Let’s Talk Brain Health

Most readers of Let’s Talk Brain Health already know the statistics: Alzheimer’s disease and related dementias are twice as common in African Americans compared to their White counterparts. There is growing evidence that this disparity is not due to “race” itself but may be due to a combination of social factors such as education, housing, socioeconomic status, lifestyle habits, and access to healthcare and medications. In fact, studies have shown that up to 40% of dementia risk may be attributed to factors that can be changed or improved to lower one’s risk. These modifiable risk factors include things like education level, diet, exercise, high blood pressure, diabetes, cholesterol problems, obesity, vitamin B12 deficiency, depression, and more.

Dr. Christian Lachner, a neuropsychiatrist and investigator in the Mayo Clinic Alzheimer’s Disease Research Center (ADRC), recently led a research team to examine the frequency of modifiable dementia risk factors in African American and White participants enrolled in the ADRC and sought to learn how these factors may relate to problems in cognition (i.e., thinking and memory abilities).

According to Dr. Lachner, “We found that the presence of high blood pressure, abnormal cholesterols, diabetes, and obesity was higher in African American participants. In our study, however, these conditions were not associated with thinking and/or memory problems.” Depression, however, was highly associated with cognitive difficulties. African Americans who reported having depression were 4x more likely to show cognitive problems. Among White participants, those with depression were 3x more likely to show cognitive problems.
Although depression was associated with increased risk of cognitive difficulty in both groups, cognitive functions in African Americans with depression declined significantly faster over time than White participants with depression. According to Dr. Lachner, “one possible reason for this is that fewer African American participants with depression reported being treated with antidepressant medications as compared to White participants with depression” (See Figure 1).

The reason why more White than African American individuals were receiving treatment for their depression is unclear but may in part reflect differences in cultural attitudes and beliefs towards mental health issues, access to mental health resources, and willingness to seek help.

Another factor that was found to be associated with faster cognitive decline in African American participants was low vitamin B12 levels. Unlike depression, however, there is essentially no difference between African American and White participants with regard to presence or treatment of Vitamin B12 deficiency (Figure 1).

The observed disparities in the impact of both depression and vitamin B12 deficiency on changes in memory and thinking ability are important discoveries that warrant further exploration to ensure equity in the prevention and management of cognitive decline in older African Americans.

“We are grateful to our community participants who contributed to this important study of dementia risk” says Dr. Lachner. The Mayo Clinic ADRC aims to support equitable brain health and memory care for all through discoveries made possible by ongoing partnership with the Jacksonville African American community. Representation in these discoveries is important, and if you would like to join a study, please refer to the contact information on the back page of this newsletter. The full text of Dr. Lachner’s study, “Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans” is published in the journal Annals of Neurology.

If you’ve ever thought about learning another language but have been putting it off, a new study from investigators at Iowa State University might make you want to sign up for lessons right away. That’s because they found that people who can speak more than one language can often delay the onset of Alzheimer’s disease better than people who speak only one language.

While learning to speak a new language may
not prevent or reverse Alzheimer’s disease, it can create changes in the brain that provide benefit and resilience against disease. Everyone’s brain is made up of millions of specialized cells called neurons. Neurons communicate with each other by sending signals to the receptors of neighboring cells. The spaces where this signaling occurs are called synapses (Fig. 1).

It has long been known that people who are bilingual since childhood have more neurons and more synapses than people who speak only one language. This is true even for those who learn a second language later in life.

The reason is because immersing oneself in new cognitive experiences plays an important role in strengthening and expanding brain cell connections. The more connections there are, the more information can be processed.

When you learn a new language, you combine two important facilitators of neuronal growth: exposure to something new and repetition/rehearsal. This
combination gives brain cells a workout that increases the number of places along the cell that information can be received and transmitted (See Fig. 2). The more neuronal connections there are, the greater the brain’s resilience against changes caused by dementia. Scientists call this enhancement “cognitive reserve” and it refers to the brain’s ability to withstand the impact of disease. In the case of learning a new language, the adage “Use it or lose it” may have true meaning!

The opportunity to delay dementia onset is important, because it offers the ability to remain independent and enjoy a greater quality of life for a longer time. Other ways to keep the brain healthy have been featured in past issues of Let’s Talk Brain Health and include a healthy Mediterranean-style diet, physical exercise, obtaining proper sleep, managing stress, and remaining socially engaged. Add “learning a new language” or other mentally stimulating activities to the list and it could be just what the doctor ordered!

If you are interested in learning a new language, classes are often offered through local schools, continuing education programs and lifelong learning programs.

If you have visited the Edward Waters University Schell Sweet Community Resource Center, then chances are you have met Ms. Shirley Brown, as she is highly active in many programs at the Center. In addition, Ms. Brown has been involved in the Dementia Friendly Community Program in the New Town neighborhood since the program began. From her participation in the very first focus groups that provided insight into the community’s dementia-related needs to her ongoing service on the New Town Dementia Friendly Community Sustainability Committee, Ms. Brown has been a steadfast and dedicated champion of the community. She is also a champion of Alzheimer’s research and faithful participant in studies of aging and brain health, such as the one featured in the cover story of this issue of Let’s Talk Brain Health.

