Rhythm Experience and Africana Culture Trial (REACT)

节奏体验和非洲文化试验（REACT）

• 批准号: 9770760
• 负责人: Kirk I Erickson
• 金额: $ 69.81万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9770760
• 关键词: Address; Adherence; African; African American; Age; Alzheimer' s Disease; Anxiety; Area; Biological; Biological Testing; Blood Glucose; Blood Pressure; Brain; Brain region; Caucasians; Cerebrovascular Circulation; Cognition; Cognitive; Cognitive aging; Communities; Control Groups; Dancing; Data; Dementia; Education; Educational Intervention; Elderly; Enrollment; Exercise; Fatigue; Funding; Future; Health; Health Benefit; High Prevalence; Hippocampus (Brain); Hypertension; Impaired cognition; Infrastructure; Intervention; Loneliness; Magnetic Resonance Imaging; Measures; Mediating; Medicare; Memory; Mental Depression; Methods; Minority; Mission; Moods; Neurocognitive; Neuropsychology; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Pain; Pathway interactions; Perfusion; Physical Function; Physical activity; Physiological; Pilot Projects; Population; Prevalence; Procedures; Public Health; Race; Randomized; Randomized Clinical Trials; Research Personnel; Rest; Risk Factors; Sampling; Testing; Time; Translating; Translations; United States National Institutes of Health; Vascular Diseases; base; blood lipid; blood-based biomarker; brain health; brain morphology; cognitive function; cognitive performance; cost; dementia risk; exercise intervention; experience; health disparity; human old age (65+); improved; innovation; interest; low socioeconomic status; neuroimaging; psychosocial; racial disparity; recruit; relating to nervous system; response; statistics; waist circumference; white matter

Abstract African Americans are almost two times more likely than whites (i.e., Caucasians) to experience Alzheimer's disease or other dementias. For those over the age of 65, the prevalence of cognitive impairment is 8.8% in whites and 23.9% in African Americans. Even in the age range of 55-64, African Americans are 4 times more likely to experience cognitive impairment than their age-matched white counterparts. Increased risk of dementia among African Americans may be attributed to lower levels and quality of education, lower socioeconomic status (SES), and higher prevalence of vascular diseases, Type II diabetes, hypertension, and obesity, all of which are recognized as risk factors for dementia. A critical public health question emerges from these statistics that we intend to address in this proposal: Is there an effective method for reducing or eliminating the race disparities in cognitive and brain health? Fortunately, physical activity (PA) interventions may be effective at improving neurocognitive function and reducing risk for dementia. Despite these promising results, prior PA interventions have had few African Americans making it difficult to stratify results by race to determine whether African Americans respond to PA in a similar manner and magnitude as whites. In addition, the terms `physical activity' and `exercise' are often considered unpleasant, painful, and fatiguing, which can negatively influence interest, enrollment, and long-term adherence. Methods that increase PA without using the term PA (e.g., dancing) could be effective at improving health outcomes while simultaneously having a wider impact on translation and long- term adherence. Here we propose an innovative and culturally sensitive method of increasing PA in older (60- 80 yrs) African Americans. We propose a randomized intervention where 180 older African Americans are assigned to either a moderate intensity African Dance group 3 days per week (N=90) or to an African Education group 3 days per week (N=90) for 6-months. Both before and at the completion of the intervention, we will collect a comprehensive neuropsychological battery and MRI metrics of brain health and function to identify biological pathways by which PA influences neurocognitive health in an African American population. This proposal has the potential to utilize community-based activities to improve health of older African Americans. In addition, it could establish a platform (i.e., dance) to implement future interventions targeting minority populations to reduce health disparities. We have three primary aims: Aim 1. Examine whether a 6- month African Dance intervention improves cognitive performance compared to an educational control group. Aim 2. Examine whether African Dance influences brain morphology, task-evoked neural responses, cerebral blood flow, and resting state connectivity. Aim 3. Explore potential physiological and socioemotional mechanisms of the dance intervention. We will collect measures of physical and psychosocial health such as waist circumference, blood pressure, blood glucose and lipid levels, mood, anxiety, depression, and loneliness and examine whether intervention-related changes to these measures mediate improvements in cognitive performance.

抽象的 非裔美国人患阿尔茨海默氏症的可能性几乎是白人（即白种人）的两倍 疾病或其他痴呆症。对于 65 岁以上的人来说，白人中认知障碍的患病率为 8.8% 非洲裔美国人中这一比例为 23.9%。即使在 55-64 岁的年龄范围内，非洲裔美国人的可能性也是其他人的 4 倍 与同龄白人相比，他们经历了认知障碍。患痴呆症的风险增加 非裔美国人的教育水平和质量较低、社会经济地位 (SES) 较低、 血管疾病、二型糖尿病、高血压和肥胖症的患病率较高，所有这些疾病 被认为是痴呆症的危险因素。我们从这些统计数据中发现了一个关键的公共卫生问题 本提案拟解决：是否有有效的方法来减少或消除种族差异 认知和大脑健康？幸运的是，体力活动 (PA) 干预措施可能有效改善 神经认知功能并降低痴呆风险。尽管取得了这些有希望的结果，但之前的 PA 干预措施 很少有非洲裔美国人，因此很难按种族对结果进行分层以确定是否是非洲裔美国人 美国人对公共活动的反应方式和程度与白人相似。此外，术语“体力活动” “锻炼”通常被认为是不愉快的、痛苦的和疲劳的，这会对兴趣产生负面影响， 注册和长期坚持。不使用术语 PA 来增加 PA 的方法（例如跳舞）可以 有效改善健康结果，同时对翻译和长期影响产生更广泛的影响 术语遵守。在这里，我们提出了一种创新且文化敏感的方法来增加老年人（60- 80 岁）非裔美国人。我们提议对 180 名老年非裔美国人进行随机干预 分配到每周 3 天的中等强度非洲舞蹈组 (N=90) 或分配到非洲舞蹈团 教育组每周 3 天 (N=90)，为期 6 个月。在干预之前和完成时， 我们将收集全面的神经心理学电池和大脑健康和功能的 MRI 指标，以 确定 PA 影响非裔美国人神经认知健康的生物学途径。 该提案有可能利用基于社区的活动来改善非洲老年人的健康 美国人。此外，它可以建立一个平台（即舞蹈）来实施未来的干预措施 少数民族人口的健康差距。我们有三个主要目标： 目标 1. 检查 6- 与教育对照组相比，非洲舞蹈干预可改善认知表现。 目标 2. 检查非洲舞蹈是否影响大脑形态、任务诱发的神经反应、大脑 血流量和静息状态连接。目标 3. 探索潜在的生理和社会情感 舞蹈干预机制我们将收集身体和心理健康的测量数据，例如腰围 周长、血压、血糖和血脂水平、情绪、焦虑、抑郁和孤独， 检查这些措施的干预相关变化是否会介导认知能力的改善 表现。