Public Communication of Science: The Experience of the Rio Grande Valley Alzheimer’s Disease Resource Center for Minority Aging Research

Introduction: There are multiple models of public communication of science. Some models focus on communication within the science community, while others involve public participation. At the Rio Grande Valley AD-RCMAR, we hope to implement a public outreach program to aid in the dissemination of accurate information regarding Alzheimer’s disease and related dementias. Objective: The purpose of this project was to identify behavioral change models that will allow the RGV AD-RCMAR to increase awareness and engagement of brain aging, including Alzheimer’s disease, within the Rio Grande Valley. Methods: A literature review was conducted to identify models of behavioral change that will assist the center in the dissemination of science. Public communication models were narrowed down to models that aligned with the goals of the center. Results: We identified four models and found that the Precaution Adoption Process Model (PAPM) and the Tailored Health Communication (THC) model were grounded in behavioral change and would best fit the needs of the AD-RCMAR. We integrated these models by building profiles to highlight Latinx researchers and a database of neuroscience seminars that will aid in the increased awareness and recruitment of individuals on topics that are tailored to their interests. Discussion: In order to make an impact, we must consider human behavior. By integrating the PAPM and THC models, individuals will have access to topics that are tailored to what they are searching for, which will result in raised awareness. Conclusion: These models will allow us to raise engagement and awareness in the RGV and support the recruitment of participants in research. There are some factors to consider prior to implementing these models including Hispanic values and their effect on involvement and communication of scientific information. Then, we will begin to question the changes in the levels of engagement and action

Critical reflection in practice: Generating Knowledge from the Interactions with Promotores for Engagement in Neurocognitive Disorders

Background: Colonias are underserved areas along the Texas-Mexico border, with high incidences of neurocognitive disorders, dementia, and Alzheimer\u27s disease (AD). Our goal is to build capacity to reduce risk, facilitate treatment for affected individuals, and provide caregiver support. Our aim was to construct an approach that was reflective and would reveal the rich and diverse ways in which people make meaning of their experiences and interactions with scientists, faculty, staff and students. Methods: We examined our work with local community health workers. (CHWs), promotores in Spanish, to establish contact with, engage, mobilize, and educate the Hispanic communities of the Lower Rio Grande Valley (LRGV). Qualitative research methods were the principal way to approach this aim, including critical reflection. Results: We now have 347 certified promotores in LRGV: 174 in Cameron County, 169 in Hidalgo County, 3 in Starr County, and 1 in Willacy County. Most of the promotores in LRGV are female, Spanish-speakers (98%) although half of them are also fluent in English and more than half of the promotores have five years or more as a state-certified CHW. Assumptions about knowledge, power and reflexivity surfaced in the interactions with members of the academic world interacting with Colonia’s residents. Conclusions: Aspects of critical reflection, including deconstructing assumptions about knowledge, power and reflexivity, are useful to guide actions that facilitate capacity building in the Colonias, as well as action research methodology. The LRGV population’s characteristics make early detection of AD and dementia and support for patients and caregivers’ high priorities and clearly understanding the role of promotores as mediators is important

Gen-Z ambassadors: students supporting persons with Alzheimer’s disease and their caregivers in the Rio Grande Valley

Background: Youth participation in policy, research, education and community development initiatives is a right embedded in the United Nations Convention on the Rights of the Child (UNCRC, General Assembly, 1989). However, avenues for youth participation in health promotion and care remains limited. Our Ambassadors program prepares high-school students on the Texas-Mexico border to understand and empathize with persons with Alzheimer’s disease (PwAD) and to empower their family and caregivers, consummating the UNCRC in the service of transformative community change actions. Methods: Our long-term objective is youth participation, defined as practices that involve collaboration between students and various community stakeholders in AD. The initial phase of the program is the design of a curriculum for early high school students to develop the knowledge, skills and attitudes required for that participation. We used a cooperative strategy (a high school students-faculty collaborative), guided by empowerment and ecological theories to achieve optimal youth advancement in the context of the UNCRC social, health and cultural rights of children. Results: The GenZ Ambassadors curricular units were identified through an iterative process in which faculty documented their activities with youth and tested sessions ranging from the biological basis and clinical presentations of AD to family impact, principles of caregiving, youth as change agents, building intergenerational partnerships, and self-reflection exercises. Ambassadors selected settings and strategies designed to empower their peers and to transform communities by skill and confidence building. Discussion: The process implemented and content analysis revealed a variety of themes that benefited persons with AD and their caregivers in the Rio Grande Valley. Several strategies will be tested to generate interactive training materials and culturally and age-competent as well as delivery strategies, including peer-to-peer delivery

Understanding the resources, barriers, facilitators and interests about aging and dementia research of community members from the Rio Grande Valley

