Alzheimer's disease (AD) is a devastating progressive neurodegenerative disease resulting in memory loss and a severe reduction in ability to perform activities of daily living. The role of caring for someone with AD frequently falls to female family members, often daughters. The burden of caregiving can increase stress and anxiety and cause health decline in the caregiver. The combination of ethnicity-related genetic factors promoting the development of dementias among African-Americans (AA) and the increased risk among women for developing AD means that AA women who are caregivers of a parent with AD are at great risk for developing dementias including AD. The proposed study would compare the cognitive, motor, and psychosocial benefits of a well-established 12 week, 20-lesson adapted Argentine Tango intervention (N = 30) to a no-contact control group (N = 10) in middle-aged (45-65 years) AA women who are caregivers of a parent with AD in the metro Atlanta area.

Corticobasal degeneration (CBD) has no available treatment to slow disease progression and generally resists drug therapy. CBD has symptoms and decreased quality of life similar to Parkinson's disease. Adapted Tango, a successful rehabilitation for Parkinson's, may address CBD. A 63-year-old African-American male with CBD (alias: YD; CBD duration=2 years) was evaluated for motor, cognitive and psychosocial function before, immediately after, one-month after and six-months after 12 weeks of 20, bi-weekly 90-minute AT lessons. After intervention, disease-related motor symptoms improved and YD reported fewer problems in non-motor experiences of daily living, which include mood, cognition, pain, fatigue, etc. Motor symptoms remained above baseline at six-month posttest. YD's balance confidence improved postintervention, but declined below baseline at six-month posttest. Quality of life was maintained despite worsened depression. YD improved or maintained executive function, and visuospatial function and attention at posttest and one-month posttest. At posttest, YD maintained mobility and improved on dynamic balance. At one-month posttest, most mobility measures had improved relative to baseline. Yet, YD showed executive function and overall motor decline six months postintervention. AT may have temporarily slowed disease progression, and improved or maintained mobility and cognition. Gains were poorly maintained after six months. Further study is warranted.

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Background: Alzheimer's disease (AD) is a devastating, progressive neurodegenerative disease resulting in memory loss and a severe reduction in ability to perform activities of daily living. Ethnicity-related genetic factors promoting the development of dementias among African Americans (AA) and increased risk among females for developing AD indicates that AA female with a parent with AD are at great risk for developing dementias.Method: This phase I study assessed the impact of a 12 week, 20-lesson adapted Argentine Tango intervention (N=24) vs. a no-contact control group (N=10) on measures of cognition, motor and psychosocial performance, and plasma inflammatory markers in middle-aged (45-65 years) AA females who are at increased risk for AD by virtue of parental history.Result: Some females (n=17) were also caregivers, and thus the impact of the program on caregiving burden was examined in this subset. Preliminary analysis of efficacy was conducted with significance tests on biomarkers and key measures of balance, strength, and cognition, including visuospatial and executive function. After 12 weeks, Tango participants had significantly decreased inflammatory cytokine levels: IL-7 (p=.003), IFN-γ (p=.011), and TNFα (p=.011), compared to controls. Participants in Tango improved on the Fullerton Advanced Balance Scale, which measures both dynamic and static balance (p=.023), the 30 second chair stand, which assesses functional lower body strength in older adults (p=.018), and inhibition of the color word interference test, which measures to ability to inhibit cognitive interference (p=0.031).Large effects were noted for the Tango group from pre to postintervention in the Trails B test score, which measures executive control and functioning. Other non-significant, yet large effects were noted in gait speed, spatial cognition, and executive function.Moderate effects were noted in caregiving burden measures among the subset of caregivers. Conclusion:These data show substantial cognitive and motor improvements and reduction in inflammatory biomarkers through a non-pharmacologic and affordable intervention among a small cohort of AA females with a parental history of AD.

Background and Objectives: This paper reports on an interpretive evaluation conducted to identify successes and weaknesses of an 8-week educational intervention co-taught by medical students and faculty that was designed to foster communication between clinicians and researchers and ultimately increase participation in clinical research by older adults, including underrepresented groups. Weekly topics focused on age-related changes and health conditions, socio-contextual factors impacting aging populations, and wellness strategies. Research Design and Methods: A post-intervention focus group was conducted with a representative group of eight older adults (mean age = 76 ± 11 years) from 51 total participants who completed the educational intervention. Participants were diverse in race, socio-economic status, education level, sex, and marital status. Results: Thematic analyses show several participants were motivated by their personal experiences to join the study and continue coming to the seminars throughout the study. While participants viewed most aspects of the study as a success and stated that it was a productive learning experience, most participants had suggestions for improvements in the program content and implementation. Specifically, the composition of and direction to small breakout groups should be carefully considered and planned in this population, and attention should be paid to delivery of sensitive topics, e.g., death, dementia. A clear main benefit of this programmatic approach is the development of rapport among participants and between participants and clinical researchers. Discussion and Implications: Results provide useful insights regarding improving participation among hard-to-reach and historically under-represented groups of older adults in clinical research. Future iterations of the DREAMS program and similar educational interventions can use these findings to improve the program and better achieve the programmatic objectives.