Balancing the Alzheimer's Equation

Something is off with the math of Alzheimer’s disease. African American seniors are twice as likely to have Alzheimer’s disease as white seniors according to the Alzheimer’s Association, and yet they hardly enter into the equation when it comes to clinical trials of new therapies for the disease. Balancing that equation will require more African American researchers trained in conducting Alzheimer’s research.

More than 89,000 South Carolinians currently live with Alzheimer’s. That number is expected to increase by 34.8 percent by 2025.

That projected spike is in part due to an influx of retirees. But it is also fueled by health care disparities facing its large African American population, 24.3 percent of whom live below the poverty line, many in rural areas.

“When we think who is most invested in doing this work, it’s the communities who are being devastated by these diseases,” says Marvella Ford. Ford is associate director of population science and cancer disparities at MUSC Hollings Cancer Center. She is also SmartState Endowed Chair in Cancer Disparities at South Carolina State University.

Ford and University of South Carolina (UofSC) Assistant Dean Lucy Annang Ingram will co-lead the research education component of the newly funded Carolina Center on Alzheimer’s disease and Minority Research (CCADMR). CCADMR is a resource center for minority aging research (RCMAR) supported by the National Institute on Aging.

The center aims to increase the diversity of researchers focused on population health and to reduce disparities in Alzheimer’s disease. It does so by providing research training for underrepresented and minority faculty.

The CCADMR is a consortium of six South Carolina educational institutions. These include three historically black colleges and universities (HBCUs) — South Carolina State University and Claflin University, both in Orangeburg, and Allen University, in Columbia. Also included are the state’s three research universities — UofSC, MUSC, and Clemson University.

Through the research education component, Ford and Ingram will offer education in health disparities and minority aging research to interested faculty at all partner institutions. Offerings will include a yearly research symposium, monthly seminars on topics related to Alzheimer’s disease and minority aging, and one-on-one mentoring sessions. Ford and Ingram will also oversee the yearly application process for CCADMR funding of pilot projects.

The analysis core is led by UofSC’s Katrina Walsemann, associate professor, and James Hardin, professor and associate dean. It will provide the data management and analysis infrastructure for the CCADMR. Walsemann and Hardin will also train the pilot project recipients in rigorous methodological approaches to population-based Alzheimer’s disease research. That research will focus on identifying and understanding determinants of Alzheimer’s disease.

The administrative core will be co-led by CCADMR principal investigators, Sue Levkoff and Daniela Friedman, professors at UofSC.

“We have resources here in the state; we just need to build on them,” says Ford. We don’t always have to recruit in from outside. We need to strengthen what we have.”

Ford is especially excited that pilot project teams will have members from several of the state’s institutions. “What a great opportunity to have cross-institutional collaboration—people from different universities working together on the same shared projects,” explains Ford.

“The fact that South Carolina has not had a RCMAR for several years now is a glaring omission,” says Ford. “We’re really hoping to move the needle forward for Alzheimer’s disease in the state.”

Recent research implicates vascular disease in Alzheimer’s disease, and African Americans carry a heavy burden of vascular disease. According to the American Heart Association, African Americans have the highest rate of high blood pressure in the world (a key risk factor for heart disease and stroke) and are more likely to develop diabetes and obesity.

For Ford, that represents an opportunity. Taking steps to reduce vascular risk factors in younger African Americans could have a big payoff down the road. Population-based research funded by CCADMR could contribute to the identification of mid-life risk factors, such as vascular disease, for predicting new-onset Alzheimer’s disease.

“If African Americans are disproportionately affected by vascular diseases, that sheds light on why these populations are also disproportionately affected by Alzheimer’s disease,” says Ford.

“It also helps us identify points of intervention earlier. We want to identify people in these communities in their mid-to-late 30’s and 40’s who have vascular disease. If we can address it that far up the road, there is the potential to prevent Alzheimer’s disease or at least mitigate the effects of the disease once it starts.”