Ms. Brown has served as community editor of the Dementia Connection newsletter since the first issue went to press in 2019. Dementia Connection features news, information, and support for a sector of the community that is near and dear to Ms. Brown’s heart: the caregivers of loved ones who have

Ms. Bernice Bryant is an outreach coordinator and a clinical study coordinator in the Mayo Clinic Alzheimer’s Disease Research Center. If you have come to any ADRC community outreach events, you have no doubt seen Bernice at our information table talking to community members about brain health, dementia research, and community resources. She also works with participants who enroll in ADRC studies by collecting background information and administering tests of memory and thinking ability. We caught up with her and asked her to share with readers a little more about herself, her work, and her interests.

Hi Bernice! Let’s start by telling us a little about yourself.
My parents are of Puerto Rican descent, but I was raised in The Bronx New York. I moved to Jacksonville when I was 20 years old to attend the University of North Florida, where I studied health science and community health. I am currently working on my master’s degree in public health. I have always been an advocate for community health and would like to see greater access and equity in our communities. Before joining Mayo Clinic, I was the operations manager and interim director of Community Health Outreach, a free medical and dental clinic serving low income, uninsured adults here in Jacksonville. I also taught adolescents health education with Duval County schools. My plan is to continue to spread education, awareness and services that would benefit the personal health of individuals in my community.

Why did you join the ADRC Outreach team?
I joined the ADRC Outreach team because this disease has affected many close relatives in my family. I wasn’t seeing enough education and resources available to minorities like me and my family out there in the community. There wasn’t much information to help combat the increasing cases of Alzheimer’s and related dementias. I saw it becoming a norm. Joining this team gives me a chance to not only increase my own knowledge on how to reduce my risk of

disease, but it also gives me a chance to share resources, education, and what I have learned with others in the community to help them reduce their own dementia risk factors. It also gives me the chance to share with community members how important it is to be represented in the studies that are advancing the understanding and treatment of Alzheimer’s disease. We don’t want to be left behind!

What about outside of work, what keeps you busy?
As a mother of five children, I spend a lot of my time outside of work helping with homework, supporting athletic ventures, and traveling with my family. Aside from my family duties, I am a coach for the girls’ soccer and swim team at Westside Middle School.

Anything else you would like to share?
Every year I collect sanitary items to create starter kits to donate to middle schools in low-income areas for students to have access to and learn about the different items to keep their hygiene up. I find it uplifting to know that small things can have a powerful positive impact on others.

Pathways 2 Brain Health
On Saturday, January 13, 2024, Mayo Clinic dementia experts and community partners joined together to provide the second installment of the Pathways 2 Brain Health series at Bethel Baptist Institutional Church. The event, attended by nearly 100 community members, offered attendees four different interactive workshops to promote brain health (brain healthy food choices, advance care planning, caregiver support, and latest dementia treatments), as well as a vendor expo of community support services for people with memory loss and their care partners.

Did you know that Mayo Clinic has a program designed to assist older adults who have memory or thinking difficulties but are still able to manage their daily activities independently?

This condition is called "Mild Cognitive Impairment" (MCI) and the Mayo Clinic HABIT program (Healthy Action to Benefit Independence & Thinking®) is designed to help people with MCI learn the best skills to maintain their independence despite their memory problems.

The 10-day program engages the person with MCI and a loved one in education and skill building activities to help them compensate for memory loss, improve self-esteem, and cope with emotions that arise from having MCI. Participants also learn about brain wellness, engage in physical and cognitive exercises, and develop stress management skills.

Dr. Melanie Chandler, Director of the HABIT program, explains that "HABIT offers state of the art, evidence-based, lifestyle or behavioral treatments for MCI." Participants in the HABIT program work with a multidisciplinary team of neuropsychologists, social workers, occupational therapists, cognitive therapists, and certified yoga instructors. All participants must bring a loved one with them, to help ensure the skills learned in the session are practiced at home.

According to Dr. Chandler, the program does not cure MCI, but "provides the tools necessary to help combat memory loss as best as we know how." In fact, studies show that daily functioning, psychological well-being, and quality of life improves significantly for those with MCI and their care partners after completing the program. To quote one recent HABIT attendee: “I feel encouraged and better equipped for facing my experience with MCI. Being with others with MCI gave me hope. I am not alone in this journey.”

Other ways to reach us:

• Email: FLAMayoADRC@mayo.edu
• Phone: 904-953-6523

Interested in ADRC Resources or Research?

Use the QR Code or Call/Email us as noted above. Visit our website www.dementiaoutreach.mayo.edu Follow us on Facebook | Subscribe to our YouTube Channel