomized controlled trial will be conducted in older adults (without dementia) with both sedentary lifestyle and nocturnal sleep complaints to examine the effectiveness of a 24-week personalized behavioral intervention implemented with smartwatch technology on promoting physical activity, nocturnal sleep, and cognition compared against a control group; we have successfully tested this in a pilot study. Serum inflammatory biomarkers will be assessed to explore hypothesized mechanisms for associations among the study outcomes. In order to optimize outcomes at the subject level, a personalized physical activity plan will be calculated based on the individual?s characteristics, personal circadian rhythm at baseline, and the optimal characteristics of napping and physical activity that were identified in the K99 phase. The R00 study will examine: 1) whether the intervention increases participants? non-nap period physical activity, optimizes napping duration, and enhances nocturnal sleep; 2) whether the intervention improves participants? overall cognitive performance; 3) whether the relationship between the study intervention and cognitive performance is mediated by changes in physical activity, healthy nap duration, and nocturnal sleep duration; and 4) (exploratory aim) if the proposed intervention changes serum inflammatory biomarkers, including cytokines (IL-6, IL-1, TNF-?) and C-reactive protein, and whether these biomarkers relate to changes in physical activity, sleep, and cognitive function. Upon completion, this proposal will provide important insights on the optimal features of physical activity and napping for cognitive function. The proposed intervention may provide a novel way for older adults to optimize wellness and achieve active, healthy lives while aging, a key theme of the National Institute of Nursing Research in its mission to enhance public health. It will also build a strong foundation for my future career as an independent researcher.

Public Health Relevance

The findings of the proposed project will inform older adults and clinicians how to optimize their physical activity and daytime napping in order to maximize cognitive benefits. The proposed intervention may provide a novel way for older adults to achieve active and healthy aging. The results will expand our understanding of the underlying mechanisms for the relationship among physical activity, sleep, and cognition in older adults.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Career Transition Award (K99)
Project #
5K99NR016484-02
Application #
9493551
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Tully, Lois
Project Start
2017-06-01
Project End
2019-05-31
Budget Start
2018-06-01
Budget End
2019-05-31
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Pennsylvania
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
Li, Junxin; Yang, Binbin; Varrasse, Miranda et al. (2018) Physical Activity in Relation to Sleep Among Community-Dwelling Older Adults in China. J Aging Phys Act 26:647-654
Ji, Xiaopeng; Li, Junxin; Liu, Jianghong (2018) The Relationship Between Midday Napping And Neurocognitive Function in Early Adolescents. Behav Sleep Med :1-15
Li, Junxin; Vitiello, Michael V; Gooneratne, Nalaka S (2018) Sleep in Normal Aging. Sleep Med Clin 13:1-11
Petrovsky, Darina V; McPhillips, Miranda Varrasse; Li, Junxin et al. (2018) Sleep disruption and quality of life in persons with dementia: A state-of-the-art review. Geriatr Nurs 39:640-645
Seo, Jin Young; Li, Junxin; Li, Kun (2018) Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States. J Obstet Gynecol Neonatal Nurs 47:52-63
Li, Junxin; Chang, Yu-Ping; Riegel, Barbara et al. (2018) Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults. J Gerontol A Biol Sci Med Sci 73:360-366
Sullivan, Suzanne S; Li, Junxin; Wu, Yow-Wu Bill et al. (2017) Complexity of Chronic Conditions' Impact on End-of-Life Expense Trajectories of Medicare Decedents. J Nurs Adm 47:545-550