# Leveraging the 24-hour movement paradigm to preserve cognitive function and prevent Alzheimer's disease: The MESA 24H-ACT Study

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2024 · $1,442,176

## Abstract

ABSTRACT
Alzheimer’s Disease and Related Dementias (ADRD) are an emerging epidemic in the United States 
(U.S.). Some population subgroups are particularly vulnerable to ADRD. Without effective prevention 
strategies to target and optimize resilience to ADRD, 14 million U.S. adults will be living with 
ADRD by 2060, with an associated financial burden of $511 billion by 2040. While physical activity 
has been consistently identified as a modifiable, protective factor to prevent cognitive decline 
and delay age of dementia onset, the majority of this evidence is based on reported estimates of 
leisure-time moderate to vigorous intensity physical activity (MVPA), which provides an incomplete 
characterization of this complex behavioral phenotype. Approximately 95% of waking hours are spent 
sedentary or in light intensity physical activity; however, there is limited research exploring the 
health impacts of these different intensity categories. Also, less than 10% of adults accumulate 
sufficient MVPA to meet recommendations, and this prevalence is even lower in minority groups.
Studies have also demonstrated that sleep disturbances, particularly sleep duration and 
sleep-disordered breathing may increase risk of cognitive impairment. However, this body of 
evidence is still emerging. Further, differences in the prevalence of disordered sleep across 
population subgroups have been observed. Despite the potential importance of both waking and sleep 
behaviors to optimize cognitive resilience, their impacts are often studied in isolation. To 
address these critical research gaps, we propose the Multi-Ethnic Study of Atherosclerosis 24-Hour 
Activity Cycle Study (MESA 24H-ACT), a four-year ancillary study to MESA. The overall goal of the 
MESA 24H-ACT Study is to quantify the impact of physical activity and sleep via the 24-hour 
movement paradigm to preserve cognitive function and prevent Alzheimer’s disease. Participants who 
meet eligibility criteria and agree to participate (estimated n=2,125) will be included. As part of 
MESA 24H-ACT, we propose to augment MESA with a 7-day accelerometer and sleep actigraphy protocol 
to objectively measure the 24-hour activity cycle (sedentary behavior, light intensity physical 
activity, MVPA, and sleep). To accomplish these goals, this study will examine the associations of 
24-hour activity cycle behaviors, ascertained via device-based measures, cross-sectionally with 
cognition; markers of cerebrovascular disease, neurodegeneration, and amyloid burden; and the 
prevalence of MCI and dementia (AIM 1); examine self-reported 24-hour activity cycle behaviors with 
prospective changes in global cognitive function, cerebrovascular disease and neurodegeneration 
(AIM 2); and elucidate the bidirectional relationship between impaired cognitive function and 
24-hour activity cycles over 12 years. MESA 24H-ACT will address current evidence gaps and provide 
empirical evidence to accelerate a paradigm shift towards an ...

## Key facts

- **NIH application ID:** 10832998
- **Project number:** 5R01AG071032-04
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Keith M Diaz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,442,176
- **Award type:** 5
- **Project period:** 2021-05-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10832998

## Citation

> US National Institutes of Health, RePORTER application 10832998, Leveraging the 24-hour movement paradigm to preserve cognitive function and prevent Alzheimer's disease: The MESA 24H-ACT Study (5R01AG071032-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10832998. Licensed CC0.

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