Background: One of ten people aged 65 develops Alzheimer’s Disease and it is one of the sixth-leading cause of death in the United States. The Rio Grande Valley (RGV) is mostly constituted by Hispanic/Latinos (93%), a population that has a 1.5X increased risk of AD onset. Nevertheless, there are not enough resources to support people living with dementia and their care partners. This study will leverage research efforts deployed by the RGV Alzheimer’s Disease Resource Center for Minority Aging Research to understand the social representations about the resources, barriers, facilitators, and interests of the RGV community about dementia and Alzheimer’s Disease research. Methods: Four focus groups were conducted online via Zoom on April 2022 with a total of 15 participants (people living with dementia, caregivers, and community leaders from the RGV). Interactions occurred at their preferred language, mostly in Spanish and the discussion was based on six semi-structured questions about aging and dementia research. Focus groups were translated to English and analyzed using the Consolidated Framework for Implementation Research (CFIR). Results: Community health workers (promotoras) are one of the most important resources and facilitators in the Valley due to their deep knowledge of the dynamics of the community. The main barrier for dementia and aging research is the lack of information, which leads to fear, and stigmas and ultimately keeping target communities away from the resources. Focus groups served also as a channel of communication. After conducting the focus groups, some of the participants went from being unaware of the presence of Alzheimer’s disease and dementia research in the Valley to deciding about acting toward their prevention and participating in the research. Conclusions: The information collected during the focus groups will be used to strengthen community engagement strategies and to support the design and implementation of health disparities frameworks to facilitate tailoring of our strategies to maximize the impact of the resources developed to be used in the communities of the RGV

Alzheimer’s Disease Studies in the Tex-Mex Border: Dissecting a Complex Multifactorial Problem

Purpose: Alzheimer’s Disease (ALZ) is the leading cause of dementia in the aging population, and Latinos have \u3e3 times higher risk to develop dementia than the overall US population. Although several studies have examined for possible causes of this increased risk, lack of comprehensive information plus a reduced number of Latino samples available in each study have hindered the answers. Description: The University of Texas Rio Grande Valley has joined two large studies looking for multiple biomarkers associated with ALZ: The South Texas Alzheimer’s Center Clinical Data Repository and Biobank (STAC) and the Texas Alzheimer’s Research and Care Consortium (TARCC). We are now collecting clinical data along with neuroimaging and lab biomarkers from each individual enrolled in these studies, with the aim to enroll a large majority of Latinos in our site sample, which will help to elucidate the differences and risk factors inherent to our population in the border. We are also analyzing data from different Latin-American studies to study specific genetic risks, environmental factors, and their interactions. Partners: UTRGV has partnered with UTHSCSA for the STAC study and with many other academic research institutions at TARCC. We aim to provide experiences of clinical training to our psychology students and residents of medical specialties, as well as analysis opportunities and opening postdoctoral positions related to the development of this field at UTRGV. Looking Ahead: We expect to generate substantial contributions to the knowledge of cognitive decline in underserved populations, which can lead to improved treatments and better clinical care. Postdoctoral positions will be opening soon at the Institute of Neuroscience

Architectural Features of Streetscapes and Aging in Cameron County, Texas: Preliminary Results

The impact of architectural features in urban settings reveals priorities for its residents and the integration of social and natural environments. It has been estimated that 23% of global deaths to the environments in which people live. We aim to characterize the most prevalent architectural features of Cameron County, Texas streetscapes and analyze their role in health promotion and healthy aging

Addressing the disparities in dementia risk, early detection and care in Latino populations: Highlights from the second Latinos & Alzheimer\u27s Symposium

The Alzheimer\u27s Association hosted the second Latinos & Alzheimer\u27s Symposium in May 2021. Due to the COVID-19 pandemic, the meeting was held online over 2 days, with virtual presentations, discussions, mentoring sessions, and posters. The Latino population in the United States is projected to have the steepest increase in Alzheimer\u27s disease (AD) in the next 40 years, compared to other ethnic groups. Latinos have increased risk for AD and other dementias, limited access to quality care, and are severely underrepresented in AD and dementia research and clinical trials. The symposium highlighted developments in AD research with Latino populations, including advances in AD biomarkers, and novel cognitive assessments for Spanish-speaking populations, as well as the need to effectively recruit and retain Latinos in clinical research, and how best to deliver health-care services and to aid caregivers of Latinos living with AD

Glaucomatous Optic Neuropathy Associated with Nocturnal Dip in Blood Pressure: Findings from the Maracaibo Aging Study

