Rhythm Experience and Africana Culture Trial (REACT)

摘要 非裔美国人患阿尔茨海默氏症的可能性几乎是白人(即白人)的两倍 疾病或其他痴呆。对于65岁以上的人，白人认知障碍的患病率为8.8% 非洲裔美国人的比例为23.9%。即使在55-的年龄范围内，非裔美国人也有4倍以上的可能性 比他们年龄匹配的白人同龄人更容易经历认知障碍。患痴呆症的风险增加 非裔美国人可能归因于较低的教育水平和质量，较低的社会经济地位(SES)， 血管疾病、II型糖尿病、高血压和肥胖症的患病率更高，所有这些都是 被认为是痴呆症的危险因素。从这些统计数据中出现了一个关键的公共卫生问题，即我们 打算在本提案中解决的问题是：有没有缩小或消除种族差距的有效方法 在认知和大脑健康方面？幸运的是，体力活动(PA)干预可能会有效地改善 神经认知功能和降低痴呆症风险。尽管有这些有希望的结果，但之前的PA干预 几乎没有非洲裔美国人，这使得很难根据种族对结果进行分层，以确定非洲人 美国人对PA的反应方式和程度与白人相似。此外，“体力活动”一词 和“锻炼”通常被认为是令人不快、痛苦和疲惫的，这会对兴趣产生负面影响， 招生，并长期坚持。在不使用术语PA(例如，舞蹈)的情况下增加PA的方法可能 在有效改善健康结果的同时，对翻译和长期- 任期坚持。在这里，我们提出了一种创新的、对文化敏感的方法，以增加老年人(60岁- 80岁)非裔美国人。我们建议对180名年长的非裔美国人进行随机干预 被分配到一个中等强度的非洲舞蹈组，每周三天(N=90)或一个非洲人 教育组(N=90)每周3天，疗程6个月。无论是在干预之前还是完成干预时， 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影响非裔美国人群体神经认知健康的生物学途径。 这项提议有可能利用社区活动来改善老年非洲人的健康 美国人。此外，它可以建立一个平台(即舞蹈)，以实施未来的干预措施 减少少数群体的健康差距。我们有三个主要目标：目标1。检查6- 与教育控制组相比，每月非洲舞蹈干预改善了认知表现。 目的2.研究非洲舞是否影响大脑形态、任务诱发的神经反应、大脑 血流和静息状态的连通性。目标3.探索潜在的生理和社会情感 舞蹈干预的机制。我们将收集身体和心理社会健康的测量指标，如腰围 周长、血压、血糖和血脂水平、情绪、焦虑、抑郁和孤独以及 检查这些测量的干预相关变化是否会调节认知能力的改善 性能。

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.