The Rev. Vivian Cook knows what it takes to keep Alzheimer’s at bay. And she’s using that knowledge to help protect her community, too.
“I’m getting exercise, and eating right, and staying mentally active,” she says. “I’m really into it, and I try to help other women with it, because once they have the knowledge of what they can do, they really benefit.”
At the age of 81, Cook is both a participant and an outreach worker in the Rutgers University-Newark Aging & Brain Health Alliance, a program whose mission over the past 15 years has been to serve older Black adults with a community-based combination of education and research designed to address the alarmingly high rate of Alzheimer’s disease among people of color.
The racially disproportionate impact of Alzheimer’s is well-documented. Blacks in the United States are twice as likely to get dementia as the overall population.
The risks for dementia include genetics and such lifestyle factors a obesity, diabetes, hypertension, poor and being sedentary.
“It’s a probably a mixture of all the various risk factors for Alzheimer’s, primarily due to health and lifestyle,” says Mark A. Gluck, professor of neuroscience and public health at Rutgers-Newark. “We know those factors are highly prevalent in the Black community. The good news is, most of those are addressable by lifestyle and behavior changes. Most are things people have the power to change in their lives.”
That is the message the Rutgers-Newark Aging & Brain Health Alliance has been delivering for a decade and a half now, but not from an ivy tower. The strength of the program is its community outreach — offering programming in churches, senior centers, public housing, parks and anywhere else it can directly get in front of those it aims to serve.
Its innovative efforts to spread the message of Alzheimer’s prevention have included everything from the “Jazz Your Brain” program (“it’s 95 percent jazz music and 5 percent brain education,” Gluck says) to the “Neuroscience of Bible Study” in churches and the Classic Car Show, Bar-B-Que and Men’s Health Fair that took place annually until COVID restrictions put it on hiatus.
Staples of its program include exercise classes and health education workshops that feature brain-healthy snacks.
Gluck, director of the Aging & Brain Health Alliance, launched that effort in 2006 but he says it really accelerated after the arrival of Chancellor Nancy Cantor in 2014, expanding to include research and student training. “She’s made community engagement the signature identity for Rutgers-Newark,” he says.
The research component now involves nearly 350 participants in a longitudinal study that is exploring such questions as how individual differences in health and lifestyle affect the risk for cognitive decline and Alzheimer’s disease in Black adults ages 60 and older.
Traditional dementia research has focused largely on people of European descent. As a result, Gluck says, “there is a lack of data on the brain changes that occur across the lifespan in older African Americans.”
The Rutgers research effort already has produced six scholarly papers, including a study that drew national attention in February for its finding on how exercise can rewire the brain of older adults to help give them greater protection against cognitive loss.
While that research effort expands, Gluck says the mainstay of the program remains community outreach and education.
“Even when we go out now, 80 to 90 percent of our time in the community is bringing value in terms of brain health,” he says. “Most of the people who come to us come because they know a friend or family member who’s had dementia. For a lot of people who participate in our study, their primary motivation is to fight back against Alzheimer’s. This is something they can do to enhance the knowledge about Alzheimer’s, particularly Alzheimer’s in the Black community.”
That was certainly true of Vivian Cook, who has a history of dementia in her family. When the Rutgers-Newark program offered a workshop at her church, she signed up right away.
“It was about how women over 60 can exercise and be healthy,” she says. “Then they had a person who spoke about Alzheimer’s and dementia, and they had a test for people to see if you had it. I took that test, and fortunately, I passed with flying colors.”
Cook embraced what she learned about brain health, and continues to perform so well on cognitive tests that she’s been named one of the program’s “SuperAgers.” And it’s not just her cognition that’s benefitted. She says her overall health has improved, too.
“I’ve lost quite a few pounds through exercise and learning what to eat or not eat,” Cook says. “Doctors are fine and medicine is fine, but you have to know how to take care of yourself. I had arthritis in one of my legs, and with exercise it has diminished. I’m not on the pain medicine I used to be on.”
Even in her 80s, Cook stays active and socially engaged and keeps her mind challenged. At Franklin-St. John’s United Methodist Church, she’s not only a ministry assistant, she’s also the church secretary and membership secretary. On top of that, she’s the church secretary at St. Matthew’s United Methodist Church and Trinity United Methodist Church. Yet when she was offered an opportunity to do outreach for the Rutgers-Newark program, she took on that role too.
“It helps me to do more in the program, not just as a participant but as a person who gets the word out,” she says.
Community engagement is the foundation of the Rutgers-Newark program. It has a Community Stakeholder Board, and emphasizes the importance of involving trusted community leaders in the effort and reaching people through local institutions.
For instance, the program has long partnered with the Newark Housing Authority, which oversees publicly funded low-income housing and Section 8 housing. Gluck says risk factors such as lower levels of income, education and access to healthcare leave this population particularly vulnerable. “The rate of Alzheimer’s in these housing sites is much higher than on average,” he says.
Glenda Wright, who’s spent decades as a leader in tenant advocacy in Essex County, understands how social and economic disadvantage can impact people of color. That’s one of the reasons she’s been doing outreach for the Rutgers-Newark program since 2015.
