Nearly 20% of older Black Americans are living with a form of dementia
Many people think that dementia is not preventable, but there is growing evidence that healthy lifestyle choices, such as regular exercise, not smoking tobacco, a healthy Mediterranean-type diet, and staying socially engaged help prevent and delay the onset of dementia.
Dementia, or persistent and often progressive changes in memory and thinking, is about twice as common among U.S. Black older adults compared with U.S. white older adults. The Alzheimer’s Association estimates that one in five Black older adults is living with dementia.
Although Alzheimer’s disease is the most common type of dementia, there are several other primary causes or types. Vascular dementia develops from strokes and changes in the small blood vessels of the brain. Uncontrolled high blood pressure, diabetes, and chronic kidney disease all contribute to the development of disease in the small vessels of the brain.
Parkinson’s disease and the related Lewy Body Dementia are additional causes of dementia. Most cases of dementia are due to a combination of two or more causes. The combination of Alzheimer’s and vascular dementia is the most common.
Physical activity is a key component of dementia prevention. In a recent study that combined data from 29 studies and included over one million older adults, those who were active in their free time had a 17% lower risk of developing dementia. The older adults in these studies participated in a wide range of activities to stay active, including walking for exercise, dancing, and yoga.
Physical activity enhances cognitive function and protects against dementia through multiple mechanisms. Aerobic exercise, such as walking briskly or jogging, increases blood flow to the brain, and increases release of a hormone that stimulates the brain cells (brain-derived neurotropic factor).
It is well known that diabetes and high blood pressure increase risk for dementia. Importantly, physical activity helps your body respond better to insulin and lowers blood pressure. Physical activity may even decrease deposition of proteins (e.g. amyloid and tau) in the brain that cause Alzheimer’s Disease.
The Centers for Disease Control and Prevention (CDC) recommends 150 minutes per week of moderate-intensity exercise such as brisk walking. In a study that combined data from over 200,000 adults, walking 500 steps more per day (approximately ¼ mile or four city blocks) was associated with a 7% decreased risk of dying from a heart problem and a 15% decreased overall risk of death by.
Similar patterns are seen with dementia prevention. Importantly, any increase in physical activity is good for heart and brain health.
The CDC recommends three types of exercise for older adults—moderate-intensity activity such as brisk walking or mowing the lawn; activities that strengthen muscles such as lifting weights or digging in the garden; and activities to improve balance such as Tai Chi or standing on one foot.
You are most likely to engage in activities you enjoy and can incorporate into your daily routine. For example, if you meet friends for coffee, consider getting coffee to-go and walking with your friends. Or, if you live near a community center, consider trying out a yoga or Tai Chi class. Any increase in physical activity will help you, and your brain, stay healthy as you age.
Healthy aging research
Participating in the new Healthy Aging in the Senior Years—or HATS study—offers a new opportunity to help advance research in dementia in the Black population. The HATS study is designed to identify risk factors for dementia in Black patients to help prevent dementia and to help with early detection of cognitive impairment and dementia.
The study is a five-year observational study—not a clinical trial, so no medications will be given—that will measure cardiovascular and other risk factors for dementia in Black community members 55 years and older in the Twin Cities. It is a collaborative study between Dr. Anne Murray and the Berman Center, part of the Hennepin HealthCare Research Institute in downtown Minneapolis, Dr. David Knopman and the Mayo Clinic, and two community engagement partners, HueMan and the Lync.
You don’t have to have memory problems to participate in HATS. Their goal is to enroll a broad spectrum of older Black people—from those having no symptoms, to early or moderate dementia. The HATS study will see participants every 15 months for five years and measure cognitive function and physical function (gait speed, grip strength—both can predict risk of dementia).
It will measure general health (blood pressure, weight, BMI) and collect blood samples to measure cholesterol, as well as the new research blood tests that measure dementia blood biomarkers (such as amyloid and tau proteins), which in the future may provide early detection of dementia.
To be eligible for HATS, you must be 55 years and older, self-identify as Black, reside in the metro Twin Cities area, speak English as your primary language, and not have severe dementia (or be unable to participate in memory tests). HATS researchers also request that each participant have a study partner who knows them very well (family member, close friend, caregiver) to provide a history of the participant’s symptoms.
Healthy Aging in the Senior years participants and their study partner will be compensated for their time and contributions to science. The HATS study is funded by a Minnesota Partnership Research Grant, the National Institutes of Health, and philanthropic funds from the Mayo Clinic Rochester.
HATS is actively enrolling. If you would like to inquire about or enroll in HATS, call 612- 449-5347, or email HATSstudy@bermancenter.org. By participating you will directly contribute to dementia research in the Black community.
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