David X. Marquez, Ph.D. - US grants

DESCRIPTION: (Adapted from the Applicant's Abstract): The candidate's future research endeavors will be focused in the area of determinants of physical activity in older Latino adults. Latinos will become the largest minority group in the United States by the early 21st century (Council on Scientific Affairs, AMA, 1991). Unfortunately, 36 percent of Latino adults report no participation in leisure time physical activity (National Center for Health Statistics, 1999) and 51 percent of those aged 65-74 report no leisure time physical activity. In addition, attrition from physical activity programs approximates 50 percent within the first 6 months. The proposed research program is designed to combine two theoretical approaches, social cognitive theory and self-presentation theory, in an effort to understand the determinants of physical activity among Latino adults. The candidate proposes to begin this work by examining the relationships among social physique anxiety, self-efficacy, and the exercise behavior of older adults in an existing data set. Findings from this study will be used to assist in designing a study examining the role of these constructs in the exercise behavior of older Latinos and to identify strategies for changing the exercise environment to maximize participation in this population.

DESCRIPTION (provided by applicant): Older Latinos are expected to constitute 20% of the older adult population by 2050. Physical activity (PA) can influence potential declines in the health outcomes of physical and cognitive function that lead to self- reported functional limitations and disability. Unfortunately, Latinos aged 65-74 are 46% less likely to engage in leisure time PA than older non-Latino whites, and little is known about PA maintenance among ethnic minorities. In part due to low levels of PA, older Latinos are twice as likely to report difficulty walking than non- Latino whites and Alzheimer's disease symptoms begin 7 years earlier in Latinos than in non-Latino whites. Participation in PA has substantial potential to help older Latinos maintain both physical and cognitive function as they age. Dance holds promise as a culturally appropriate form of PA for this disadvantaged population, and is a form of PA that challenges individuals both physically and cognitively. To date, PA programs designed for older Latinos are lacking. BAILAMOS(c) is a dance program that has been developed based on input from older community-dwelling Latinos and in collaboration with an accomplished Latin dance instructor. A single group, pre-post 3-month pilot of BAILAMOS(c) demonstrated substantial program feasibility, and effect sizes indicated greater self-reported participation in lifestyle PA, along with improvements in physical and cognitive function. The original 3-month BAILAMOS(c) dance program has been revised according to participant and dance instructor feedback. A randomized controlled trial (RCT) is proposed in sedentary, older Latinos at risk for disability. Participants will be randomized to the BAILAMOS(c) condition or a health education attention control group. BAILAMOS(c) encompasses four dance styles with the simplest style introduced first (i.e., Merengue) and the most difficult style last (i.e., Salsa) to enhance self-efficacy. Each style is taught for four weeks, twice weekly for one hour per class (32 sessions total). Group discussions on how to increase lifestyle PA are included. To enhance maintenance of PA after the formal program, 2-3 indigenous leaders from each site will be trained to teach the 4-months of dancing of BAILAMOS(c). Control condition activities consist of health education classes conducted in Spanish by bilingual/bicultural health educators of University of Illinois Extension. A total of 332 older Latinos will be recruited across nine sites over three years. Sites include senior centers, community centers, and parks. Each site will enroll approximately 40 individuals (20 treatment, 20 control). This clinical trial will test the impact of the BAILAMOS(c) program on lifestyle PA at 4 months and BAILAMOS(c) maintenance activities on lifestyle PA maintenance at 8 months. The impact of the BAILAMOS(c) program at 4 months and BAILAMOS(c) maintenance activities at 8 months on self-efficacy (mediators) and on health outcomes of physical function, cognitive function, and self-reported functional limitations and disability will be tested. Long term goals include the prevention of disability among this disadvantaged group. PUBLIC HEALTH RELEVANCE: Latino adults are one of the fastest growing groups in the US and are at serious risk for disability, which can be explained in part by alarming rates of physical inactivity. Latin dance holds great promise as a culturally-appropriate physical activity intervention in this population, yet little is known about the health benefits of Latin dance. The current study will continue a line of research aimed at developing evidence-based culturally-appropriate physical activity interventions for older Latino adults at high risk for adverse health outcomes.

