Notre Dame Study of Health & Well-being
Science of Wellness
The Science of Wellness study is looking at the ever increasing age of the global population that's expected to result in increased burden on seniors, their families and caregivers, and the health care system. This is, in part, a result of the expected increase in age-related diseases, most notably Alzheimer’s disease (AD). AD is the most common form of dementia and significantly reduces the quality of life and ability to live independently. The consensus is that the harbingers of AD begin a decade or so before clinical symptoms manifest, and interventions aimed at this time window provide the most efficacious approach to mitigating the deleterious consequences of AD neuropathology. Little is known, however, about the influence lifestyle, personality, and other factors occurring in middle adulthood on later development of AD neuropathology and conversion to AD. Our study will address this by investigating how stress exposure and stress resiliency during middle and later adulthood play an important role in the development of AD neuropathology. We will take advantage of a well characterized longitudinal sample of participants from the Notre Dame Study of Health and Well-Being (NDHWB). We will measure three neural markers that are predictive of conversion to AD. Participants will undergo structural MRI to obtain two measures of brain anatomy that predict conversion to AD - hippocampal volume and a measure of cortical thinning referred to as a ‘personalized cortical AD signature’. Additionally, participants will undergo transcranial magnetic stimulation (TMS) in conjunction with electroencephalography to measure TMS evoked electrical potentials. Prior research has demonstrated that AD is associated with dysfunctional brain activity elicited by TMS. Lastly, we will genotype participants for the apolipoprotein (APOE) e4 allele, which increases risk for development of AD. We expect that increased stress exposure combined with decreased stress resilience predict increased evidence for AD neuropathology as indexed by our three neural markers (i.e., increases in the cortical signature of AD, abnormal neural responses elicited by TMS). If this is found, it will provide a specific early indicator of AD risk - coping with stress.
This research will provide the seed for external funding to enroll new individuals and identify high risk cases (i.e., individuals with poor stress responses) prospectively. With the longitudinal data from the NDHWB and our predictive modeling, we will be able to to identify such "at risk" individuals for personalized intervention. The long term goal is a prospective study that will provide a multifaceted intervention for individuals at elevated risk that includes factors thought to protect against, and in some cases reverse symptoms of, AD (e.g., diet, exercise, social engagement, and lifelong learning opportunities). Briefly, our proposed longitudinal intervention would involve bringing at risk older adults "back to school" - to engage them in an intellectually and socially stimulating environment similar to a college campus, complete with exercise classes, classes of interest, diet regulation, and social engagement. The aim is to establish individualized identification of at-risk cases, and have the individuals participate in a targeted intervention. This grant will plant the seed for establishing a Predictive, Preventive, Personalized and Participatory way to address the devastating effects of AD.
How old would you be if you didn't know how old you were? ~ Satchel Paige