PHILADELPHIA - Researchers in the Departments of Psychiatry and Neurology at Jefferson Medical College of Thomas Jefferson University were recently awarded a $2.6 million grant from the National Institutes of Health to study whether increasing participation in cognitive, physical and/or social activities prevents cognitive decline in older African Americans with mild cognitive impairment (MCI). Barry W. Rovner, M.D., professor of Psychiatry and Neurology; and Robin Casten, Ph.D., associate professor of Psychiatry and Human Behavior, will lead the single site, 24-month study of 200 community-residing older persons.
MCI is a transition state between normal aging and dementia that affects ten to 20 percent of older persons and may predict progression to dementia, particularly Alzheimer's disease (AD). African Americans are more likely to have MCI and AD than Caucasians, possibly because of genetic factors, co-morbid medical problems (diabetes, hypertension), disparities in access to health care, fewer years of education of uncertain quality, occupational discrimination, scarce economic resources and limited opportunities for leisure activities increase their risk.
"There is a pressing need to develop interventions to prevent cognitive decline in this high risk population," said Dr. Rovner. "Given the enormous personal and societal costs of Alzheimer's disease, especially as it affects older African Americans, demonstrating that a culturally relevant, non-pharmacological intervention prevents cognitive decline would boost public health efforts to encourage all older persons to pursue active lifestyles."
This randomized, controlled trial will test the efficacy of a culturally relevant intervention, known as behavior activation (BA), which increases participation in self-identified meaningful activities, to prevent cognitive decline. Two hundred trial participants from multiple community sites (e.g., senior centers, senior high rise apartment houses) that predominately serve older African Americans, will be randomized to either BA therapy or supportive therapy (ST), which provides supportive counseling. A nurse will deliver five initial in-home BA treatment sessions over two to three months and then six subsequent in-home booster sessions (one session every three months) using language, materials and concepts that are culturally relevant to older African Americans. A nurse will similarly deliver in-home ST at the same treatment intensity as BA.
"Until we find better treatments for Alzheimer's disease, behavioral interventions may hold the best hope for preserving cognitive functioning." said Dr. Casten.
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