ABSTRACT - LATINO CORE The Rush Alzheimer's Disease Core Center (Rush ADCC; P30AG10161) supports the performance of innovative research on the etiology, pathogenesis, diagnosis, treatment, and prevention of AD and related conditions, by providing researchers with a stimulating inter-disciplinary environment, and unique and highly valued clinical and post-mortem data, and biologic specimens. The Rush ADCC has eight cores that support a variety of timely and important areas of research including risk factors for the transition from normal aging to MCI to AD, the neurobiology of normal aging and MCI, and the use of contemporary omics technologies to identify novel therapeutic targets. The Rush ADCC has enrolled large numbers of Blacks and Whites without dementia into the Clinical and Religious Orders Study Cores. Although the Latino community has not been a major focus, considerable progress in the Latino community to date has set the stage for the Latino Core. The overall goal of the Latino Core, funded in August, 2015, is to enroll and follow older Latinos free of dementia at baseline, and generate data and ante- and post-mortem biospecimens, to support high quality, cutting edge, externally-funded studies that focus on the full spectrum of cognition. These goals will be addressed with four Specific Aims designed to enhance the Rush ADCC and the wider ADC research community: Aim 1 is to recruit and enroll older Latinos without dementia who agree to annual, detailed clinical evaluations and the collection of ante-mortem biologic specimens. Aim 2 is to conduct uniform structured baseline and annual follow-up evaluations, including neurological examinations and neuropsychological and motor performance testing, of community-dwelling Latinos, and apply uniform diagnostic criteria for incident AD and MCI, and harmonize data collection with the Religious Orders Study Core and the Clinical Core to facilitate health disparities research. Aim 3 is to integrate innovative and culturally tailored educational programs into the clinical evaluation to increase awareness of the importance of brain and spinal cord autopsy in Latinos and to facilitate a high autopsy rate with a short post-mortem interval; and harvest and preserve brain tissue in a fashion that retains maximum flexibility to support a diverse array of studies. Aim 4 is to increase the capacity to conduct externally-funded research, including studies that incorporate contemporary biochemical and molecular techniques and clinical trials, by providing an environment and resources to facilitate the inclusion of subjects, clinical data, and post-mortem tissue into research projects and to provide training opportunities for junior faculty.

ABSTRACT ? LATINO CORE The overall goal of the Latino Core is to support high quality, cutting edge, research projects on the etiology, pathogenesis, diagnosis, treatment, and prevention of Alzheimer?s disease and related dementias (ADRD) by providing data and biospecimens from well-characterized, longitudinally followed Latinos who initially enroll without dementia from the community. Latinos are at greater risk of ADRD than non-Latino Whites, but the field has struggled to engage this population in clinical research. In response to the NAPA milestones on health disparities/equity, our Latino Core will support studies that assess the epidemiology, and mechanistic pathways of disparities in health burden of ADRD, and facilitate engagement, understanding, and partnership with our diverse participants using culturally-tailored approaches and research efforts to understand and advance the science of disparities. Despite the existence of large, productive studies that include Latinos, progress in the field has been hampered by a critical lack of brain tissue from well characterized older Latinos without dementia. Moreover, there is limited data regarding cognitive decline and transitions from normal aging to mild cognitive impairment (MCI) and dementia among older Latinos; and few studies have examined blood biomarker differences across race/ethnicity. Building on our history of success and experience working with underserved communities, the Latino Core is poised to fill a critical gap in our knowledge base, and accelerate research in health disparities by providing resources, including participants, clinical data, and ante- and postmortem biospecimens to support a wide range of research studies ? particularly those that historically have had limited data from diverse groups (e.g., neuroimaging, genomics, epigenomics, proteomics, and metabolomics).