Latinos Unique Scenario, Addressing Cognitive Impairment via Dance

Older Latinos are disproportionately affected by chronic diseases and are at higher risk of developing Alzheimer’s disease (AD) and related dementias compared to non-Latino whites. Given the high burden of chronic disease among older Latinos and its relationship to mild cognitive impairment (MCI), tackling chronic diseases via physical activity (PA) may help prevent or delay progression to AD. Unfortunately, most PA interventions targeting older adults exclude individuals with MCI, and there are even fewer PA interventions targeting underserved populations with MCI. Thus, the purpose of this study was to conduct a pilot, randomized controlled study to investigate the feasibility and impact of a Latin dance program on older Latinos with MCI. Spanish-speaking older Latinos [N=21, 75.4 ± 6.3 years old, 76.2% female, 22.4± 2.8 MMSE score], were randomized into a 16 week, twice-weekly dance intervention or to a wait-list control group; the wait-list control group crossed over at week 17 and received the dance intervention. Feasibility was determined by assessing reach, retention, adherence, dance logs, dance evaluations, and focus groups post-intervention. Participants were given a GT3X+ accelerometer and ActivPAL to wear for 7 consecutive days. Questionnaires assessing cognition, physical function, cardiorespiratory fitness, sedentary behavior, quality of life, and depression were administered. All data was collected at baseline, month 2, month 4, month 6, and month 8. Findings indicate that participants found the Latin dance program as an appealing, enjoyable, and safe mode of PA. The study also revealed modest effects on physical and cognitive function and warrants further research in the study of the impact on PA and sedentary behavior related outcomes. Researchers may consider recruiting older Latinos with MCI who are not attending an adult day service center in order to determine whether PA programs are efficacious among individuals who do not have access to these centers. Future dance studies should involve a larger randomized controlled trial and should continue to include underserved populations

Impact of Latin Dance on Physical Activity, Cardiorespiratory Fitness, and Sedentary Behavior Among Latinos Attending an Adult Day Center

The aim of this study was to determine if a Latin dance program with sedentary behavior information would have an impact on physical activity, cardiorespiratory fitness (CRF), and sedentary behavior among older Latinos attending an Adult Day Center (ADC). Participants [N=21, 75.4 ± 6.3 years old, 22.4± 2.8 MMSE score] were randomized into a dance or wait-list control group. Participants wore an accelerometer and inclinometer, completed a sedentary behavior questionnaire, and a non-exercise equation was used to calculate CRF. Results indicate small-medium effect sizes in the desired direction during midpoint of the intervention for physical activity, sedentary behavior-related outcomes, CRF, and self-reported sedentary behavior in the dance group, however; dance participants did not maintain that trajectory for the remaining two months of the intervention. Future studies may consider implementing behavioral strategies during midpoint of the intervention to encourage participants attending an ADC to maintain physical activity and sedentary behavior changes

The preliminary efficacy of Caring of Caregivers Organically (CoCO) health education program on the health of Latina caregivers of persons with Alzheimer\u27s disease and related dementias

