1. < Home

Let’s Talk Brain Health Winter 2025

Unraveling the Complexities of Alzheimer's Disease in Diverse Communities

Alzheimer’s disease (AD) is a complex condition involving multiple mechanisms influenced by genes, proteins, metabolites, and environmental exposures, to name a few. Each of these mechanisms has its own vast field of study, which scientists call “omics.” For example, the study of all things related to genes is called “genomics.” The study of proteins is called “proteomics.” To better understand and treat AD, scientists must understand how all the multiple mechanisms involved with the disease interact and contribute to raising or

Winter 2025

In This Issue

  • The Complexities of AD
  • Benefits of the MIND Diet May Vary by Race
  • Meet a Community Champion
  • Meet an ADRC Team Member
  • What's Cooking?
  • Finding Strength in Shared Experiences
  • Community Pages
  • Upcoming Events

lowering risk. This approach is called “multi-omics.” Readers of Let’s Talk Brain Health know that Black and Hispanic/Latino Americans are dis-proportionately affected by dementia, with Black people facing about 2x the risk of non-Hispanic Whites and Hispanic/Latinos facing 1.5x higher risk. Despite these disparities, communities of color have historically been under-represented in research. Typically, over 90% of participants in multi-omics studies are non-Hispanic Whites of European ancestry. The disparities gap will only widen if multi-omics discoveries of risk factors and potential therapeutic targets do not include greater representation of people from diverse backgrounds and communities. To help address this, investigators from Mayo Clinic – including those from our Alzheimer’s Disease Research Center (ADRC) - joined colleagues from Columbia University, Mt. Sinai School of Medicine, Emory University, and Rush University to pool information collected from over

600 Black and Hispanic/Latino research participants from their own programs and from studies at other institutions in their research networks. The investigators also included information from about 300 non-Hispanic White participants to achieve equivalent representation across groups. The information gathered for this initiative was derived from cognitively normal volunteers and people with dementia (mostly AD). Some of these participants also completed memory testing, bloodwork, and brain scans documenting the presence, onset, course, and cause of any memory problems. Importantly, all volunteers agreed to donate brain tissue, which was collected at the time of their passing. This was crucial because brain tissue provides essential genetic, protein, and metabolic information about AD that is not otherwise available.

In fact, donated brain tissue holds a wealth of multi-omics information that was carefully characterized by the investigators and integrated with information known about the donor’s health and brain pathology.

The investigators recently published their work in the journal Alzheimer’s & Dementia and have made their data available to researchers who seek to identify or confirm risk mechanisms in AD and related diseases in diverse communities. According to Dr. Nilüfer Ertekin-Taner (pictured left), who is the senior investigator on the project, Enterprise Chair of the Mayo Clinic Department of

Neuroscience, and leader of the Genomics core of the Mayo Clinic ADRC, “This initiative promotes inclusivity in research and will lay the groundwork for bridging the knowledge disparities in AD to uncover pathways that drive or contribute to AD in underrepresented communities. The ultimate goal is to ensure that scientific breakthroughs in the detection, treatment, and prevention of AD are equitable and will improve the lives of all individuals affected by this devastating disease.”

Much more work is needed to achieve these goals. Although this initiative reflects the largest collection of Black and Hispanic/Latino Americans in a multi-omics study to date, it lags far behind most other multi-omics studies, which typically involve datasets derived from thousands to tens of thousands

An illustration of some biological system relationships investigated in multi-omics studies of Alzheimer’s disease (modified from: Kumar, 2017. International Journal of Current Research & Review).

of participants who identify as non-Hispanic White. Such large numbers are needed to confidently find meaningful associations among the many combinations and levels of information examined, and to detect subtle biological effects.

Dr. Ertekin-Taner notes that, to date, the Mayo Clinic Brain Bank, which is supported in part by our ADRC, has contributed the most data to this project, known as the Accelerating Medicines Partnership in Alzheimer's Disease (AMP-AD) Diversity Initiative. She adds that "projects such as AMP-AD cannot achieve their ultimate goals of equity in dementia care without the generous support of volunteers, such as those from the Jacksonville Black and Hispanic community, who join and participate in ADRC studies."

