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New Study Helps Hispanic Seniors in Miami Fight Depression with Exercise

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University of Miami Miller School of Medicine psychologist Daniel Jimenez, Ph.D., assistant professor of psychiatry and behavioral sciences, has just kicked off a study that uses exercise and social engagement as a way to stem depression and anxiety among local Hispanic seniors.

Using a small army of local health promoters or promotoras de salud, Jimenez will enroll 60 Hispanic seniors over age 60, who will take part in group exercise at local parks in Miami-Dade County. His hometown of Hialeah will be one of his first stops for recruitment.

As part of the initiative, groups of six participants will meet three times per week for 16 weeks and perform 10 minutes of stretching and 30 minutes of moderately intense exercise. At the end of each session, the seniors will spend five minutes planning a future activity with a friend or family member, such as going to the movies or another enjoyable outing.

“The idea is for them to keep the body active and keep their minds entertained,” said Jimenez, a Cuban-American who has studied mood disorders among Hispanics for the past seven years. The study, he said, is a novel way of addressing mental health, as it focuses on prevention instead of treatment.

The four-year study is funded by a $670,000 National Institutes of Health grant. It’s Jimenez’s first major undertaking since joining the Miller School in June. Miami, he said, is fertile ground for studying mental health trends among Hispanic communities. But his study is also aimed at intervention and long-term mental health stability.

“By the first two sessions, we hope to see a decrease in symptom severity. By the completion of the study, we hope to see a continued trend,” said Jimenez.

Previous research, he says, has shown that Hispanic seniors in the U.S. have higher rates of depression than their white, non-Hispanic counterparts. Often times, Jimenez says, they feel socially isolated due to feelings of detachment from their homeland.

“Feelings of isolation, especially due to immigration, is a common narrative among this group,” he said, adding that the claim has some validity. However, “often times, people who deal with depression are genetically predisposed to it,” he said. “It just takes a change in their environment, such as immigration, to trigger it. It then becomes an unpleasant stressor.”

Family and cultural connectivity are prominent traits in Hispanic culture, and it’s something that Jimenez knows first-hand. “To be removed from that can be very devastating, especially if you base your whole being on collectivistic culture.”

And while Hispanic seniors share similar anxiety levels with non-Hispanic whites in the U.S., Jimenez explains, they are less likely to seek mental health treatment, which exacerbates the problem.

Elderly Hispanics also have vastly different perceptions of their mental health and what causes the disorder. “You often hear ‘If we hadn’t left Cuba, my spouse wouldn’t have gotten Alzheimer’s.’” Denial and stigma, he says, are also barriers to treatment. Obesity, diabetes and cardiovascular ailments are additional risk factors for depression that are also prevalent among Hispanic seniors.

The study targets seniors who have not yet crossed the threshold of clinical depression or anxiety but show some related symptoms and are identified as being at risk.

Upon recruitment, participants will take a brief questionnaire that assesses their level of community involvement, social support, physical activity, ability to do activities and self-confidence. They will be reassessed with the same questionnaire after six months and a year later.

“The goal is to intervene before the water really gets over their heads and they’re really depressed and not seeking treatment,” said Jimenez.

For more information on the study, contact Dr. Daniel Jimenez at 305-355-9063 or dej18@med.miami.edu .

 

University of Miami Researchers Receive $12.6 Million NIH Grant to Study Genetics of Alzheimer’s Disease

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Researchers from the University of Miami Miller School of Medicine’s John P. Hussman Institute for Human Genomics are part of a five-university collaboration receiving a $12.6 million, four-year grant from the National Institute on Aging (NIA), part of the National Institutes of Health (NIH), to identify rare genetic variants that may either protect against, or contribute to Alzheimer’s disease risk.

At the University of Miami, the Consortium for Alzheimer’s Sequence Analysis (CASA) is led by Margaret A. Pericak-Vance, Ph.D., Director of the John P. Hussman Institute for Human Genomics and the Dr. John T. Macdonald Foundation Professor of Human Genomics, who is one of the principal investigators of the study. Other University of Miami investigators include Eden Martin, Ph.D., professor of human genetics and public health sciences; Gary Beecham, Ph.D., assistant professor of human genetics; Michael Schmidt, Ph.D., research assistant professor of human genetics; Jeffery M. Vance, M.D., Ph.D., professor of human genetics and neurology; Brian Kunkle, Ph.D., postdoctoral fellow; Kara Hamilton, Research Support Project Manager; and James Jaworski, Research Support Project Manager.

