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Besser LM, Wiese L, Cook DJ, Holt J, Magzamen S, Minor B, Mitsova D, Park J, Sablan O, Tourelle M, Williams C. Rural Roads to cognitive Resilience (RRR): A prospective cohort study protocol. PLoS One 2025; 20:e0312660. [PMID: 39804889 PMCID: PMC11729925 DOI: 10.1371/journal.pone.0312660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2024] [Accepted: 10/16/2024] [Indexed: 01/16/2025] Open
Abstract
BACKGROUND Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer's disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning. We will (1) examine contributions of smoke-related fine particulate matter (PM2.5) exposures to SI and cognitive function; (2) determine effects of built and social environments on SI and cognitive function; and (3) contextualize SI and cognitive function among residents from different ethnoracial groups during burn and non-burn seasons. METHODS We will recruit 1,087 community-dwelling, dementia-free, ≥45-year-olds from five communities in Florida's Lake Okeechobee region. Over 36 months, participants will complete baseline visits to collect demographics, health history, and health measurements (e.g., blood pressure, body mass index) and 6-month follow-ups assessing cognitive function and social isolation at each visit. A subsample of 120 participants representative of each community will wear smartwatches to collect sensor data (e.g., heart rate) and daily routine and predefined activities (e.g., GPS-captured travel, frequent destinations) over two months. Ecological momentary assessments (EMA) (e.g., whether smoke has bothered participant in last 30 minutes) will occur over two months during agricultural burning and non-burning months. PurpleAir monitors (36 total) will be installed in each community to continuously monitor outdoor PM2.5 levels. DISCUSSION We expect to identify individual- and community-level factors that increase the risk for SI and cognitive decline in a vulnerable rural population.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, United States of America
| | - Lisa Wiese
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Diane J. Cook
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, United States of America
| | - Janet Holt
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, United States of America
| | - Bryan Minor
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, United States of America
| | - Diana Mitsova
- Department of Urban and Regional Planning, Florida Atlantic University, Boca Raton, FL, United States of America
| | - Juyoung Park
- College of Nursing, University of Arizona, Tucson, AZ, United States of America
| | - Olivia Sablan
- Department of Atmospheric Science, Colorado State University, Fort Collins, CO, United States of America
| | - Madeleine Tourelle
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, United States of America
| | - Christine Williams
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, United States of America
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Besser LM, Wiese L, Cook DJ, Holt J, Magzamen S, Minor B, Mitsova D, Park J, Sablan O, Tourelle M, Williams C. Rural Roads to Cognitive Resilience (RRR): A prospective cohort study protocol. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.10.13.24315411. [PMID: 39484275 PMCID: PMC11527081 DOI: 10.1101/2024.10.13.24315411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2024]
Abstract
Background Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer's disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning. We will (1) examine contributions of smoke-related fine particulate matter (PM2.5) exposures to SI and cognitive function; (2) determine effects of built and social environments on SI and cognitive function; and (3) contextualize SI and cognitive function among residents from different ethnoracial groups during burn and non-burn seasons. Methods We will recruit 1,087 community-dwelling, dementia-free, ≥45-year-olds from five communities in Florida's Lake Okeechobee region. Over 36 months, participants will complete baseline visits to collect demographics, health history, and health measurements (e.g., blood pressure, body mass index) and 6-month follow-ups assessing cognitive function and social isolation at each visit. A subsample of 120 participants representative of each community will wear smartwatches to collect sensor data (e.g., heart rate) and daily routine and predefined activities (e.g., GPS-captured travel, frequent destinations) over two months. Ecological momentary assessments (EMA) (e.g., whether smoke has bothered participant in last 30 minutes) will occur over two months during agricultural burning and non-burning months. PurpleAir monitors (36 total) will be installed in each community to continuously monitor outdoor PM2.5 levels. Ethics and expected impact This study received Florida Atlantic University's Institutional Review Board approval and will require participant informed consent. We expect to identify individual- and community-level factors that increase the risk for SI and cognitive decline in a vulnerable rural population.
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Affiliation(s)
- Lilah M. Besser
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, 7700 Camino Real Suite 200, Boca Raton, FL 33433, United States of America
| | - Lisa Wiese
- C.E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, United States of America
| | - Diane J. Cook
- School of Electrical Engineering and Computer Science, Washington State University, Box 642752, Pullman, WA 99164, United States of America
| | - Janet Holt
- C.E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, United States of America
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, 1681 Campus Delivery, Fort Collins, CO 80523, United States of America
| | - Bryan Minor
- School of Electrical Engineering and Computer Science, Washington State University, Box 642752, Pullman, WA 99164, United States of America
| | - Diana Mitsova
- Department of Urban and Regional Planning, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, United States of America
| | - Juyoung Park
- College of Nursing, University of Arizona, 1305 N Martin Avenue, Tucson, AZ, 85721
| | - Olivia Sablan
- Department of Atmospheric Science, Colorado State University, Campus Delivery, Fort Collins, CO 80523, United States of America
| | - Madeleine Tourelle
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, 7700 Camino Real Suite 200, Boca Raton, FL 33433, United States of America
| | - Christine Williams
- C.E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Boca Raton, FL 33431, United States of America
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Wiese LK, Pratt BA, Heinze K, Besser L, Ifill A(A, Williams CL. Community-Based Strategies to Reduce Alzheimer's Disease and Related Dementia Incidence Among Rural, Racially/Ethnically Diverse Older Adults. CURRENT GERIATRICS REPORTS 2023; 12:205-219. [PMID: 38223294 PMCID: PMC10783445 DOI: 10.1007/s13670-023-00400-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 01/16/2024]
Abstract
Purpose of Review The purpose of this paper was to address the research question "What recent advances in Alzheimer's Disease and Related Dementias (ADRD) risk reduction strategies can be tailored for rural, racially/ethnically diverse populations?" A rural resident's life story that grounded the work is shared. Next, a brief description is provided regarding ADRD risk factors of importance in rural, multicultural settings. Gaps in U.S.-based research are highlighted. Policy actions and interventions that may make a difference in alleviating rural, ADRD-related disparities are offered. Recent Findings More than a dozen factors, including lack of built environment, periodontitis, poor air quality, and sensory loss, were identified that are of particular relevance to rural groups. Evidence of importance to underserved residents has also emerged regarding the harmful effects of ultra-processed foods on brain health, benefits of even minimal physical activity, and importance of social engagement, on brain health. Summary Resident-led initiatives will be key to creating change at the community level. Health providers are also called to assist in identifying and adapting culturally specific upstream approaches, in partnership with community stakeholders. These mechanisms are vital for decreasing ADRD burdens in underserved communities facing the largest disparities in preventive care.
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Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Beth A. Pratt
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Katherine Heinze
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Lilah Besser
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
| | - Antoinita (Annie) Ifill
- Palm Health Foundation/Community Partners of South Florida, 491 E. Main Street Suite 5A, Pahokee FL 33476, USA
| | - Christine L. Williams
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
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Lam HR, Fleming K, Lee J, Li TCF, Mendonca N. Challenges Experienced by Subsidized Housing Residents with Dementia or Cognitive Impairment: A Scoping Review. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.1963387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Helen R. Lam
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Kelly Fleming
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Jeff Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | | | - Nisha Mendonca
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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