Spring 2024

Mayo Clinic Investigators Learn More About Dementia Risks in African Americans
Most readers of Let’s Talk Brain Health already know the statistics: Alzheimer’s disease and related dementias are twice as common in African Americans compared to their White counterparts. There is growing evidence that this disparity is not due to “race” itself but may be due to a combination of social factors such as education, housing, socioeconomic status, lifestyle habits, and access to healthcare and medications. In fact, studies have shown that up to 40% of dementia
Spring 2024
In This Issue
- Dementia Risk in African Americans
- Staying Mentally Sharp
- What's Cooking?
- Meet the ORE Core
- Meet Ms. Shirley Brown
- Calendar of Events
- Community Pages
- The HABIT Program
risk may be attributed to factors that can be changed or improved to lower one’s risk. These modifiable risk factors include things like education level, diet, exercise, high blood pressure, diabetes, cholesterol problems, obesity, vitamin B12 deficiency, depression, and more.
Dr. Christian Lachner, a neuropsychiatrist and investigator in the Mayo Clinic Alzheimer’s Disease Research Center (ADRC), recently led a research team to examine the frequency of modifiable dementia risk factors in African American and White participants enrolled in the ADRC, and sought to learn how these factors may relate to problems in cognition (i.e., thinking and memory abilities).
According to Dr. Lachner, “We found that the presence of high blood pressure, abnormal cholesterols, diabetes, and obesity was higher in African American participants. In our study, however, these conditions were not associated with thinking and/or memory problems.” Depression, however, was highly associated with cognitive difficulties. African Americans who reported having depression were 4x more likely to show cognitive problems.

Although depression was associated with increased risk of cognitive difficulty in both groups, cognitive functions in African Americans with declined significantly faster over time than White participants with depression. According to Dr. Lachner, “one possible reason for this is that fewer African American participants with depression reported being treated with antidepressant medications as compared to White participants with depression” (See Figure 1).
The reason why more White than African American individuals were receiving treatment for their depression is unclear but may in part reflect differences in cultural attitudes and beliefs towards mental health issues, access to mental health resources, and willingness to seeking help.
Another factor that was found to be associated with faster cognitive decline in African American participants was low vitamin B12 levels. Unlike depression, however, there is essentially no difference between African American and White participants with regard to the presence or treatment of Vitamin B12 deficiency (Figure 1).
The observed disparities in the impact of both depression and vitamin B12 deficiency on changes in memory and thinking ability are important discoveries that warrant further exploration to ensure equity in the prevention and management of cognitive decline in older African Americans.
“We are grateful to our community participants who contributed to this important study of dementia risk” says Dr. Lachner. The Mayo Clinic ADRC aims to support equitable brain health and memory care for all through discoveries made possible by ongoing partnership with the Jacksonville African American community. Representation in these discoveries is important, and if you would like to join a study, please refer to the contact information on the back page of this newsletter. The full text of Dr. Lachner’s study, "Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans” is published in the journal Annals of Neurology.

Key Points
- Conditions that are known to increase risk of dementia are frequently observed in both African American and White individuals.
- Depression and vitamin B12 deficiency have a stronger relationship with cognitive decline in African Americans than in White Americans.
- Raising awareness, increasing screening efforts, and improving treatment of these modifiable factors may help lower the risk of dementia in the African American community, where risk of dementia is higher.
- If you are experiencing depression or suspect depression in a loved one, your primary care physician may be able to help. Your doctor can also check your vitamin B12 level to make sure it is not deficient.
- Depression may be challenging to address given cultural stigma regarding mental health. Communities can help by raising awareness and providing education about depression, facilitating access to mental health services, and supporting the training of healthcare professionals in the delivery of culturally competent mental health care.