BACKGROUND: By 2060, the prevalence of Alzheimer\u27s disease and related dementias (ADRD) in Latinos is projected to increase by 832%,1 representing an increased demand of caregivers. Caregiving has been shown to increase risk for depression and anxiety,2 poorer quality of life (QoL)3 and health behaviors.4 There is a critical need to create linguistically and culturally responsive interventions to promote caregiver health as they often forgo their own health to help the person with ADRD. CoCO is a health education program centered on caregiver\u27s physical and mental health. The purpose of this study was to assess the preliminary efficacy of CoCO on health-related QoL, health behaviors, and symptoms of depression among Latina ADRD family caregivers. METHODS: Fourteen Latina ADRD family caregivers were randomized to the 8-week, 2-hours per week CoCO health education program delivered by health companions (n=8, mage =59.41±11.1) or a wait-list control group who received the CoCO manual (n=6, mage =43.3±18.2). Health-related QoL was assessed through the RAND 36-item Health Survey (SF-36).5 The Positive Health Behaviors scale6 was used to assess engagement in healthy activities. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale.7-8 T-tests were used to assess change in the measures per group pre-post intervention. Cohen\u27s d was used to calculate effect sizes. RESULTS: There were statistically significant increases in depressive symptoms pre-post in both the intervention group (PreM =14.1±13.3, PostM =22.5±14.9, p=.007, d=1.32) and the control (PreM =5.5±3.6, PostM =14.0±10.0, p=.046, d=1.08). There were statically significant decreases in the emotional well-being domain of the SF-36 questionnaire in the control group only (PreM =79.3±18.5, PostM =67.3±15.5, p=.030, d=1.23). Cohen\u27s d values showed medium effect sizes showing a positive directionality in the physical activity domain of the health behavior scale for the intervention group only (PreM =5.50±4.90, PostM =7.75±4.03, p=.152, d=0.57). CONCLUSION: Participants in the intervention demonstrated medium effects for the physical activity domain, suggesting an increase in physical activity. However, findings also indicate increased depressive symptoms and poorer health-related quality of life. Health education interventions promoting health behavior changes in Latina ADRD family caregivers might benefit from including more extensive problem solving and coping strategies to improve depressive symptoms and QoL

Social Cognition and Socioecological Predictors of Home-Based Physical Activity Intentions, Planning, and Habits during the COVID-19 Pandemic.

'Shelter in place' and 'lockdown' orders implemented to minimize the spread of COVID-19 have reduced opportunities to be physically active. For many, the home environment emerged as the only viable option to participate in physical activity. Previous research suggests that availability of exercise equipment functions as a determinant of home-based physical activity participation among the general adult population. The purpose of this study was to use a socioecological framework to investigate how the availability of exercise equipment at home predicts behavioral decisions, namely, intention, planning, and habits with respect to participation in physical activity. Participants (n = 429) were adults recruited in U.S. states subject to lockdown orders during the pandemic who completed measures online. A structural equation model indicated that availability of cardiovascular and strength training equipment predicted physical activity planning. Social cognition constructs mediated the relationship between each type of exercise equipment and intentions. Autonomous motivation and perceived behavioral control were found to mediate the relationship between each type of exercise equipment and habit. The availability of large cardiovascular and strength training equipment demonstrated significant predictive effects with intention, planning, habit, and autonomous motivation. Facilitating these constructs for home-based physical activity interventions could be efficacious for promoting physical activity

Social Cognition and Socioecological Predictors of Home-Based Physical Activity Intentions, Planning, and Habits during the COVID-19 Pandemic

‘Shelter in place’ and ‘lockdown’ orders implemented to minimize the spread of COVID-19 have reduced opportunities to be physically active. For many, the home environment emerged as the only viable option to participate in physical activity. Previous research suggests that availability of exercise equipment functions as a determinant of home-based physical activity participation among the general adult population. The purpose of this study was to use a socioecological framework to investigate how the availability of exercise equipment at home predicts behavioral decisions, namely, intention, planning, and habits with respect to participation in physical activity. Participants (n = 429) were adults recruited in U.S. states subject to lockdown orders during the pandemic who completed measures online. A structural equation model indicated that availability of cardiovascular and strength training equipment predicted physical activity planning. Social cognition constructs mediated the relationship between each type of exercise equipment and intentions. Autonomous motivation and perceived behavioral control were found to mediate the relationship between each type of exercise equipment and habit. The availability of large cardiovascular and strength training equipment demonstrated significant predictive effects with intention, planning, habit, and autonomous motivation. Facilitating these constructs for home-based physical activity interventions could be efficacious for promoting physical activity.peerReviewe

BAILAMOS©: Development, Pilot Testing, and Future Directions of a Latin Dance Program for Older Latinos.