If you would like to learn more about ways that you can make a difference in Alzheimer's disease research
discoveries, contact the Mayo Clinic ADRC by any of the means listed on the back page of this newsletter.

Benefits of the MIND Diet May Very by Race

Mounting evidence suggests that our diet can play an important role in brain health as we age. In fact, specific dietary recommendations like the Mediterranean diet and Dietary Approaches to Stop Hypertension (DASH) diet have been shown to benefit cognitive health.

The MIND diet, which stands for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” incorporates features from both the Mediterranean and DASH diets. It emphasizes 10 brain-healthy food groups, including leafy green vegetables, other vegetables, berries, beans, whole grains, nuts, fish, poultry, olive oil, and wine (in moderation), while limiting five unhealthy food groups such as red meats, butter, cheese, sweets, and fried or fast foods. By focusing on foods rich in antioxidants, healthy fats, and nutrients linked to better cognitive function, the diet is designed to reduce the risk of cognitive decline and diseases like Alzheimer’s disease and related dementias.

Most of what we currently know about the impact of diet on brain health comes from studies of predominantly non-Hispanic White populations. A new study from the Rush University Alzheimer’s Disease Research Center, however, aimed to investigate whether the MIND diet’s protective effects against cognitive decline apply equally across racial groups.

The study involved over 5,000 participants aged 65 and older, most (62%) of whom identified as Black.

Participants were selected from an existing study that was following them with memory and cognitive testing over time. Over an eight-year period, they were surveyed from time to time regarding their dietary habits. They were not Benefits of the MIND Diet May Vary by Race instructed to make any changes to their diets, but the investigators scored their diet surveys to determine how many of the 15 MIND diet recommendations they were reliably following in their typical food choices. The investigators then evaluated how MIND diet scores related to the participant's cognitive scores and diagnoses.

The MIND diet was associated with slower cognitive decline among all participants. Moreover, adding one
MIND diet recommended component to one's diet resulted in less cognitive decline equivalent to being 2
years younger in age.

Overall, Black older adults consumed less of certain MIND diet components than non-Hispanic Whites,
including fewer vegetables other than leafy greens, fewer berries, and less chicken, olive oil, and wine. In
contrast, Black participants reported eating more fish and whole grains than White older adults.

Although both Black and White participants showed cognitive benefits from the MIND diet, the degree
of benefit differed across groups. Among White participants, a moderate degree of adherence to the
diet was sufficient to observe significant effects whereas Black participants needed to adhere to the
guidelines more strictly to experience similar benefit.

Black older adults who followed nine or more of the 15 MIND diet recommendations showed slower cognitive decline than those who followed five or fewer components. Among White older adults, however, following just seven or more MIND diet components was associated with slower cognitive decline.

The authors believe that various lifestyle habits and/or vascular risk factors may play a critical role in understanding the observed differences in the relationship between diet and brain health.

It is hoped that these findings, observed in a diverse sample of predominantly Black American older adults, will help inform future studies on diet and cognition and encourage more Black Americans to help address underrepresentation in Alzheimer's disease research.

Meet a Community Champion, Mrs. Brenda Frinks

Mrs. Brenda Frinks is an ADRC Community Ambassador and active participant in clinical research. When asked to say a few words about herself, she immediately shares her passion for travel, describing herself as "a traveler at heart."

She notes that her father, a railroad bridgeman, and her mother, an educator, both viewed travel as an essential part of learning.

Growing up in a close-knit community, family involvement was paramount. Mrs. Frinks' mother worked hard to assist members of her community with voter registration and adult literacy, while her father was always ready to lend a hand with community needs. Their philosophy was simple: "If you can support others, you just do it."

Mrs. Frinks recalls a pivotal moment in her journey towards dementia advocacy. A relative living alone in Chicago had pulled back from family contact

without the family realizing this was because of memory loss.

