Alzheimer's disease has profound effects on quality of life, affecting not only cognition, but mobility and opportunities for social engagement. Dance is a form of movement that may be uniquely suited to help maintain quality of life for older adults, including those with dementia, because it inherently incorporates movement, social engagement, and cognitive stimulation. Here, we describe the methods and results of the pilot study for the IMOVE trial (NCT03333837, www.clinicaltrials.gov), a clinical trial designed to use improvisational dance classes to test the effects of movement and social engagement in people with mild cognitive impairment (MCI) or early-stage dementia. The pilot study was an 8-week investigation into the feasibility and potential effects of an improvisational dance intervention on people with MCI or early-stage dementia (PWD/MCI) and their caregivers (CG). The pilot aimed to assess changes in quality of life, balance, mood, and functional brain networks in PWD/MCI and their CG. Participants were recruited as dyads (pairs) that included one PWD/MCI and one CG. Ten total dyads were enrolled in the pilot study with five dyads assigned to the usual care control group and five dyads participating in the dance intervention. The intervention arm met twice weekly for 60 min for 8 weeks. Attendance and quality of life assessed with the Quality of Life in Alzheimer's disease (QoL-AD) questionnaire were the primary outcomes. Secondary outcomes included balance, mood and brain network connectivity assessed through graph theory analysis of functional magnetic resonance imaging (fMRI). Class attendance was 96% and qualitative feedback reflected participants felt socially connected to the group. Increases in quality of life and balance were observed, but not mood. Brain imaging analysis showed increases in multiple brain network characteristics, including global efficiency and modularity. Further investigation into the positive effects of this dance intervention on both imaging and non-imaging metrics will be carried out on the full clinical trial data. Results from the trial are expected in the summer of 2022.

Extensive research has shown that diet-induced obesity induces a bidirectional relationship between the gut microbiome and physiological health. However, the majority of this research was conducted using only male subjects. This is particularly problematic because sex hormones strongly influence the gut microbiome. Women have a different composition of gut bacteria than men. Additionally, imbalances in the gut microbiome have also been linked to diseases that are both predominately found in women, such as: PCOS and endometriosis. Interestingly, these reproductive conditions are comorbid with obesity. Therefore, the objective of this study was to examine the impact of diet-induced obesity on the female gut microbiome before and after ovariectomy and hormone replacement. To induce obesity, female Sprague-Dawley rats were fed a HFHS (high fat, high sugar) diet for 10 weeks. After this initial diet exposure, pre-operative fecal samples were collected and fasting blood glucose and insulin levels were determined. Following these procedures, all animals underwent bilateral ovariectomies. Half of each diet group was given a constant release 17β-Estradiol pellet (OVX+E), while the other half were not (OVX). Ovaries were fixed in paraformaldehyde and prepared for histology. A second fecal sample was collected two weeks post operation. At termination, blood samples were collected and fat pads were removed and weighed. Fecal DNA was extracted and then analyzed using qPCR. Primers for the major bacterial phyla were utilized. We focused primarily on Firmicutes and Bacteriodetes because the ratio of these phyla (Firmicutes: Bacteriodetes) is an established measure of gut health. If the ratio shifts towards Firmicutes, it is thought that the organism displays a greater level of gut dysbiosis. After 10 weeks on the diet, the HFHS rats weighed significantly more than the control animals. HFHS rats also displayed higher fasting blood glucose levels, higher fasting insulin levels, and insulin resistance. Similarly, the HFHS rats showed significantly larger Firmicutes: Bacteriodetes ratios indicating gut microbiome imbalance. After removal of the ovaries and estradiol replacement, OVX+E rats, regardless of diet, lost weight compared their OVX counterparts. This estradiol-driven weight loss was also associated with healthier gut microbiome profiles in the OVX+E rats. Interestingly, HFHS animals had a greater number of irregular estrus cycles and showed elevated numbers of ovarian cysts compared to control-fed females. This study provides a novel insight into the complex relationship between sex hormones, obesity, and the gut microbiome. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that...

COVID-related safety concerns mandated suspension of our ongoing trial testing the effects of movement and social engagement in older adults with early-stage dementia and their caregivers (dyads). Participant vulnerability and the requirement for group social interaction complicated intervention resumption. We present results from a successful pilot to rapidly and iteratively optimize study interventions for remote delivery targeting intervention mediators (social connection, movement) based on participant feedback. Three-dyad groups (n=6 individuals) completed cycles of intervention via Zoom immediately followed by an interview with open-ended and quantitative feedback. Cycles were repeated until no new information was solicited, then repeated with new participants. Optimization revealed needs for technological support, more intensive movement, and social connection. Specifically, the inability to make eye contact, see others’ full body, and technology-associated timing asynchronies impeded social connection in the movement group. We will present practical tips for crafting remote group interventions for caregiver/person living with dementia dyads.