Background: Recent evidence suggests that increasing dietary intake of minerals reduces the risk of dementia. This study aimed to examine the relationship between potassium and diagnosis of mild ...cognitive impairment (MCI) in a sample of older Mexican-Americans from rural and urban populations. Methods: The sample was formed of a total of 139 participants with MCI and 371 normal controls from two independent cohorts: a rural cohort (Facing Rural Obstacles to Healthcare Now through Intervention, Education and Research Project FRONTIER) and an urban cohort (the Health and Aging Brain among Latino Elders HABLE study). Serum electrolytes examined were sodium and potassium. Age and education were entered in the model as covariates. Results: Across both cohorts, the Project FRONTIER (OR = 3.1; p = 0.01) and the HABLE Project (OR = 2.0; p = 0.04), the results indicated that serum potassium levels significantly increased the risk of diagnosis of MCI. Conclusion: Our finding suggested a link between serum potassium levels and a diagnosis of MCI in Mexican-Americans. The results of this study support a previous research which has suggested that the risk factors for MCI may vary by ethnicity.
Background
Previous research shows that chronic stress and depression have deleterious effects on cognition. African American (AA) women disproportionately experience higher rates of poor mental and ...physical health outcomes, and a growing body of research links chronic stressors to these inequities. In AA’s, Subjective Cognitive Concerns (SCC) have not been widely studied and may be an early indicator of cognitive decline. This study aims to investigate the effect of psychosocial factors such as chronic stress, depression, and SCC on cognitive test outcomes in cognitively unimpaired AA women.
Method
Data from 232 cognitively unimpaired AA women were collected from the Health and Aging Brain Study: Health Disparities, a community‐based epidemiological study of aging. To assess chronic stress, we used the Chronic Stress scale. Depression was accessed via Geriatric Depression Scale (GDS). SCC, which is an algorithm‐derived variable was used to classify participants as either having or not having SCC. Linear regressions were calculated with cognitive test scores as the outcome variable and chronic stress, GDS, age, education, and SCC as predicting variables. The cognitive tests included Weschler Memory Scale ‐III Logical Memory (LM) 1 & 2, Trail Making Test (TMT) Part ‐ A & B, and Digit Span (DS). For each significant linear regression, structure coefficients were calculated.
Result
All linear regression models were statistically significant, ranging from LM1, LM2, TMT A & B p < 0.001 to DS p = 0.005. In LM1, structure coefficients demonstrated that education was the only significant factor correlated with the effect in the model. For TMT A and B, education and age were significantly correlated. LM2 and DS establish a different pattern with GDS, and education significantly correlated with the effect. Stress was also significantly associated with the effect on DS.
Conclusion
The results demonstrate in cognitively unimpaired AA women, the GDS scores were related to decreased performance across multiple memory measures (DS and LM2). Chronic stress may be related to reduced performance in working memory. In AA women, future research should examine the relationship between discrimination, chronic stress, affective symptoms, and allostatic load on cognition. Early interventions targeting psychosocial factors may improve care for diverse communities.
Background
The HABS‐HD study is an epidemiological study of aging in diverse populations and began transitioning from entirely paper‐based charting to electronic data capture (EDC) in 2018. As the ...study evolved, the team realized that neuropsychological testing, scoring, and quality review consumed many resources and much staff time. This aims to describe how the HABS‐HD study moved from paper‐based capture of neuropsychological data to EDC with a small data team.
Method
The HABS‐HD staff recognized the time commitment for scoring and reviewing scores for the neuropsychological assessment, which created a delay between a participant completing the study and the research diagnosis. Senior research assistants worked with internal developers to create an EDC for the neuropsychological assessment. The data core is small and consists of a director, an assistant director, two developers, two data entry personnel, and a clinician. Specific components were completed on paper to prevent an increase in equipment cost and maintain methodological consistency. These components were reviewed post‐assessment, and a senior research assistant directly entered the scores into the EDC.
Result
The EDC neuropsychological assessment was tested before going live. The team adapted data capture from the older method into the EDC. The new system allows the research director to obtain statistics of individual testers and provide more training as needed. It also permits more senior personnel to review the paper components and enter them directly into the EDC, which improves throughput.