They discovered too late that someone had been taking advantage of their loved one, opening multiple bank accounts in her name.

This unsettling experience underscored Mrs. Frinks' desire to be supportive of the needs of people with dementia, both within her family and her community. When asked why she volunteers for dementia research, Mrs. Frinks states that "Knowledge is crucial, especially in passing accurate family and medical history to future generations. For the African American community, this is a way to strengthen and support one another."

She strongly believes her research participation makes a difference for her community. "Many medications and treatments are developed through research that often does not include us and other diverse populations. This means the outcomes may not be suitable for African Americans and other ethnic groups as they weren't part of the studies."

Mrs. Frinks is an active participant in the Mayo Clinic Alzheimer's Disease Research Center, which she believes “offers individuals the chance to have a voice and access vital information that can be shared with their healthcare providers."

In fact, she has dedicated the last seven years to participating in clinical research studies, following in the footsteps of her mother, brother, cousin, and other family members.

Mrs. Frinks is quick to add that she and her family members have also consented to brain donation. “My mother donated her brain, and I’m signed up to donate mine,” she says. When it comes to brain donation, she acknowledges that some community members express concern with regard to religious beliefs, but she does not believe brain donation undermines spirituality. “In my opinion” she says, “it actually enhances our understanding of life and its continuity beyond death.”

She continues: "Alzheimer’s disease is a serious public health issue, and we need to be part of the solution. By participating in Alzheimer’s research, you can pass on the legacy of brain health, as well as a wealth of documented medical information, to future generations of your family.”

Meet an ADRC Team Member
Paula Aduen, Ph.D., L.P.

Dr. Paula Aduen is a relatively new member of our ADRC, having joined Mayo Clinic in 2023. She is an Assistant Professor of Psychology and a clinical neuropsychologist, providing assessments of memory and cognition to patients with known or suspected brain diseases. She earned her doctoral degree from the University of Virginia and completed her internship and fellowship training, respectively, at University of Chicago Medicine and Massachusetts General/Brigham & Women’s Hospital. She has been actively involved in community outreach since joining the ADRC and we have asked her to share a little about herself.

Hello Dr. Aduen. What would you like our readers to know about you?

I'm originally from Colombia and most of my life has been with one foot in Colombia and one foot in the United States. I have a specialized interest in multicultural neuropsychology and Alzheimer's disease and related dementias, including the development and implementation of culturally and linguistically appropriate measures to best assess memory and cognition in diverse populations. I’m also interested in the impact of stress on cognition, and how cultural and personal factors may contribute to resilience against stress. In my work as a co- investigator in the ADRC outreach, recruitment, and engagement (ORE) core, I feel passionate about addressing health disparities that exist in historically underrepresented communities. I enjoy being in the community and learning about the specific dementia and brain health needs that people have, so we can better address them both in clinical practice and in our research.

Was there a driving force in your wanting to study neuropsychology and focus on AD and related dementias?

I have always been interested in human behavior and was drawn to the study of neuropsychology as it allowed me to further dive into how the brain and its networks contribute to how we think and what we do. My connection to Alzheimer's disease and related dementias is a personal one. My grandmother was diagnosed, lived, and ultimately passed away from Alzheimer's. As a close-knit family, every member of our family had a seat at the table when it came to her care and quality of life. Experiencing Alzheimer's disease in a loved one sheds a unique light on the truly devastating nature of the disease. It also motivated me to be part of the many minds who are passionate and dedicated to understanding the disease, management of symptoms, and improving circumstances for those who live with dementia and their families.

Some may not know what a neuropsychologist is. Can you provide an overview?

A neuropsychologist is a clinical psychologist who receives further specialized training on how the brain and its functions relate to behavior and cognition. As neuropsychologists we use various assessment measures to evaluate memory and thinking. These tests help us understand whether there are impairments or changes in cognition relative to what can be expected for normal aging. When integrated with a patient's medical history, as well as onset and course of symptoms, interpretation of these tests help inform diagnosis for further evaluation by other medical specialists. Neuropsychology is a very interdisciplinary field, and we often are part of a larger team that may include a neurologist, a psychiatrist, and other healthcare providers.

