Challenges exist in recruiting and retaining minorities in research on Alzheimer?s disease (AD), thereby limiting the ability to elucidate mechanisms for health disparities in AD risk and to adequately measure treatment efficacy in underserved populations. African Americans represent an especially important group to target for research due to their two-fold risk of AD compared to non-Hispanic Caucasians. Advances in technology to evaluate cognitive functioning, particularly the use of mobile applications such as smartphones, offer the promise for overcoming barriers that may limit African American research participation including scheduling difficulties, associated study costs, and examinee/examiner cultural mismatches. Remotely administered neuropsychological measures can be performed at an individual?s convenience, and outcomes can be collected at multiple time points. In the proposed R03 study, we will leverage the resources and volunteers who have signed up for a new community initiative at our institution, the Emory Healthy Aging Study, involving remote engagement of individuals through smartphone technology. The Co-PIs have selected tasks from the cognitive neuroscience literature that are non-proprietary and have strong behavioral and neuroimaging correlates in APOE-?4 carriers, amnestic mild cognitive impairment and AD patients, and healthy aging groups. The proposed grant will pilot these measures when administered via smartphones to middle-aged and older African Americans and Caucasians, with the overall goal of determining whether group differences exist that could have diagnostic relevance in future studies. Sixty African American and 60 non-Hispanic Caucasian adults 45-75 years of age will complete the traditional versions and the smartphone adaptations of the cognitive measures in the clinic setting and will then complete the smartphone applications remotely at 3 and 6 months post-baseline assessment.
Specific Aims are to 1) Establish reliability of the smartphone applications (both internal consistency and in comparison to the traditional version (inter-modality reliability)) 2) Establish test- retest reliability of the smartphone measures; and 3) Assess adherence rates of the remotely administered smartphone measures. A secondary Aim is to examine factors (i.e., quality of education, socioeconomic status, and vascular comorbidities) that we expect to be correlated with performance on cognitive measures administered via smartphones and that are underlying factors often associated with cognitive performance differences between African Americans and Caucasians. The long-term goal of a future study is to validate these mobile cognitive measures against neuroimaging, genetic, and CSF biomarkers of central amyloidosis.

Public Health Relevance

African Americans are especially important group to include in clinical research on Alzheimer?s disease (AD) due to their increased risk for AD compared to non-Hispanic Caucasians. Advances in technology to evaluate cognitive functioning, particularly the use of mobile applications such as smartphones, offer the promise for overcoming barriers that may limit African American research participation including scheduling difficulties, associated study costs, and examinee/examiner cultural mismatches. The findings of high adherence rates and reliability of remote ambulatory cognitive assessment measures in African American adults, and at levels comparable to Caucasian adults, would demonstrate the feasibility of overcoming logistical barriers and could improve recruitment and retention efforts.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Small Research Grants (R03)
Project #
5R03AG055810-02
Application #
9472886
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Elliott, Cerise
Project Start
2017-04-01
Project End
2019-03-31
Budget Start
2018-04-15
Budget End
2019-03-31
Support Year
2
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Emory University
Department
Neurology
Type
Schools of Medicine
DUNS #
066469933
City
Atlanta
State
GA
Country
United States
Zip Code
30322