Conclusion
Smaller data core teams can transition larger projects from paper methods to EDC. The change does not need to be entirely paper or electronic, but investigators should evaluate which methodologies function best for their populations. Finally, communication between the personnel capturing the data, reviewing the quality of the capture, and writing the EDC software is essential.
Background
Despite the increase in Alzheimer’s disease (AD) research among ethnic and racial minority populations, they are underrepresented in research and successful recruitment of diverse cohorts ...remains challenging. Culturally specific recruitment strategies and community engagement are needed to increase diverse participant enrollment in aging research. In 2020, we designed and implemented a strategy to recruit 1,000 African Americans (AA), 50 years and older into the Health & Aging Brain Study‐ Health Disparities (HABS‐HD) project. In this study, we examined the effectiveness of recruitment strategies among this group.
Method
HABS‐HD is an epidemiological study of cognitive aging among diverse communities. The team recruited an initial cohort of 1,000 non‐Hispanic whites and 1,000 Mexican Americans using a community‐based approach. This foundation was expanded to reach the AA community through the engagement of key stakeholders and the use of an integrated marketing and outreach strategy. Recruitment methods included an integrated approach combining traditional marketing (print, radio); social media (influencers and online ads), and in person community recruitment and education events at local churches, barbershops, health fairs, etc. The reach and enrollment data were collected and analyzed.
Result
Out of 4066 participants that were interested in HABS‐HD, 1362 (33.5%) identified as AA. While recruiting the AA cohort outreach team participated in over 140 community events, ranging from state fairs, barbershops, and church events. Enrollment data indicated participants heard of us through word of mouth (35%); community events (21.6%); news (12.7%); refer a friend program (6.8%); print media (6.4%) radio (4%); and social media (3.6%). In terms of traditional marketing and overall general study awareness, the social media approach reached 179,200 individuals. Of this number12.1% of people interacted with the landing site and then a further 747 clicked to sign up. The reach of our radio advertising was 2,200,000 listeners.
Conclusion
Recruiting diverse communities into research involves targeting the recruitment techniques and materials to the target population. The creation of a culturally appropriate media campaign and utilizing community based methods such as outreach, engagement, and collaboration between the research team and key stakeholders in the community led to the successful recruitment of AA into our study.
Background
Vascular risks including hypertension are significant factors in the development of Alzheimer’s and related dementias . Multiple blood pressure (BP) measurements are commonly used in ...clinical and research practice to assess this vascular risk. Anecdotal evidence suggests that the first BP measurement taken is more elevated than the second measurement as a participant may be nervous about the study. This study explores if the first measurement is elevated compared to the second and then explores the differences between morning and afternoon measurements.
Method
Data from 1705 participants (non‐Hispanic Whites and Mexican Americans) was collected from a community‐based epidemiological study of aging. The average age was 66, and the average education was 12 years. Participants are scheduled either for AM or PM visit. BP measurements are taken post the consent and then after the participant interview prior to the start of neuropsychological testing. The systolic (SBP) and diastolic blood pressure (DBP) changes were calculated by subtracting the second measurement from the first. T‐tests were performed comparing AM to PM groups. Chi‐square tests compared ethnicity and cognitive status in the AM and PM groups. One‐way ANOVAs examined group differences (ethnicity and AM/PM draw groups) in BP measurement.
Result
Results showed significant differences in SBP change between the AM (M = ‐0.52, SD = 12.74) and PM (M = ‐4.03, SD = 10.89); t(1666)= 6.07, p < 0.000) draw and DBP change in the AM (M = 0.16, SD = 7.68) and PM (M = ‐2.32, SD = 6.68); t(1670)=7.09, p <0.000). Chi‐square tests demonstrated significant differences between the AM and PM groups in ethnicity X2(1, N= 1705) = 33.27, p = 0.000. There were no significant differences between the AM and PM regarding cognitive status (normal, MCI, dementia). ANOVAs demonstrated significant differences between the groups in SBP change (F3, 1672 = 12.76, p <0.000) and DBP change (F3, 1672 = 17.10, p <0.000).