What can a potential patient or research participant expect from a neuropsychological assessment?

A patient referred for a neuropsychological assessment can expect evaluation of various aspects of thinking or cognition as well as emotional functioning. The evaluation typically involves a combination of paper-pencil, auditory or visual tests that are designed to inform how well the brain is working. The patient will work with a trained individual (psychometrist, clinical research coordinator) who will administer these tests. Neuropsychological evaluations can vary in length depending on the clinical purpose or research goal. Results can inform the nature and extent of cognitive impairment, possible underlying causes of cognitive difficulties, which together provide recommendations for intervention and guidance for caregivers or family members on how to best support the individual.

What interested in you in wanting to work with the Mayo Clinic ADRC ORE Core?

The community is what drives research forward and what makes scientific discoveries possible. The role of the ADRC ORE core is to partner with our local community to better understand its needs as it pertains to dementia education, community resources, and barriers and facilitators to research participation. I was drawn to working with the Mayo Clinic ADRC ORE core because I believe there is no better way to address existing dementia health disparities than hearing and learning from the community firsthand. This makes our approach personalized and targeted. Engaging and collaborating with our communities, guided by the roadmap that is provided by our community partners, is ultimately what will make our approaches more effective and applicable. It is a privilege to work alongside members of our community who are equally as passionate about addressing disparities in Black American and Hispanic/Latino communities.

When not working what do you enjoy?

Spending time with my family is my favorite hobby. My other joy is running and the community that forms around the sport. My husband and I enjoy exploring and diving into the local culture of the cities that we call "home ".

What’s Cooking?

Courtesy of Mayo Clinic Staff

There is a lot to love about this recipe, which combines four of the 10 healthy MIND diet components into a single dish. Add a whole grain dinner roll to add a fifth brain healthy component!

This one-skillet dinner can be ready in as little as 20 minutes and includes the time saving option of using frozen vegetables if you prefer not to chop your own.

Even better, leftovers - if you have any - can be transformed the next day into tacos or a Mexican inspired chicken chili bowl.

Southwest Chicken and Beans

Serves 4

Ingredients

  • 1-pound boneless, skinless chicken breast, diced
  • 1 package reduced sodium taco seasoning mix
  • 1 15-ounce can unsalted black beans, rinsed and drained
  • 1 1/2 cups frozen corn
  • 3/4 cup fresh or frozen pepper stir-fry vegetables (onions and green, red, and yellow peppers), chopped.
  • 3/4 cup water
  • 3/4 cup reduced-fat shredded cheddar cheese

Directions

  1. Spray a 10-inch skillet with cooking spray. Add 1 TBS olive oil over medium-high heat.
  2. Add chicken to the skillet and cook for 2 minutes, stirring from time to time.
  3. Add the seasoning mix, beans, corn, stir-fry mix and water.
  4. Cook over medium-high heat for8 to 10 minutes. Stir often, until the sauce is slightly thickened, and the chicken is no longer pink.
  5. Top with shredded cheese and serve.

Strength in Shared Experiences: The Connect2Caregivers Study

Emotional support is important to everyone’s health and well-being but is especially vital to caregivers of loved ones with Alzheimer’s disease (AD) or AD-related dementias (ADRD).

According to the Alzheimer’s Association, nearly 60% percent of family caregivers of people with AD or ADRD rate the emotional stress of caregiving as high or very high. Many say they feel alone and isolated, and two out of every three caregivers report difficulty finding resources to support their emotional needs.

Sometimes, the most effective emotional support for dementia caregivers can come from other caregivers. Why? Because no one can better understand the journey of dementia caregiving than a person who has been, or is currently, on a similar path. Roseanne, a caregiver to her husband who has Alzheimer’s disease, shares that connecting with other caregivers has been a blessing.

