Let’s Talk Brain Health

A Community Newsletter of the Mayo Clinic Florida Alzheimer’s Disease Research Center (ADRC)

Mayo Clinic Investigators Learn More About Dementia Risk in African Americans.

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.

Dr. Christian Lachner, Dept. of Neurology, Mayo Clinic

Key Points

  • Conditions that are known to increase risk of dementia are frequently observed in both African American and White individuals.
  • Depression and vitamin B12 deficiency have a stronger relationship with cognitive decline in African Americans than in White American.
  • Raising awareness, increasing screening efforts, and improving treatment of these modifiable factors may help lower the risk of dementia in the African American community, where risk of dementia is higher.
  • If you are experiencing depression or suspect depression in a loved one, your primary care physician may be able to help. Your doctor can also check your vitamin B12 level to make sure it is not deficient.
  • Depression may be challenging to address given cultural stigma regarding mental health. Communities can help by raising awareness and providing education about depression, facilitating access to mental health services, and supporting the training of healthcare professionals in the delivery of culturally competent mental health care.

Want to Stay Mentally Sharp?

Try Learning a New Language.

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.

Figure 1. Schematic of brain cells (neurons). Inset: Close up view of a neuronal synapse

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!

Figure 2. Illustration of a neuron showing the increase in possible connections (synapses) before (top) and after (bottom) new learning

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.

What’s Cooking?

Courtesy of Mayo Clinic Staff

The cool temperatures of spring are great for growing beets – a brain and heart healthy vegetable that is the star of this healthy spring salad! You can serve this as a starter salad or enjoy it as the main course by mixing in some slices of grilled chicken or other lean protein. The recipe calls for gorgonzola cheese (Italian-style blue cheese) but if that’s not your cup of tea, feel free to substitute goat cheese, which goes equally well with this dish. Finally, be sure to dress the greens at the last minute so they don’t get soggy. Have the beets and other toppings chopped and ready to go once the greens are plated!

Beet Walnut Salad

Nutrition per serving: 90 cal., 5g fat, 1.5g saturated fat, 115mg sodium, 9g carbohydrates, 2.5g fiber, 3g protein. Serves 8


1 small bunch of fresh beets 1/4 cup red wine vinegar 3 tablespoons balsamic vinegar 1 tablespoon olive oil1 tablespoon water 8 cups fresh salad greens 1/4 cup chopped apple 1/4 cup chopped celery Freshly ground pepper 3 tablespoons chopped walnuts 1/4 cup Gorgonzola cheese, crumbled


  1. Steam raw beets in water in a saucepan until tender.
  2. Rinse to cool and slip off skins.
  3. Slice beets into 1/2-inch-thick rounds and toss gently with red wine vinegar.
  4. In a large bowl, combine balsamic vinegar, olive oil and water. Add salad greens and toss.
  5. Put greens onto individual salad plates. Top with sliced beets.
  6. Chop apples and celery, and sprinkle on top.
  7. Add chopped walnuts, cheese, and pepper to taste.
  8. Serve immediately.

*If fresh beets are not available, you can substitute (3 cups of drained, no-salt-added canned beets) and skip to Step 3.

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

Alzheimer’s disease or related dementias. Each issue of Dementia Connection contains helpful caregiver tips and resource information, and highlights neighborhood events and support activities that make New Town truly “dementia friendly.”

A lifelong Floridian, Ms. Brown was born in West Palm Beach and moved to Jacksonville at the age of 3. After being raised in Jacksonville, she returned to West Palm Beach at age 19, and then back to Jacksonville in 2004. She had a successful career in retail from 1969 to 1999. In 2007 she registered as a participant in the Schell Sweet computer class for seniors. The following year, she signed up as a volunteer at the Center and has been a welcoming presence there ever since.

Among other things, Ms. Brown has worked with a GED program in partnership with Florida State College Jacksonville and several faith-based programs. She is instrumental in organizing community food distribution programs, which take place at Schell Sweet every 2nd Saturday of the month. If that weren’t enough, she also helps support the New Town Success Zone Impact Days, which are held the 4th Saturday of every month at the Health Disparities Center and have included services such as health screenings, vaccinations, and grocery giveaways.

Creating connections is very important to Ms. Brown. She enjoys spending time with her brothers and sisters and extended family. She enjoys Bible study and writes a Testimony to the Community in each issue of the Dementia Connection newsletter. She also enjoys cooking when she has time and is proud of her homemade baked beans. If you’re passing by Schell Sweet one day, stop in and see if she will give you the recipe!

Thank you, Ms. Brown, for your many contributions to our community!

Meet an ADRC Team Member
Bernice Bryant

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.

We can’t thank you enough…

Members of the Mayo Clinic ADRC Community Advisory Board (“Ambassadors”) gathered for an annual event on December 4, 2023, to acknowledge a productive year of raising dementia awareness and bringing information about healthy brain aging to the community. This group of dedicated community advocates meets monthly to help plan outreach programs and educational offerings that raise awareness and advance ADRC goals of addressing dementia-related health disparities.

This year, Mr. Kenneth Reddick and Ms. Sherri Randolph were recognized as “Ambassador Heroes” for their tireless dedication to dementia awareness. Each served on guest panels, led workshops, and volunteered at countless events on brain health and dementia throughout 2023. Additionally, Ms. Marcia Ellison was recognized as a “Community Champion” for her leadership of the New Town Dementia Friendly Sustainability Committee, a group of volunteers who are committed to serving the needs of dementia caregivers through monthly support meetings, memory café, and a quarterly caregiver newsletter, Dementia Connection. We appreciate all you do!

From L-R, Ms. Sherri Randolph, Mr. Kenneth Reddick, Ms. Marcia Ellison

Community Pages

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.

Pathways 2 Brain Health attendees gather information from the Mayo clinic Memory Center vendor table.
Community Ambassador, Ms. Sherri Walker (seated), helps sign in guests to the ADRC research participant appreciation event.

Research Participant Appreciation
Did you know that several hundred people participate in clinical research projects at the Mayo Clinic Florida ADRC? The many projects focus on enhancing brain health, exploring new medications and lifestyle changes to possibly delay and prevent difficulties with memory and thinking due to Alzheimer’s Disease and Related Dementia. On January 20, 2024, study participants attended an annual appreciation brunch reception to hear about the progress that has been made thanks to their study participation. Among the presenters was Dr. Christian Lachner, who spoke about his study of modifiable dementia risk factors (see cover story).

Calendar of Events

HABIT®: Healthy Actions to Promote Independence & Thinking

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.”

Visit HABIT on the Mayo Clinic website

For more information

Contact the Mayo Clinic Florida HABIT program:

Phone: 904-953-8853

email: HabitProgram@mayo.edu

Visit the "Living with MCI" blog on Mayo Clinic Connect

Spread the Word About Brain Health!

If you or someone you know would like to receive this newsletter, contact us through any of the methods described below to be added to our distribution list. If you have received this newsletter in error, or otherwise do not wish to receive future issues, please let us know. You can also reach out to us if you would like to:

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