Conclusion
The study results demonstrate that there was a relationship between BP and measurement time, which supports evaluating when BP measurements are taken and how this may affect outcomes. Future studies should examine how the blood pressure measurements relate to current guidelines.
Background
Recruitment of older adults into aging research is a challenge. Several research studies and clinical trials have failed due to low participant enrollment. Older adults face many barriers ...to study participation (mistrust of research, lack of transportation, health status, etc.), so special efforts must be made to recruit them into research. We created a recruitment questionnaire with the goal of understanding how to better promote the study and to obtain participant suggestions of groups and locations where the study team could recruit new participants.
Method
The Health and Aging Brain Study: Health Disparities (HABS‐HD) is a community based research study of cognitive aging in diverse communities. We designed a voluntary exit questionnaire for current study participants regarding their recruitment preferences. The questionnaire included the following questions: 1) How did you find out about the study? 2) How can we promote the study to someone similar to you? 3)Which of the following advertising methods do you prefer? 4) Do you know any organization/group that would benefit from the study information? Questionnaire data was compiled and analyzed to assess recruitment preferences and suggestions.
Result
The total number of participants who responded to the questionnaire was 413. 26.9% of respondents stated that they would prefer TV as their main advertising method, followed by the internet (23%) and postal service (mail) (22.7%). Word of mouth was listed as the best way to promote the study (26.9%) followed by community engagement (16.2%) and church (8.2%). When asked for names of organizations, participants recommended tradition groups such as churches, senior centers, and retirement homes. Participants also recommended groups such as rotary clubs, veterans associations, libraries, and the community college senior education program.
Conclusion
Participants can assist in recruitment efforts through suggesting organizations that study personnel may not have reached out to. The input allows for assessment of recruitment and the suggestions can broaden the study’s reach.
Background
Mexican Americans (MA) experience cognitive decline at younger ages and have higher rates of cardiovascular disease (CVD) than Non‐Hispanic whites (NHW). Persons who are depressed are more ...likely to have one or more risk factors for cardiovascular disease. The purpose of this study was to examine the impact of depression and Atherosclerotic Cardiovascular Disease (ASCVD) on cognitive function in MA and NHW.
Method
Data was collected from the Health and Aging Brain Study: Health Disparities (HABS‐HD) study. A total of 1094 participants who were classified as normal controls were stratified into 4 groups: no depression and low risk ASCVD (N= 684), no depression and high risk ASCVD (N= 222), depression and low risk ASCVD (N=140), and depression and high risk ASCVD (N=48). Depressive symptoms were assessed via Geriatric Depression Scale (GDS). ASCVD risk was calculated using a risk calculator. One‐way ANOVAs were conducted to examine differences in cognitive performance based on ASCVD risk and depression.
Result
The results showed that depressed NHW and MA males with a low ASCVD risk had significantly lower mean scores on Trail Making Test A than the non‐depressed with low ASCVD risk group (p < 0.006), (p < 0.017). Depressed MA males with high ASCVD risk had significantly lower mean scores on the MMSE than the non‐depressed low ASCVD risk group (p < 0.00). Depressed NHW females with low ASCVD risk had significantly lower mean scores on delayed memory than the non‐depressed low ASCVD risk group (p < 0.008). Depressed MA females with a high ASCVD risk demonstrated significantly lower mean scores on the COWA and SEVLT Trials 1‐5 and the non‐depressed low ASCVD risk group (p < 0.002), (p < 0.046).
Conclusion
The results of this study indicated that depression and risk of ASCVD can impact cognitive functioning in different ways. In men depression impacted scores on Trails A. In MA women comorbid depression and high risk for ASCVD affect scores on the COWA and SEVLT. These findings support that medical comorbidities influence cognitive function. Future research directions include exploring the relationships between other CVD risk factors and depression.