Want to Stay Mentally Sharp? Try Learning a New Language.
If you’ve ever thought about learning another language but have been putting it off, a new study from investigators at Iowa State University might make you want to sign up for lessons right away. That’s because they found that people who can speak more than one language can often delay the onset of Alzheimer’s disease better than people who speak only one language.
While learning to speak a new language may not prevent or reverse Alzheimer’s disease, it can create changes in the brain that provide benefit and resilience against disease. Everyone’s brain is made up of millions of specialized cells called neurons. Neurons communicate with each other by sending signals to the receptors of neighboring cells. The spaces where this signaling occurs are called synapses (Fig. 1).

It has long been known that people who are bilingual since childhood have more neurons and more synapses than people who speak only one language. This is true even for those who learn a second language later in life. The reason is because immersing oneself in new cognitive experiences plays an important role in strengthening and expanding brain cell connections. The more connections there are, the more information can be processed.
When you learn a new language, you combine two important facilitators of neuronal growth: exposure to something new and repetition/rehearsal. This combination gives brain cells a workout that increases the number of places along the cell that information can be received and transmitted. The more neuronal connections there are, the greater the brain’s resilience against changes caused by dementia. Scientists call this enhancement “cognitive reserve” and it refers to the brain’s ability to withstand the impact of disease. In the case of learning a new language, the adage “Use it or lose it” may have true meaning!
The opportunity to delay dementia onset is important, because it offers the ability to remain independent and enjoy a greater quality of life for a longer time. Other ways to keep the brain healthy have been featured in past issues of Let’s Talk Brain Health and include a healthy Mediterranean-style diet, physical exercise, obtaining proper sleep, managing stress, and remaining socially engaged. Add “learning a new language” or other mentally stimulating activities to the list and it could be just what the doctor ordered!
If you are interested in learning a new language, classes are often offered through local schools, continuing education programs and lifelong learning programs.

Figure 2. Illustration of a neuron showing the increase in possible connections (synapses) before (top) and after (bottom) new learning

What's Cooking?

The cool temperatures of spring are great for growing beets – a brain and heart healthy vegetable that is the star of this healthy spring salad! You can serve this as a starter salad or enjoy it as the main course by mixing in some slices of grilled chicken or other lean protein. The recipe calls for gorgonzola cheese (Italian-style blue cheese) but if that’s not your cup of tea, feel free to substitute goat cheese, which goes equally well with this dish. Finally, be sure to dress the greens at the last minute so they don’t get soggy. Have the beets and other toppings chopped and ready to go once the greens are plated!
Beet Walnut Salad
Serves 8
Ingredients
1 small bunch of fresh beets*
1/4 cup red wine vinegar
3 tablespoons balsamic vinegar
1 tablespoon olive oil
1 tablespoon water
8 cups fresh salad greens
1/4 cup chopped apple
1/4 cup chopped celery
Freshly ground pepper
3 tablespoons chopped walnuts
1/4 cup gorgonzola cheese, crumbled
*If fresh beets are not available, you can substitute (3 cups of drained, no-salt-added canned beets) and skip to Step 3 below.
Directions
- Steam raw beets in water in a saucepan until tender.
- Rinse to cool and slip off skins.
- Slice beets into 1/2-inch thick rounds and toss gently with red wine vinegar.
- In a large bowl, combine balsamic vinegar, olive oil and water. Add salad greens and toss.
- Put greens onto individual salad plates. Top with sliced beets.
- Chop apples and celery, and sprinkle on top.
- Add chopped walnuts, cheese, and pepper to taste. Serve immediately.
Nutrition per serving: 90 cal., 5g fat, 1.5g saturated fat, 115mg sodium, 9g carbohydrates, 2.5g fiber, 3g protein.

