Abstract
Alzheimer’s disease and related diseases (ADRD) disproportionately affect persons of African American ethnicity, yet persons who identify as Black/African American are consistently and ...markedly underrepresented in Alzheimer’s research. Prior research suggests that a complex array of factors, from mistrust in medical research to non-inclusive recruitment approaches, have led to the disparity. With the growing rates of ADRD among racial/ethnic groups in the US, it is imperative that research scientists develop interventions and clinical research that are culturally informed and meaningful to the lives of diverse caregivers. The goal of our research is to demonstrate the importance of community engagement and culturally informed interventions, and to offer best practices to advance the science of caregiver recruitment, which may ultimately improve overall representation across racial/ethnic caregiver groups. Research findings will highlight the variety of recruitment strategies used to build trust and more sustainable relationships with diverse communities often underrepresented in research.
Abstract
Remote cognitive screening modalities can be an initial step in assessing cognitive health. This cross-sectional study examined how risk and protective factors relate to cognitive ...performance in non-demented African Americans aged 50 and older. Participants were part of the African American-United Memory and Aging Project (AA-UMAP), a geographically diverse cohort of college-educated adults recruited and evaluated via telephone and online. Demographic, health variables and activity engagement were self-reported through an online survey. Cognition (global cognition, memory, and psychomotor/attention) was measured remotely using the Telephone Interview for Cognitive Status (TICS-40; N = 143) and the CogState Brief Battery (CBB; N = 51). Health variables included a mental health composite (e.g., depression and/or anxiety) and a metabolic conditions composite (e.g., high cholesterol, hypertension, diabetes, and/or obesity). Activity engagement was assessed with self-reported physical, mental, and social lifestyle activities. Linear regression models indicated that older age was associated with slower psychomotor/attention performance (p < 0.01) and marginally lower learning/working memory accuracy (p = 0.08) even after adjusting for covariates (e.g., sex and education). Cognitive performance was unrelated to mental health, metabolic conditions, and lifestyle activity engagement. Neither health-related risk factors nor level of engagement activities were significantly associated with cognitive performance in this remotely screened sample of highly educated middle-aged and older African American adults. More studies of midlife and older African Americans are needed to obtain a more in-depth understanding of the degree to which biopsychosocial strengths and deficits in midlife may affect or alter later-life cognitive trajectories.
Abstract
This study explores the influence of Black adults’ Alzheimer’s disease (AD) knowledge and family history of AD on cognition. A sample of Black adults (n=66, age range=45-84) completed a ...computerized cognitive (CogState Brief) battery and surveys of AD knowledge, family history of AD diagnosis, and health. On the 14-item AD knowledge survey, participants correctly answered a mean of 10.80 (SD=1.50) items. Approximately, 56% reported a biological family member diagnosed with AD, of these 30% reported this being a mother or father. Linear regression models suggested no significant association between AD knowledge and cognitive performance. However, adults with a family member diagnosed with AD had worse visual learning accuracy even after adjusting for age, education, and income. Increased age was associated with worse processing speed, particularly in adults with a mother diagnosed with AD. These findings demonstrate the importance of examining the influence of family history on Black adults’ cognitive health.
Abstract
Issues: Despite the fact that African Americans are twice more likely to develop Alzheimer’s disease (AD) compared to non-Hispanic whites, they are under-represented in AD clinical research. ...Lower representation exists in the AHEAD Study as well, which is an AD prevention clinical trial evaluating the efficacy and safety of Lecanemab in 1400 study participants. We sought to raise awareness about AD and increase clinical research participation of African Americans in the AHEAD Study, through a community-based education and recruitment program (CERP). Description: Our diverse team from Eastern Virginia Medical School and Hampton University, a Historically Black College University (HBCU), established a Community Advisory Board and Ministerial Alliance with representation from faith-based, long-standing civic and fraternal organizations within the Greater Hampton Roads Black community. The alliance guided us to identify prioritization areas for addressing sociocultural barriers and increasing clinical research awareness and participation in traditional African American events, key historic community sites, and non-traditional community centers (i.e., YMCA, independent-living, assisted-living centers, Annual Juneteenth Celebration, Black fraternity, and sorority events.) Community health workers, embedded within the community, of the same cultural background and ethnicity, drove our CERP. Lessons Learned: As of July 2023, we offered our program at 45 community events, including community health fairs, civics events, and Purple Sunday luncheons and talks at Black churches in urban and localities in Hampton Roads, in partnership with fraternal and civic community organizations. Out of over 1700 participants, 177 community members have been prescreened for the AHEAD Study.
Traditional neuropsychological batteries may account for disparities in education and may produce testing anxiety, particularly for older Black adults. Computerized batteries may be more amenable to ...use. The current study used mixed-methods content analysis to explore the perceptions of middle-aged and older Black adults (N = 92) about the CogState Brief Battery (CSBB) and Joggle® computerized battery and a traditional paper-and-pencil neuropsychological battery. The data was analyzed using Atlas.ti. Themes were developed and qualitative responses were converted to quantitative counts to make comparisons to thematic differences based on demographics. Results: The majority of participants liked all three batteries. There were no differences based on demographics. Two prevalent themes across all three measures for what participants liked were 1) mental stimulation and memory, and 2) challenging. A disliked theme specific to the computerized batteries was personal competence. In summary, an array of accessible cognitive batteries is necessary to address individual preferences.