“You see the disparities and how people can do better,” she says. “I believe people should pull themselves up by the bootstraps, but you have to make sure they have solid boots. I love going from senior building to building doing workshops and telling them how we can lessen our chances of getting Alzheimer’s disease. Believe me, it helps.’’
But Wright says she needed to become educated about brain health herself before she could educate the community.
“The kicker for me was the statistics on African-Americans and Alzheimer’s disease,” she says. “I never knew African-Americans were two and a half times more likely to get it. It was a life-changer for me.”
And for older Black adults, some of the biggest changes have to come in health habits and lifestyle, she says.
“We don’t get enough sleep, we don’t exercise, we don’t eat right,” Wright says.
“A lot of us coming up from the South, as we age, a lot of the food we ate in our early lives, we can’t do that anymore,” she says. “We have to change our eating habits, eat better, socialize more. We have to get more sleep, and less stress. Pray more, worry less. Awareness is the best medicine anyone can have. We have to take care of ourselves.”
That message is resounding in churches across Essex County as well. The Rev. Glenn Wilson Sr., pastor of Pilgrim Baptist Church, has been making brain health and prevention of Alzheimer’s a priority within his own congregation and helping recruit other ministers to the cause.
“We’re trying to make sure individuals know about preventative measures and what they can do, so they will have a healthier life,” he says.
Wilson says early detection of cognitive loss is key.
“We have presentations at church and educate them about what signs to look for,” he says. “If they have a parent or relative or friend, and they are forgetting things, or there are early signs of dementia, they can refer them to our program. We tell them, ‘Let us help make your life easier by making their life easier.’”
He’s also actively involved in recruiting other ministers. “I do a lot of networking,” he says. “I let them know about the Aging & Brain Health Alliance. This has really won over the hearts of the pastors throughout Newark and East Orange.”
More recently, Wilson and other church leaders joined in a video to encourage their congregations to take advantage of the COVID vaccine.
In addition, Pilgrim Baptist Church is a testing site for a long-term study called the Pathways to Healthy Aging in African Americans. It’s an element of the Rutgers-Newark program that was launched in 2015 to focus on a population that’s been greatly underserved in Alzheimer’s research until now.
The study involves some 350 Black adults over the age of 60 from the Newark area. The participants, who are cognitively normal for their age, are being tracked over time to better understand healthy aging and how to prevent Alzheimer’s.
Those who enroll undergo genetic testing and brain imaging, and take part in a health, fitness and lifestyle assessment. There is also an optional week of home sleep monitoring, and the option of taking part in exercise studies. Participants receive a stipend of up to $200, plus transportation allowance.
Participants are re-evaluated every two years, or annually once they turn 80. This includes monitoring that occurs at Pilgrim Baptist Church, where on Tuesday and Thursday mornings, participants can come in for their periodic testing and evaluation. Even during this time of COVID restrictions, the church has been able to put precautions in place that allow participants to come in safely for follow-up.
Wilson takes a personal interest in those in the study, and makes an effort to see them individually during their visit, to help assess how they’re doing cognitively. “This way, I can observe if their eyes are clear and bright coming in,” he says.
“We document what we see, and turn the information over to Dr. Gluck, so he’s able to track how they’re doing and their progress,” he says. “There have been a lot of positive results, data wise.”
The study has put Rutgers and Newark on the map, in terms of research on brain health in minority populations. The cutting-edge nature of the program and the steady flow of new research findings helped earn Newark the opportunity to host a national conference on “Risks and Resilience to Alzheimer’s Disease in African Americans.” The event was originally planned for 2020 and tentatively rescheduled for this year, but now will take place in 2022.
In February, Gluck and his colleagues published a study showing that regular aerobic exercise literally rewires the brain, helping different parts of the brain better connect in ways that benefit memory formation.
The study involved older Black adults who had previously been sedentary and were recruited to take part in twice-weekly dance exercise classes at churches and senior centers. Those who took part in the exercise program showed greater neural connectivity in their hippocampus and medial temporal lobe, regions of the brain where Alzheimer’s is known to strike first.
The study, which drew wide attention, including an article in the New York Times, suggests an important way that regular exercise may protect against dementia. “It allows the memory circuits to be more flexible, jumping from conversation to conversation with different parts of the brain,” Gluck says.
The ongoing research has received almost $8 million in funding since 2015. Just this month, Rutgers-Newark received an additional $643,000 grant from the National Institute of Aging to study the cognitive consequences of COVID-19 in older Black adults and how that may relate to the risk of Alzheimer’s disease.
Gluck’s goal is to continue to expand the research effort, eventually reaching 1,000 participants by the year 2025, while continuing to help older adults lower their risk through community programs.
“We reach people by building a long-term reputation of 15 years of bringing value to the community,” he says. “They know our primary role is bringing value through education and health-enhancing programs.”
Vivian Cook says Gluck and his team have touched many lives in Newark over the years and the connection between the program and the community runs deep.
“The staff, the people that run it, they really have a heart for it,” she says. “It’s not just a job to them. It’s a way of life. I praise God that we have these medical people in Newark, and the quality of a program like this.”
For more information on the Rutgers-Newark Aging and Brain Health Alliance, visit the website or call (973) 353-3673.
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