“I felt stressed isolated, lonely, and exhausted. I was grieving. And then I met Darlene. Darlene was also caring for her spouse with dementia. We started meeting for coffee on a regular basis. We both knew firsthand what isolation felt like. We would text, talk on the phone, and email in between. Knowing that I could reach out to someone who really 'got it' was a lifeline."

Roseanne and Darlene were fortunate to cross paths and find each other for support. But what of the thousands of other family caregivers who haven't found their own "Darlenes"? Mayo Clinic investigators are working alongside dementia caregivers to find solutions that address the challenges of caregiving and its impact on health and wellbeing. The Connect2Caregviers program was developed to help caregivers find each other for the purpose of emotional support. Currently, investigators are evaluating how useful caregivers find this new tool.

Participants who join this 15-month study complete an online matching profile, answering questions about their needs, interests, and preferences in a support partner. Caregivers are then matched based on their profile and provided information on how to connect with each other. Every three months, participants touch base with the study coordinator and share their feedback about their support experience. Participants may connect with up to 5 other caregivers over the course of the study.

It is hoped that participants will gain new connections with whom they can both give and receive emotional support related to dementia caregiving. For more information, or to complete an eligibility screening to participate in this project, email: connect2caregivers@mayo.edu.

Community Pages

Fall was a busy season for the outreach team of the Mayo ADRC! Victor, Evanie, Bernice, Francine, and our ADRC investigators were out in the community in full force, facilitating conversations about brain health and sharing resource information about memory loss, dementia, and caregiver support.

ACEing Alzheimer's Disease

On November 9-10, over 60 people participated in the ACEing Alzheimer’s Tennis Tournament fundraiser, organized by Bern’s Angels for Community Education. Bern’s Angels was founded by three sisters who lost their beloved mother, Mrs. Bernice Caswell, to Alzheimer’s disease. As family caregivers, they understood the power of being informed about Alzheimer’s and caregiving strategies. Their mission is to share such information with the Black community and to be resourceful advocates to families living with AD and to organizations that are fighting for a cure. Proceeds from their second annual tournament were donated to the Alzheimer’s Association.

2024 Walk to end Alzheimer's Disease

Team Mayo Clinic ADRC participated in the Alzheimer Association’s Walk to End Alzheimer’s Disease in November at the University of North Florida. Despite a drizzly start to the day, over 1500 people turned out to support the Alzheimer’s Association in its mission to raise awareness for those with Alzheimer’s disease and to support research and discovery. With options to walk a short (0.9 mile) or long (2 mile) course through the wooded campus surrounding the UNF Amphitheater, participants raised over $320,000!

New Alzheimer's Treatment

On November 8, Dr. John Lucas presented an update on new treatments for Alzheimer’s disease to a group of community members at the Mary L. Singleton Senior Center. We thank Ms. Ruby James and Ms. Jolita Wainwright for their kind invitation to speak, and the Singleton Center staff for hosting the presentation.

A Helping hand for Caregivers

On November 16, the Mayo Clinic ADRC partnered with Dr. Taquanta Feely, Director of Healthcare Ministries for St. Paul Missionary Baptist Church, for a caregiver event titled, Everybody Needs a Helping Hand: A Conversational Guide for Caregivers. A panel of experts including ADRC investigators, outreach staff, and community ambassadors answered questions from attendees about dementia and community resources for caregivers. Over 60 people attended the event in person or online. Given the great success of this event, a follow-up program has been scheduled for January 2025.

Cultural Expressions: The Arts & Brain Health.

Mr. Victor Cora (left) was invited to speak at this AARP event, held at the Ritz Theater & Museum on November 7. The event highlighted how the arts can help lower stress and promote better brain health as we age. According to AARP, “brain health is a top priority for both AARP members and non-members.” Mr. Cora shared information with event attendees about the Mayo Clinic ADRC and its programs that study Alzheimer’s disease and provide support to caregivers of loved ones with dementia. Also present at the event were representatives from ElderSource and the Alzheimer’s Association.

Calendar of Events

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.

Other Ways to reach us: