Creating a Dementia Friendly Community in an African American Neighborhood: Perspectives of People Living with Dementia, Care Partners, Stakeholders, and Community Residents.

A dementia friendly community allows people with dementia and their care partners to remain engaged in their community well into the disease. This study presents the results of primary research aimed at exploring perceptions regarding building a dementia friendly community in an African American neighborhood in northeast Florida. Twelve focus groups and five interviews were conducted with people living with dementia, informal and formal care partners, community stakeholders and neighborhood residents, and analyzed using a grounded theory approach. Three main themes emerged from the analyses, including (1) perceived needs, (2) facilitators and barriers to being dementia friendly, and (3) opportunities for the community to become more dementia friendly. Study findings highlight the unique needs of a single African American neighborhood and the importance of culturally tailoring the dementia friendly model to diverse communities.

Testing an Alzheimer's Disease Educational Approach in Two African American Neighborhoods in Florida.

African Americans experience a significantly greater burden of Alzheimer's disease (AD) compared to non-Hispanic White Americans. Raising awareness and increasing knowledge of AD within African American communities is an important step towards addressing these disparities. The purpose of this study was to assess the effectiveness of two approaches to sharing AD knowledge with community residents. Using a quasi-experimental design, African American participants were recruited through community partners and local resources in two comparable neighborhoods in Duval County, Florida, which formed the intervention and the comparison groups for this study. The identical 40-min educational lecture was provided to both groups. In the intervention community, the lecture was followed by focus group sessions modeled after the Dementia Friendly America toolkit. In the comparison community, the lecture was followed by a social event where participants could interact informally with the speaker and dementia outreach staff. A brief quantitative survey assessing AD knowledge was administered to participants in both groups before the education session, immediately after the lecture, and 2 months later. Results indicate that both groups improved their knowledge scores at immediate post-test. Scores for both groups declined at 2-month follow-up, but the comparison group's scores declined more precipitously than the intervention group's scores (p = 0.0.21). These results suggest that conducting focus groups and interviews following a lecture on AD may help better retain AD knowledge over time.

A cost effective method of identifying and recruiting persons over 80 free of dementia or mild cognitive impairment.

For observational or prevention studies, accurately identifying by mail and telephone cognitively normal elderly volunteers would be cost effective. We describe how to recruit cognitively normal sib-pairs over age 80 using commercially available lists by age and ZIP code. We mailed an Institutional Review Board-approved letter to 24,366 persons over 85 around Jacksonville, FL, and received approximately 3,000 postcard replies with approximately 500 answering 3 screening statements affirmatively. Of these, we recruited 128 persons who underwent both in-person and telephone evaluations, the latter using the Telephone Interview of Cognitive Status-modified (TICS-m) and Clinical Dementia Rating scale (CDR). Blinded to the TICS-m and CDR data, clinicians made a consensus diagnosis for each participant, 120 were normal and 8 had mild cognitive impairment. With CDR, 119 patients (93%) screened as normal, and of these 115 (97%) were confirmed as normal with the consensus diagnosis. A TICS-m score cut-off of <29 resulted in a similar proportion of normals in the screened sample (97% or 103/106); however, 13 normal volunteers would have been excluded because they scored <29 on the TICS-m. Supplementing the sample, we recruited 12 age-matched cases having consensus diagnosis of dementia (n=2) or mild cognitive impairment (n=10). A CDR>0 correctly identified 12/12, whereas the TICS-m <29 correctly identified 7/12. Hearing loss present in 50% did not influence TICS-m or CDR performance. Using stringent entry criteria and the telephone CDR, this method accurately identified normal elderly persons.

Mayo's Older African Americans Normative Studies: normative data for commonly used clinical neuropsychological measures.

This report describes the methodology and sample characteristics of Mayo's Older African Americans Normative Studies (MOAANS). These studies reflect a multidisciplinary, collaborative effort by investigators at Mayo Clinic to provide age-appropriate normative data for African American elders on commonly used neuropsychological tests. A sample of 309 community-dwelling individuals over age 55 contributed to the MOAANS sample. Norms were calculated for midpoint age groups, based on percentile scores derived from cumulative frequencies of raw test scores. Demographic, medical, and sociocultural data were also collected, and are summarized to assist clinicians in making determinations regarding the appropriateness of these norms for individual patients. In most cases, the use of MOAANS norms should improve diagnostic accuracy in dementia evaluations of African American elders.