David Marquez is PI of project awarded a 2022 Prevention Research Center Special Interests Projects grant

David Marquez is principal investigator of the project "Dementia Risk Reduction Research Network - Collaborating Centers," selected to receive a 2022 Prevention Research Center Special Interests Projects grant ($500,000 over two years) from the National Center for Chronic Disease Prevention & Health Promotion, Division of Population Health. This is a competitive special interest project that will be administered under the UIC Policy Practice and Prevention Research Center. Marquez will collaborate with a team of researchers from the University of Illinois Chicago, University of South Carolina at Columbia and Washington Unviersity in St. Louis.

Specific aims of project
By 2065, the Latino population in the U.S. is expected to grow to 107 million.1 Currently, 12% of older Latinos are diagnosed with Alzheimer’s disease (AD); it is estimated their number will increase by 832% by 2060.2 Latinos have a greater risk of developing chronic conditions involving modifiable lifestyle factors,3 and evidence suggests that cardiovascular disease risk factors may also be a risk for AD and related dementias (ADRD), thus placing Latinos at even greater risk for ADRD.4
Pharmacological treatments available for ADRD have shown limited effectiveness in reducing cognitive and functional decline,5 thus, the establishment of interventions that can reduce ADRD risk is critical.6 While there is no cure for AD, evidence suggests that protective factors for AD include regular physical activity (PA).7 Unfortunately, older Latinos are 46% less likely to engage in leisure time PA than older non-Latino whites.8
Walking and dancing are the two most commonly reported forms of PA among older Latinos.9 However, urban older Latinos cite unsafe neighborhoods and extreme weather conditions as significant barriers to walking. Older Latinos value functional independence, and relate physical fitness to feeling healthy and being able to perform normal activities with ease,10 but have rarely had traditional exercise programs adapted to their needs. We propose that indoor PA programs can overcome the biggest barriers to participation.
Latin dance is a particularly promising PA modality that is a culturally acceptable type of PA for middle-aged and older Latinos.11 Randomized controlled trials (RCTs) have examined changes in cognitive performance among several types of dance styles12,13 and have found improvements in global cognition, executive function, episodic and working memory, and attention. However, PA interventions have not implemented dance programs specifically for Latinos, a historically excluded population at high risk of cognitive impairment.2 Given the need to address health inequities in Latinos, Marquez and colleagues created a Spanish-language, Latin dance program (BAILAMOSTM – Balance and Activity In Latinos, Addressing Mobility in Older Adults).11 Smaller studies of BAILAMOSTM have found greater improvement in global cognition in the dance group compared to a health education group,14 and increases in brain functional connectivity.15 Moreover, we established the feasibility and impact on PA in older Latinos who already had MCI (n=20).16,17
UIC faculty have also designed and tested Fit & Strong!, a PA program for older adults with arthritis, that is recognized by the National Council on Aging as an Evidence-based program and have established the feasibility of ¡En Forma y Fuerte!, an adaptation of Fit & Strong! for Latinos with arthritis.18 A small trial found significant improvements in lower-extremity strength, perceived physical function, and pain from baseline to 8 weeks (p < .05) that were maintained at 6 months. No major program adaptations (other than language) were observed or reported; however, the instructors provided several suggestions for program improvements, including adjusting the literacy level and length of the program.
The current pandemic allows us to adapt both of these evidence informed programs, the BAILAMOSTM dance program and ¡En Forma y Fuerte!, for remote delivery among older Latinos (i.e., BAILAMOSTM @home/en casa and ¡En Forma y Fuerte! @home/en casa). The overall purpose is to implement promising, evidence-informed interventions and solutions to reduce risk for ADRD and improve quality of life for persons with symptoms of cognitive decline. Our previous engagement as a collaborating center of the CDC Healthy Aging Research Network (HAN) and the CDC Healthy Brain Research Network (HBRN), plus our evidence-informed PA interventions and the focus of our NIA Roybal Center on PA and cognition, make the UIC PRC DRRRN well suited to contribute expertise to the network. We will achieve the following specific aims:
AIM 1. Conduct a 6-month RCT comparing BAILAMOSTM @home/en casa and ¡En Forma y Fuerte! @home/en casa among 100 older Latino adults with symptoms of cognitive decline.
1a: We will demonstrate feasibility and intervention adherence and safety through benchmarks: (1)
feasibility of recruitment and retention─100 participants enrolled and ≥75% retained at year 2 end; (2) intervention adherence - ≥75% participants with ≥80% of intervention sessions completed across waves; (3) safety - zero unexpected adverse events (AEs) that are serious and study related.
1b: We hypothesize that participants in ¡En Forma y Fuerte! @home/en casa will show comparable improvements in self-reported and accelerometer-assessed PA, cognition, quality of life, and social connectedness compared to the BAILAMOSTM @home/en casa.
AIM 2. Collaborate with the Coordinating and Collaborating Centers and CDC through monthly conference calls, email, online meetings, or other channels to share knowledge, best practices, and other resources (e.g., survey instruments, protocols, program toolkits) to enhance intervention implementation, effectiveness, evaluation, program reach, and impact.
AIM 3. Partner with impactful and relevant organizations and other stakeholders.
AIM 4. Disseminate findings from the project through publishing research articles, presenting at conferences and meetings, and brief reports, tool boxes and program implementation guides.