Meet a Community Champion
Ms. Shirley Brown
If you have visited the Edward Waters University Schell Sweet Community Resource Center, then chances are you have met Ms. Shirley Brown, as she is highly active in many programs at the Center. In addition, Ms. Brown has been involved in the Dementia Friendly Community Program in the New Town neighborhood since the program began. From her participation in the very first focus groups that provided insight into the community’s dementia-related needs to her ongoing service on the New Town Dementia Friendly Community Sustainability Committee, Ms. Brown has been a steadfast and dedicated champion of the community. She is also a champion of Alzheimer’s research and faithful participant in studies of aging and brain health, such as the one featured in the cover story of this issue of Let’s Talk Brain Health.
Ms. Brown has served as community editor of the Dementia Connection newsletter since the first issue went to press in 2019. Dementia Connection features news, information, and support for a sector of the community that is near and dear to Ms. Brown’s heart: the caregivers of loved ones who have Alzheimer’s disease or related dementias. Each issue of Dementia Connection contains helpful caregiver tips and resource information, and highlights neighborhood events and support activities that make New Town truly “dementia friendly.”
A lifelong Floridian, Ms. Brown was born in West Palm Beach and moved to Jacksonville at the age of 3. After being raised in Jacksonville, she returned to West Palm Beach at age 19, and then back to Jacksonville in 2004. She had a successful career in retail from 1969 to 1999. In 2007 she registered as a participant in the Schell Sweet computer class for seniors. The following year, she signed up as a volunteer at the Center and has been a welcoming presence there ever since.
Among other things, Ms. Brown has worked with a GED program in partnership with Florida State College Jacksonville and several faith-based programs. She is instrumental in organizing community food distribution programs, which take place at Schell Sweet every 2nd Saturday of the month. If that weren’t enough, she also helps support the New Town Success Zone Impact Days, which are held the 4th Saturday of every month at the Health Disparities Center and have included services such as health screenings, vaccinations, and grocery giveaways.

community food distribution programs, which take place at Schell Sweet every 2nd Saturday of the month. If that weren’t enough, she also helps support the New Town Success Zone Impact Days, which are held the 4th Saturday of every month at the Health Disparities Center and have included services such as health screenings, vaccinations, and grocery giveaways.
Creating connections is very important to Ms. Brown. She enjoys spending time with her brothers and sisters and extended family. She enjoys Bible study and writes a Testimony to the Community in each issue of the Dementia Connection newsletter. She also enjoys cooking when she has time, and is proud of her homemade baked beans. If you’re passing by Schell Sweet one day, stop in and see if she will give you the recipe!
Thank you, Ms. Brown, for your many contributions to our community!
Meet an ADRC Team Member
Bernice Bryant
Ms. Bernice Bryant is an outreach coordinator and a clinical study coordinator in the Mayo Clinic Alzheimer’s Disease Research Center. If you have come to any ADRC community outreach events, you have no doubt seen Bernice at our information table talking to community members about brain health, dementia research, and community resources. She also works with participants who enroll in ADRC studies by collecting background information and administering tests of memory and thinking ability. We caught up with her and asked her to share with readers a little more about herself, her work, and her interests.
Hi Bernice! Let’s start by telling us a little about yourself.
My parents are of Puerto Rican descent, but I was raised in The Bronx New York. I moved to Jacksonville when I was 20 years old to attend the University of North Florida, where I studied health science and community health. I am currently working on my master’s degree in public health. I have always been an advocate for community health and would like to see greater access and equity in our communities. Before joining Mayo Clinic, I was the operations manager and interim director of Community Health Outreach, a free medical and dental clinic serving low income, uninsured adults here in Jacksonville. I also taught adolescents health education with Duval County schools. My plan is to continue to spread education, awareness and services that would benefit the personal health of individuals in my community.
Why did you join the ADRC Outreach team?
I joined the ADRC Outreach team because this disease has affected many close relatives in my family. I wasn’t seeing enough education and resources available to minorities like me and my family out there in the community. There wasn’t much information to help combat the increasing cases of Alzheimer’s and related dementias. I saw it becoming a norm. Joining this team gives me a chance to not only increase my own knowledge on how to reduce my risk of disease, but it also gives me a chance to share resources, education, and what I have learned with others in the community to help them reduce their own dementia risk factors. It also gives me the chance to share with community members how important it is to be represented in the studies that are advancing the understanding and treatment of Alzheimer’s disease. We don’t want to be left behind!

