At the Ralston House, home of Penn’s Institute on Aging (IOA), a small group of older African-Americans moves to the rhythm of African music, keeping time to the beat of the drums as they follow their dance instructor’s steps. Another similarly aged group tackles mentally stimulating activities, such as creating African masks while learning the history of masks or participating in lively discussions on a variety of topics. Although the classes are clearly entertaining, they’re part of something greater: furthering research on the impact of cognitive stimulation and exercise on the progression of Alzheimer’s disease.
REACT! (Rhythm Experience and Africana Culture Trial) is a collaboration between the IOA and the University of Pittsburgh’s Brain Aging & Cognitive Health lab. “Keeping the mind engaged and learning is a way to possibly reduce the risk of dementia,” said IOA deputy director Kathy Jedrziewski, PhD, who leads Penn’s study. “Exercise will most likely be a more impactful intervention, but I think the education group will have an effect as well, through learning, engaging, and socialization.”
The study focuses exclusively on African-Americans, who are twice as likely to develop late-onset Alzheimer’s disease as Caucasians, attributed in part to their increased prevalence of obesity, type 2 diabetes, and vascular diseases. A strong association exists between these cardiovascular risks and an increased risk of dementia. All study participants, who have normal cognitive abilities or very mild impairment, have undergone screenings for cognitive measures and exercise to establish baseline numbers and will be tested again after the six-month intervention. The study uses a randomization algorithm to assign the participants to one of the groups.
Shardae Williams, project coordinator, leads the education/discussion group, putting together activities for each of the three weekly sessions. As a former biology teacher at an alternative school, “my job was to make biology interesting,” she said. “I use this experience to make learning fun for senior citizens as well.”
And fun it is. Rose Grant “loves how much information I get. After each session, I go home and tell my husband, ‘Guess what I learned today!’” Gracie Claude “couldn’t wait to sign up!” As a volunteer at a local nursing home, “I see people just sitting there, doing nothing, and I want to help them.” She takes all she learns in these sessions back to the nursing home and to her church. “The program benefits the entire community.”
In addition to creating African masks, participants have written poetry and made their life stories on scrolls. Although this group doesn’t get up and exercise, Williams embeds activities in her lessons that get them moving, for example, clapping and drumming as part of the session of how Africans use music to communicate. She also plans to teach them to use wooden maracas, which the participants will learn to design. In addition, the participants will learn about the food and culture of Africa, and make traditional West African recipes.
Getting people moving is definitely a goal of the dance group. Dance instructor Patricia Jones has experience teaching African dancing but never specifically targeted this age range. “I had to break down the steps into individual moves and modify them.” To help with the learning, she includes dance moves made famous by The Temptations, a soul group from the 1960s. Participants have no problem learning those!
But that’s only part of the requirement. In addition to adding new steps to the dance at each session, participants have to remember the order of the steps, to further stimulate their cognitive abilities.
Each of the participants in the dance group wears a heart monitor. As they move, Williams monitors their heart rate. “They have to reach a target heart rate [for the study],” she said. “I let the instructor know if she needs to speed things up or slow it down, depending on the readings.”
Although only halfway through the six-month study, the dance sessions have had an impact. Edward Barnes has seen his blood pressure fall from 145 to 120. Cornelia McPherson finds the dancing “helps with my concentration and memory… and I’m losing weight!”
The study, funded by the Alzheimer’s Association, employs rolling enrollment which means there’s still time for new participants to enroll before it ends next spring. When this small pilot study ends, Jedrziewski hopes to expand it to more sites and eventually “translate the information gained into a successful intervention in the community.”