Abstract
The normalization of memory loss continues to contribute to diagnostic delays among older adult African Americans with dementia. We utilized an innovative recruitment method to establish a ...solely online study to examine perceptions and knowledge levels of Alzheimer’s Disease in a highly educated geographically diverse cohort of 223 African Americans aged 50-84. Participants were recruited through largely electronic communications. Sample participants were primarily female (n=196), with 51.1% having completed a master’s degree, and 58.2% of participants with household incomes of $90,000 or higher. Study findings revealed that although highly educated, 42% of sample participants believed significant memory loss was a normal part of aging and 59.6% felt that God’s Will was a possible cause of AD. A sizable majority of participants, 86.5%, felt most family physicians were not trained to diagnose AD. Findings underscore the need for physician and community education within diverse populations, regardless of education and SES status.
Abstract
Understanding of unmet needs and their predictors among bladder cancer (BC) survivors is critical to optimize health care planning for patients. This study compares between younger (<65 ...Years) and older (≥65 Years) BC patients across seven domains of unmet needs (e.g., informational, psychological, supportive care, daily living, communication, logistic, and sexuality needs) and their demographic, clinical, and psychosocial predictors. BC survivors (N=159; 47% women) were recruited from the Bladder Cancer Advocacy Network and completed a questionnaire that included the needs assessment survey (BCNAS-32), hospital anxiety and depression scale (HADS), coping (BRIEF COPE), social provisions scale (SPS), and self-efficacy beliefs (GSE) scale. Although no significant group differences in all reported needs emerged, both groups reported more communication (IQR = 50 (62.5) and less sexuality needs (IQR =13 (52.1). Older patients reported higher depression and anxiety (IQR = 32 (11.5); N = 68) than younger patients (IQR = 28 (11.0); p < .01; N = 88). Multivariable analyses stratified by age showed significant effects of gender among older patients with women experiencing more psychological, care, communication, and sexuality needs than men. Multivariable analyses also showed age-related differences (p < .05) in the predictors of needs controlling for covariates (e.g., gender). Among older patients both higher depression and anxiety and lower self-efficacy beliefs were associated with more psychological, care, and communication needs. Among younger patients, higher depression and anxiety were associated with more psychological, logistic, daily living, and communication needs. Results emphasize the importance of tailoring care planning for patients based on age.
Alzheimer's disease (AD) is the most common form of dementia, accounting for 80% of all cases. Mild cognitive impairment (MCI) is a transitional state between normal aging and AD. Early detection is ...crucial, as irreversible brain damage occurs before symptoms manifest.
This study aimed to identify potential biomarkers for early detection of AD by analyzing urinary cytokine concentrations. We investigated 37 cytokines in AD, MCI, and cognitively normal individuals (NC), assessing their associations with AD development.
Urinary cytokine concentrations were measured in AD (
= 25), MCI (
= 25), and NC (
= 26) patients. IL6ST and MMP-2 levels were compared between AD and NC, while TNFRSF8, IL6ST, and IL-19 were assessed in AD versus MCI. Diagnostic models distinguished AD from NC, and in-silico analysis explored molecular mechanisms related to AD.
Significant perturbations in IL6ST and MMP-2 concentrations were observed in AD urine compared to NC, suggesting their potential as biomarkers. TNFRSF8, IL6ST, and IL-19 differed significantly between AD and MCI, implicating them in disease progression. Diagnostic models exhibited promising performance (AUC: 0.59-0.79, sensitivity: 0.72-0.80, specificity: 0.56-0.78) in distinguishing AD from NC. In-silico analysis revealed molecular insights, including relevant non-coding RNAs, microRNAs, and transcription factors.
This study establishes significant associations between urinary cytokine concentrations and AD and MCI. IL6ST, MMP-2, TNFRSF8, IL6ST, and IL-19 emerge as potential biomarkers for early detection of AD. In-silico analysis enhances understanding of molecular mechanisms in AD. Further validation and exploration of these biomarkers in larger cohorts are warranted to assess their clinical utility.
Abstract
Transitional care programs have emerged as successful models of care in which to reduce cost and improve health outcomes. However, few transitional care models have directly incorporated the ...expertise of the pharmacist as an integral member of the care coordination team. Therein lies an inherent limitation of many community-based transitional care programs, the underutilization of pharmacist during all stages of the care transition process. In 2013, the Hampton Roads Care Transitions Project (HRCTP), a partnership between Senior Services of Southeastern Virginia Area Agency on Aging in Norfolk, VA and Hampton University School of Pharmacy, was established. The goal of the HRCTP is to provide medication management services to reduce preventable hospital readmissions for adults 60 years of age and older with targeted diagnoses. Pharmacists work in collaboration with social workers who act as HRCTP care transition coaches. Between May 2017- October 2018, 678 patients were enrolled in the HRCTP. The hospital readmission rate among patients with targeted diagnoses was reduced by 55.3% with an absolute percentage point reduction of 9.9% and estimated savings amount per avoided readmission of $14,400. Patients who participated in the HRCTP showed a 14% increase in the Patient Activation Assessment indicating an improvement in self-managing efficacy. 93% of patients/caregivers indicated they felt more confident in their ability to manage their health, and 91% expressed satisfaction with the program. The program has proven effective in assisting seniors to remain in their home, reducing hospitalizations, promoting health, increasing patient satisfaction, and reducing healthcare cost.
The current study examined the association between home–school dissonance and academic cheating among 344 high school juniors and seniors at two urban high schools. Students completed two subscales ...of the Patterns of Adaptive Learning Scale (PALS) and one subscale of the Academic Motivation Scale (AMS). Analyses revealed that home–school dissonance significantly predicted both amotivation and academic cheating. In addition, results revealed that amotivation was a significant mediator of the association between home–school dissonance and academic cheating. Limitations and future research directions are discussed.
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