Rhythm Experience and Africana Culture Trial (REACT)

摘要 非裔美国人几乎是白人的两倍（即，高加索人）经历阿尔茨海默氏症 疾病或其他痴呆症。对于65岁以上的人来说，认知障碍的患病率在白人中为8.8% 非洲裔美国人为23.9%。即使在55 - 64岁的年龄范围内，非洲裔美国人也有4倍的可能性 比同龄的白色人更容易出现认知障碍。老年痴呆症的风险增加 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，所有这些疾病都是 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， 我想在这份提案中提出：是否有一种有效的方法来减少或消除种族差异 在认知和大脑健康方面的作用幸运的是，身体活动（PA）干预可能有效地改善 神经认知功能和降低痴呆风险。尽管有这些有希望的结果， 几乎没有非洲裔美国人，因此很难按种族对结果进行分层，以确定非洲裔美国人是否 美国人对PA的反应与白人相似。此外，"体力活动"一词 和"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， 长期坚持，长期坚持。增加PA而不使用术语PA的方法（例如，舞蹈）可以 有效地改善健康结果，同时对翻译和长期影响产生更广泛的影响， 长期坚持。在这里，我们提出了一个创新的和文化敏感的方法，增加PA在老年人（60- 80岁）非洲裔美国人。我们提出了一个随机干预，其中180名老年非裔美国人， 分配到每周3天的中等强度非洲舞蹈组（N = 90）或非洲舞蹈组（N = 90）。 教育组90例，每周3天，共6个月。在干预之前和干预完成时， 我们将收集一个全面的神经心理电池和大脑健康和功能的MRI指标， 确定PA影响非裔美国人神经认知健康的生物学途径。 这项建议有可能利用社区为基础的活动，以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，执行今后的干预措施， 少数民族人口减少健康差距。我们有三个主要目标：目标1。检查是否有6- 与教育对照组相比，一个月的非洲舞蹈干预改善了认知表现。 目标二。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 舞蹈干预的机制。我们将收集身体和心理健康的措施，如腰围， 腰围、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介导认知功能的改善， 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.