Older Latinos have low rates of physical activity (PA) and poor health outcomes. Focus groups and a single group, pre-post 3-month pilot of a culturally appropriate Latin dance program (BAILAMOS(©)) were conducted among older, inactive Latinos with a self-identified mobility limitation. Nine themes emerged from focus groups, including cultural influences of dance and barriers to dancing. In the pilot intervention, 9 of 13 older Latinos completed the program and attended 85% of the sessions. Self-reported PA significantly increased (p < .05; d = 1.39), but daily accelerometer-assessed PA decreased for moderate-intensity PA (p = .18; d = 0.29). Participants reported significantly greater enjoyment of PA (p < .05; d = 0.61) and improved physical quality of life (p = .23; d = 0.31). Improvements in mobility (p = .15; d = 0.56) and aspects of cognition were demonstrated. The BAILAMOS program appears to be feasible, culturally appropriate, and has the potential to improve psychosocial determinants of PA, self-reported PA, and aspects of health

Replacing sedentary time with physical activity or sleep: effects on cancer-related cognitive impairment in breast cancer survivors

Abstract Background Evidence suggests reallocating daily sedentary time to physical activity or sleep confers important health benefits in cancer survivors. Despite emerging research suggesting physical activity as a treatment for cancer-related cognitive impairment (CRCI), little is known about the interactive effects of behaviors across the 24-h period. The present purpose was to examine the cognitive effects of reallocating sedentary time to light-intensity physical activity, moderate-to-vigorous physical activity (MVPA), or sleep in breast cancer survivors. Methods Breast cancer survivors (N = 271, Mage = 57.81 ± 9.50 years) completed iPad-based questionnaires and cognitive tasks assessing demographics, health history, executive function, and processing speed (Task-Switch, Trail Making). Participants wore an accelerometer for seven consecutive days to measure their sedentary, physical activity, and sleep behaviors. Single effects (each behavior individually) and partition (controlling for other behaviors) models were used to examine associations among behaviors and cognitive performance. Isotemporal substitution models were used to test the cognitive effects of substituting 30 min of sedentary time with 30 min of light-intensity activity, MVPA, and sleep. Results MVPA was associated with faster Task-switch reaction time in the partition models (stay: B = − 35.31, p = 0.02; switch: B = − 48.24, p = 0.004). Replacing 30 min of sedentary time with 30 min of MVPA yielded faster reaction times on Task-Switch stay (B = − 29.37, p = 0.04) and switch (B = − 39.49, p = 0.02) trials. In Trails A single effects models, sedentary behavior was associated with faster completion (B = − 0.97, p = 0.03) and light-intensity activity with slower completion (B = 1.25, p = 0.006). No single effects were observed relative to Trails B completion (all p > 0.05). Only the effect of MVPA was significant in the partition models (Trails A: B = − 3.55, p = 0.03; Trails B: B = − 4.46, p = 0.049). Replacing sedentary time with light-intensity activity was associated with slower Trails A (B = 1.55 p = 0.002) and Trails B (B = 1.69, p = 0.02) completion. Replacing light activity with MVPA yielded faster Trails A (B = − 4.35, p = 0.02) and Trails B (B = − 5.23, p = 0.03) completion. Conclusions Findings support previous research suggesting MVPA may be needed to improve cognitive function in breast cancer survivors. Trails findings underscore the need to dissect sedentary contexts to better understand the impact of daily behavioral patterns on CRCI. Additional research investigating the cognitive impacts of behaviors across the 24-h period is warranted. Trial registration This study is registered with United States ClinicalTrials.gov (NCT02523677; 8/14/2015)

Mid-lumbar (L3) epidural stimulation effects on bladder and external urethral sphincter in non-injured and chronically transected urethane-anesthetized rats