Abstract
Background
Medical comorbidities are commonly associated with poorer cognition. Hypertension and depression are common comorbidities linked to cognitive decline and Alzheimer’s disease (AD). ...Mexican Americans experience higher rates of these medical comorbidities and also present with cognitive decline at younger ages as compared to their non‐Hispanic White counterparts. Increased work has expanded to look at reasons for increased risk for neurodegenerative conditions such as AD specifically among this population. The purpose of this study was to examine the role of co‐morbid hypertension and depression on cognitive and proteomic outcomes.
Method
Data from 548 Mexican Americans (415 normal control, 133 MCI/AD) was collected from a community based epidemiological study of aging. The average age was 61 and the average education was 7.7 years. Participants were stratified into 4 groups: no hypertension or depression (N= 101), hypertension only (N= 218), depression only (N=59), and comorbid hypertension and depression (N=170). One‐way ANOVAs were utilized to examine group differences in cognitive performance and proteomics. Cognition was assessed via WMSIII Logical memory 1 & 2, Trails A/B, EXIT, and MMSE. Biomarkers of inflammation (serum TNFα, IL5, IL6, IL7, IL10 and CRP) and neurodegeneration (plasma Aß42/ Aß40, Tau, NFL) were analyzed. A logistic regression was calculated with normal control versus MCI/AD as the outcome variable and comorbid condition, education and age as predicting variables.
Result
In normal controls, comorbid hypertension and depression was significantly associated with poorer executive and global cognitive function; and this comorbidity increased risk of MCI/AD diagnosis (OR= 1.950; 95/5 CI= 1.23‐3.08). Among normal controls, the comorbid group was found to have significantly higher levels of NFL (p<0.032) and IL6 (p<0.018) than the depression only group. Among those with MCI/AD, the comorbid group had significantly higher NFL levels (p<0.002) than the neither condition group.
Conclusion
The results of the study demonstrated that comorbid hypertension and depression was related to poorer cognitive functioning and increased risk for cognitive impairment among Mexican Americans. Findings support that medical conditions likely influence biomarkers of inflammation and neurodegeneration, which lends support for a precision medicine approach to treating MCI and AD specifically among minority populations.
Background
Medical comorbidities are commonly associated with poorer cognition. Hypertension and depression are common comorbidities linked to cognitive decline and Alzheimer’s disease (AD). Mexican ...Americans experience higher rates of these medical comorbidities and also present with cognitive decline at younger ages as compared to their non‐Hispanic White counterparts. Increased work has expanded to look at reasons for increased risk for neurodegenerative conditions such as AD specifically among this population. The purpose of this study was to examine the role of co‐morbid hypertension and depression on cognitive and proteomic outcomes.
Method
Data from 548 Mexican Americans (415 normal control, 133 MCI/AD) was collected from a community based epidemiological study of aging. The average age was 61 and the average education was 7.7 years. Participants were stratified into 4 groups: no hypertension or depression (N= 101), hypertension only (N= 218), depression only (N=59), and comorbid hypertension and depression (N=170). One‐way ANOVAs were utilized to examine group differences in cognitive performance and proteomics. Cognition was assessed via WMSIII Logical memory 1 & 2, Trails A/B, EXIT, and MMSE. Biomarkers of inflammation (serum TNFα, IL5, IL6, IL7, IL10 and CRP) and neurodegeneration (plasma Aß42/ Aß40, Tau, NFL) were analyzed. A logistic regression was calculated with normal control versus MCI/AD as the outcome variable and comorbid condition, education and age as predicting variables.
Result
In normal controls, comorbid hypertension and depression was significantly associated with poorer executive and global cognitive function; and this comorbidity increased risk of MCI/AD diagnosis (OR= 1.950; 95/5 CI= 1.23‐3.08). Among normal controls, the comorbid group was found to have significantly higher levels of NFL (p<0.032) and IL6 (p<0.018) than the depression only group. Among those with MCI/AD, the comorbid group had significantly higher NFL levels (p<0.002) than the neither condition group.
Conclusion
The results of the study demonstrated that comorbid hypertension and depression was related to poorer cognitive functioning and increased risk for cognitive impairment among Mexican Americans. Findings support that medical conditions likely influence biomarkers of inflammation and neurodegeneration, which lends support for a precision medicine approach to treating MCI and AD specifically among minority populations.
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