Purpose—To determine which nocturnal blood pressure (BP) parameters (low levels or extreme dipper status) are associated with an increased risk of glaucomatous damage in Hispanics. Design—Observational cross-sectional study. Participants—A subset (n=93) of the participants from the Maracaibo Aging Study (MAS) who met the study eligibility criteria were included. These participants — who were at least 40 years of age — had measurements for optical tomography coherence, visual field tests, 24-hour BP, office BP, and intraocular pressureHg. Methods—Univariate and multivariate logistic regression analyses under the generalized estimating equations (GEE) framework were used to examine the relationships between glaucomatous damage and BP parameters, with particular attention to drops in nocturnal BP. Main Outcome Measures—Glaucomatous optic neuropathy (GON) based on the presence of optic nerve damage and visual field defects. Results—The mean age was 61.9 years, and 87.1% were women. Of 185 eyes evaluated, 50 (27.0%) had signs of GON. Individuals with GON had significantly lower 24-hour and nighttime diastolic BP levels than those without. However, results of the multivariate GEE models indicated that the glaucomatous damage was not related to the average systolic or diastolic BP levels measured over 24 hours, daytime, or nighttime. In contrast, extreme drops in nighttime systolic and diastolic BP (\u3e20% compared with daytime BP) were significant risk factors for glaucomatous damage (odds ratio=19.78 and 5.55, respectively). Conclusions—In this population, the link between nocturnal BP and GON is determined by extreme dipping effects rather than low nocturnal BP levels alone. Further studies considering extreme drops in nocturnal BP in individuals at high risk of glaucoma are warranted

Neuropsychiatric Symptoms Among Hispanics: Results of the Maracaibo Aging Study

Background: Neuropsychiatric symptoms play an important role in diagnosing and clinical follow-up of cognitive impairment and dementia. Objective: We investigated the relationship between neuropsychiatric symptoms, cognitive impairment, and dementia in Hispanics. Methods: We included 529 participants (age ≥40 years) from the Maracaibo Aging Study with standardized neuropsychiatric assessments, including the Neuropsychiatric Inventory (NPI). Based on the Clinical Dementia Rating and the Mini-Mental State Examination scores, participants’ cognitive status was categorized into normal cognition, mild/moderate, and severe cognitive impairment. Diagnosis of dementia was established in a consensus conference. Statistical analyses included multivariable logistic regression models and area under the curve (AUC). Results: The mean age of participants was 59.3 years, and 71.8% were women. The proportion of dementia was 6.8%. Disturbed sleep, anxiety, and depression were the most common neuropsychiatric symptoms in the study sample. In crude analyses, the proportions of hallucinations, aberrant motor behavior, agitation/aggression, apathy, delusions, irritability, eating disturbance, depression, and euphoria were differently distributed among cognitive status groups (p \u3c 0.05). After accounting for confounders, aberrant motor behavior and agitation/aggression remained significantly associated with cognitive impairment and dementia (p \u3c 0.05). The inclusion of the NPI domains significantly improved the AUC to discriminate severe cognitive impairment and dementia above of a basic model that included sex, age, education, alcohol, obesity, serum glucose, total cholesterol, hypertension, and stroke. Conclusion: Neuropsychiatric symptoms are associated with severe cognitive impairment and dementia. The addition of NPI items to the global cognitive assessment might help early detection of dementia in primary care settings

Research on aging during the Venezuelan humanitarian crisis: the experience of the Maracaibo aging study

Background Venezuela is in the throes of a complex humanitarian crisis that is one of the worst in decades to impact any country outside of wartime. This case analysis describes the challenges faced by the ongoing Maracaibo Aging Study (MAS) during the deteriorating conditions in Venezuela. When the MAS began in 1997, it focused on memory-related disorders. Since then, strategic planning and proactive community participation allowed us to anticipate and address logistical, funding, and ethical challenges, and facilitated the enrollment and retention of more than 2500 subjects over 55 years of age. All participants, who are residents of the city of Maracaibo, Venezuela, underwent various assessments on several occasions. Here, we discuss how our approach to implementing a longitudinal, population-based study of age-related conditions has allowed our research program to continue throughout this period of political, economic, and social upheaval. Discussion As the social context in Venezuela became more complicated, new challenges emerged, and strategies to sustain the study and participation were refined. We identified five main mechanisms through which the evolving humanitarian crisis has affected implementation of the MAS: 1) community dynamics; 2) morale of researchers, staff, and participants; 3) financial feasibility; 4) components of the research process; and 5) impact on the health of staff, participants, and their families. Strategies to compensate for the impact on these components were implemented, based on inputs from community members and staff. Improved communication, greater involvement of stakeholders, broadening the scope of the project, and strengthening international collaboration have been the most useful strategies. Particular demands emerged, related to the increased mortality and comorbidities of participants and staff, and deterioration of basic services and safety. Conclusion Although the MAS has faced numerous obstacles, it has been possible to continue a longitudinal research project throughout the humanitarian crisis, because our research team has engaged the community deeply and developed a sense of mutual commitment, and also because our project has provided funding to help keep researchers employed, somewhat attenuating the brain drain