Abstract Recent pre-clinical and clinical spinal cord epidural stimulation (scES) experiments specifically targeting the thoracolumbar and lumbosacral circuitries mediating lower urinary tract (LUT) function have shown improvements in storage, detrusor pressure, and emptying. With the existence of a lumbar spinal coordinating center in rats that is involved with external urethral sphincter (EUS) functionality during micturition, the mid-lumbar spinal cord (specifically L3) was targeted in the current study with scES to determine if the EUS and thus the void pattern could be modulated, using both intact and chronic complete spinal cord injured female rats under urethane anesthesia. L3 scES at select frequencies and intensities of stimulation produced a reduction in void volumes and EUS burst duration in intact rats. After chronic transection, three different subgroups of LUT dysfunction were identified and the response to L3 scES promoted different cystometry outcomes, including changes in EUS bursting. The current findings suggest that scES at the L3 level can generate functional neuromodulation of both the urinary bladder and the EUS in intact and SCI rats to enhance voiding in a variety of clinical scenarios

The Impact of the BAILAMOS™ Dance Program on Brain Functional Connectivity and Cognition in Older Latino Adults: a Pilot Study

Dance is a culturally salient form of physical activity (PA) for older Latinos. Resting-state functional connectivity (FC) is a putative biomarker for age-related cognitive decline. We aimed to investigate the impact of the BAILAMOS™ dance program on FC in three brain functional networks (Default Mode [DMN], Frontoparietal [FPN], and Salience [SAL] networks), and cognition. Ten cognitively healthy older Latinos participated in the four-month BAILAMOS™ dance program. We assessed PA levels (self-reported and device-assessed) and estimated cardiorespiratory fitness, cognition, and resting-state FC via functional magnetic resonance imaging at baseline and post-intervention. We performed paired t-tests and Pearson correlations. Given the pilot nature of the study, significance levels were set at p < 0.05 and effect sizes are reported. We observed a significant increase in self-reported moderate leisure-time PA from pre- to post-intervention (t(9) = 3.16, p = 0.011, d = 0.66). FC within-FPN regions of interest (ROIs) significantly increased pre- to post-intervention (t(9) = 2.35, p = 0.043, d = 0.70). DMN ROIs showed an increase, with a moderate effect size, in the integration with other networks' ROIs (t(9) = 1.96, p = 0.081, d = 0.64) post-intervention. Increases in moderate leisure-time PA at post-intervention were associated with increases in the FC within-FPN (R = 0.79, p = 0.006). Our results suggest that dance might be a promising approach for improving age-related disruption of FC within- and between-networks commonly associated with cognitive decline

The Effects of the BAILAMOS Dance Program on Brain Functional Connectivity of Older Latinos: An Exploratory Study

Abstract Compared to non-Latinos whites, older Latinos are at higher risk of cognitive impairment and engage in less leisure-time physical activity (PA). Resting-state brain functional connectivity (FC) is a putative biomarker for age-related cognitive decline. PA plays a role in FC of brain networks associated with cognitive decline. Objective: Investigate the effects of the BAILAMOS™ dance program on FC in three brain networks associated with age-related cognitive decline (Default Mode [DMN], Frontoparietal [FPN], and Salience [SAL] networks). Methods: Single-group pre-post design. Ten cognitively intact older Latinos participated in the four-month (2x/week for 60min) BAILAMOS™ dance program with four Latin dance styles. MRI was obtained pre- and post-intervention. FC was analyzed using the resting-state fMRI toolbox (CONN) via pairwise BOLD signal correlations and then converted into z-scores. We performed dependent t-tests, computed Cohen’s d and 95%CI for p < 0.05. Results: Within-FPN FC significantly increased (t(9) = 2.35, p = 0.043, d = 0.70) from pre (M=0.49±0.15) to post-intervention (M=0.59±0.13). In the DMN, we observed moderate effect size changes in the ratio of the FC between-networks by the FC within-networks (Mdiff = 0.10; 95%CI = -0.01; 0.21, p = 0.08, d = 0.64). Conclusions: The BAILAMOS™ program increased within-FPN FC, which is a cognitive-control network related to adaptive control and flexibility. Moderate changes between- vs. within-DMN FC suggest BAILAMOS™ also increased whole-brain DMN integration. Taken together, results might signal that Latin dance can combat the disruption of FC between the DMN and other networks, and within-FPN, which are associated with cognitive decline