What about outside of work, what keeps you busy?
As a mother of five children, I spend a lot of my time outside of work helping with homework, supporting athletic ventures, and traveling with my family. Aside from my family duties, I am a coach for the girls’ soccer and swim team at Westside Middle School.
Anything else you would like to share?
Every year I collect sanitary items to create starter kits to donate to middle schools in low-income areas for students to have access to and learn about the different items to keep their hygiene up. I find it uplifting to know that small things can have a powerful positive impact on others.

Calendar of Events

Community Pages
Pathways to Brain Health
On Saturday, January 13, 2024, Mayo Clinic dementia experts and community partners joined together to provide the second installment of the Pathways 2 Brain Health series at Bethel Baptist Institutional Church. The event, attended by nearly 100 community members, offered attendees four different interactive workshops to promote brain health (brain healthy food choices, advance care planning, caregiver support, and latest dementia treatments), as well as a vendor expo of community support services for people with memory loss and their care partners.
Research Participant Appreciation
Did you know that several hundred people participate in clinical research projects at the Mayo Clinic Florida ADRC? The many projects focus on enhancing brain health, exploring new medications and lifestyle changes to possibly delay and prevent difficulties with memory and thinking due to Alzheimer’s Disease and Related Dementia. On January 20, 2024, study participants attended an annual appreciation brunch reception to hear about the progress that has been made thanks to their study participation. Among the presenters was Dr. Christian Lachner, who spoke about his study of modifiable dementia risk factors (see cover story).
We can't thank you enough...
Members of the Mayo Clinic ADRC Community Advisory Board (“Ambassadors”) joined together for an annual recognition event to acknowledge their efforts in raising dementia awareness in the community. This group of community advocates meets monthly and provides guidance and support to ADRC staff and investigators regarding educational programs and outreach events. This year, Mr. Kenneth Reddick and Ms. Sheri Randolph were recognized as Ambassador Heroes for their tireless dedication to dementia awareness.

Habit: Healthy Actions to Promote Independence & Thinking

Did you know that Mayo Clinic has a program designed to assist those with Mild Cognitive Impairment (MCI)?
The HABIT Program is for individuals with MCI and their loved ones to learn the best strategies for adapting, coping, and living their best lives with MCI.
Mayo Clinic’s HABIT Healthy Action to Benefit Independence & Thinking® is a 10-day program for individuals who have received the diagnosis of MCI and a partner to learn the best skills for maintaining independence in spite of memory problems, improving self-esteem, and coping with the emotions that arise for the person and their family with the uncertainty that comes with a diagnosis of MCI. The program focuses on adjustment to the diagnosis of MCI, adaptation to cognitive and functional limitations, brain wellness education, physical and cognitive exercise, and stress/emotional management.
We developed the HABIT program to provide individuals with MCI and their loved ones with state of the art, evidence-based, lifestyle or behavioral treatments for MCI. We began offering memory rehabilitation to individuals with MCI back in 2005, which grew into the first full HABIT program in 2008. We have since spread beyond Mayo to train multiple other centers across the country in delivering these types of interventions to individuals with MCI and their families.
This program does not aim go cure your MCI, but to give you tools to help cope and combat the memory loss as best as we know how.
During HABIT you will work with a multidisciplinary team made up of neuropsychologists, social workers, occupational therapists, cognitive therapists, and certified yoga instructors who are passionate about providing this care to our participants. HABIT is a group-based program, meaning that you will attend with other individuals experiencing MCI and their partners.



Spread the Word About Brain Health
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• learn more about obtaining a memory evaluation or diagnosis of dementia
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» Email: FLAMayoADRC@mayo.edu
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www.dementiaoutreach.mayo.edu
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