Just growing up in the South increases your risk of developing Alzheimer's Disease. If your background is African American, that risk goes much higher. Why? That's a good question--one UAB's Alzheimer's Disease Research Center (ADRC) is working to answer. Consider this a call for volunteers--especially African Americans over 55 who would like to make a real difference in the health of future generations.
"We're now part of a network of 31 ADRCs in 21 states, and each center has a particular focus on different aspects of Alzheimer's research. We're the only exploratory ADRC in the four-state region of Alabama, Mississippi, Arkansas and Louisiana, and we are focusing our grant on the theme of 'Deep South Disparities of Alzheimer's Disease.'
"The grant and the work we do will also enable us to support more local research," Erik Roberson, MD, PhD, director of the UAB ADRC, said. "For example, UAB has expertise in a broad range of medical specialties. If someone from our ophthalmology department thinks they may have found a biomarker for Alzheimer's that we can observe and track in the eye, it will be much easier to do the research to test that hypothesis. They won't have to start at zero and find the funding to recruit volunteers, do all the basic testing and hope to still have enough left to do the eye research. We will have already laid the groundwork in recruiting and testing volunteers who now have their data on file."
The findings of these local studies should provide answers that apply to the overall population, including people of both European and African ancestry.
"In the past, most research volunteers came from a European gene pool," Roberson said. "What we learned applied to them, but it didn't necessarily apply to everyone. We were seeing too many disparities in people from other populations. For this research, one of our primary objectives is to recruit more African Americans and other under-represented populations so our results will better reflect the people who live here."
In the South, particularly in African Americans, diseases contributing to dementia are more common, including hypertension, diabetes and cardiovascular disease. Maybe the southern diet and the tendency to move less in the heat have something to do with it, but it's far from the whole story. There are still disparities between southerners, with African Americans having higher rates of the disease.
"Multiple factors seem to be involved," Roberson said. "We know there are economic and social influences. Poverty limits the type of food people can buy and their living environment. It increases their stress and reduces the leisure time they might have for sleep and healthy activity. Social factors, particularly in the past, limited educational opportunities. Many of the African Americans who are older now may not have had the opportunities to prepare them for life-long learning.
"Adding new forms of mental stimulation seems to slow down the progression of the disease. It can be puzzles or good conversations with friends at the coffee shop--anything to avoid drifting into long periods of passive daydreams. That happens in a part of the brain that is especially vulnerable to damage."
As might be expected in a disease with disparities between populations, there seem to be significant genetic differences in people who develop the disease, how early it occurs and how it progresses.
"We have identified quite a few genes that seem to be associated with Alzheimer's Disease, but even within the genetics, there are surprises," Roberson said.
One surprise is the APOE4 gene. Its strong association with the risk for Alzheimer's Disease is why commercial gene testing programs like 23andMe offer the option for testing whether that gene is present. The surprise is that while it is common in whole countries in Africa like Nigeria, for some reason it doesn't have as strong an effect as it does in the European gene pool. Why? Are there protective genes present? Something else?
"We still have a lot to learn, and we hope the research we're doing will tell us more to help detect the disease earlier and treat it." Roberson said.
Volunteers who are 55 or older, healthy or with mild cognitive issues, are being recruited to participate in research. After gathering information including cognitive screenings, medical histories, physical exams, genetic tests and brain imaging with MRI and PET scans, participants will be tracked over time.
Areas of investigation will range from the basic mechanisms of disease to managing the symptoms and helping families cope with the effects. UAB investigators will conduct basic, clinical, translational and behavioral research and train the next generation of scientists.
To learn more about enrolling as a volunteer, contact the Alzheimer's Research Center at the UAB School of Medicine.