CASA investigators will analyze whole exome and whole genome sequence data generated during the first phase of the NIH Alzheimer’s Disease Sequencing Program, an innovative collaboration that began in 2012 between NIA and the National Human Genome Research Institute (NHGRI), also part of NIH. They will analyze data from 6,000 volunteers with Alzheimer’s disease and 5,000 older individuals who did not have the disease. In addition, they will study genomic data from 111 large families with multiple Alzheimer’s disease members, mostly of Caucasian and Caribbean Hispanic descent to identify rare genetic variants.

“There is a critical need for us to refine the genetic landscape of Alzheimer’s disease,” said Pericak-Vance. “By identifying additional genes that increase a person’s risk or that protect one from getting Alzheimer’s disease, CASAwill contribute to developing therapeutic targets that can reduce the burden to patients and families caused by this devastating disease. This landmark study is only now possible because of the technological advances that have been made over the past decade and the willingness of so many hard working researchers.”

Alzheimer’s disease, a progressive neurodegenerative disorder, has become an epidemic that currently affects as many as five million people age 65 and older in the United States, with economic costs that are comparable to, if not greater than, caring for those with heart disease or cancer. Available drugs only marginally affect disease severity and progression. While there is no way to prevent this disease, the discovery of genetic risk factors for Alzheimer’s is bringing researchers closer to learning how the genes work together and may help identify the most effective interventions.

This effort is critical to accomplishing the genetic research goals outlined in the National Plan to Address Alzheimer’s Disease, first announced by the U.S. Department of Health and Human Services in May 2012 and updated annually. Developed under the National Alzheimer’s Project Act, the Plan provides a framework for a coordinated and concentrated effort in research, care, and services for Alzheimer’s and related dementias. Its primary research goal is to prevent and effectively treat Alzheimer’s disease by 2025.

With the current award, CASA joins the NHGRI Large-Scale Sequencing and Analysis Centers program, an NIH-supported consortium that provides large-scale sequence datasets and analysis to the biomedical community. CASAresearchers will facilitate the analyses of all Alzheimer’s Disease Sequencing Project (ADSP) and additional non-ADSP sequence data to detect protective and risk variants for Alzheimer’s disease.

“We are delighted to support the important research being accomplished under this broad-based, collaborative effort. A team effort is vital to advancing a deeper understanding of the genetic variants involved in this complex and devastating disease and to the shared goal of finding targets for effective interventions,” said NIH Director Francis Collins, M.D., Ph.D.

“At a time when fellow humans are living longer, it is critical to improve our understanding of the human brain and of the chronic neurodegenerative disorders such as Alzheimer’s and monopolar depression, with the aim of sheltering susceptible individuals from such devastating conditions,” said Pascal J. Goldschmidt, M.D., Senior Vice President for Medical Affairs and Dean of the University of Miami Miller School of Medicine, and CEO of the University of Miami Health System. “At the same time, the spectra of complex brain development anomalies, as in autism, seem to become more prevalent. This research initiative will go a long way in helping scientists and doctors understand, prevent, diagnose and resolve such brain anomalies.

“We are proud at the Miller School of Medicine to take part in such an important initiative, with our John P. Hussman Institute for Human Genomics and all of our scientists and physicians who are collectively providing exceptional expertise to this project on the human brain, in full collaboration with the other institutes and medical schools that have been selected. It is a great day for science and medicine.”

CASA is a collaboration of the University of Miami and four other American universities. Jonathan Haines, Ph.D., will lead the project at Case Western Reserve University, Richard Mayeux, M.D., at Columbia University, Gerard D. Schellenberg, Ph.D., at the University of Pennsylvania, and Lindsay Farrar, Ph.D., at Boston University.

This research is supported by the NIA grant UF1-AG047133.

Dietary supplement ‘like a touch of magic’ for Alzheimer’s patients

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Miller School study finds dramatic improvements in cognitive functioning

When Rina Torres was diagnosed with Alzheimer’s in her 70s, she gradually lost her ability to communicate or recognize family members. Then, she joined a University of Miami Miller School of Medicine study to test if a dietary supplement, aloe polymannose multinutrient complex (APMC), might improve her mental condition.

“When my grandmother started the treatment, I was very skeptical,” said her grandson, Lisandro Sierra, a doctor in eastern Cuba who enrolled her in the study. “But then I saw her move from darkness to the light. She became more aware of her surroundings, asked for water when she was thirsty, and went to the bathroom by herself. It was like a touch of magic.” Torres’ dramatic improvement lasted until she passed away in 2012 at the age of 84.

Torres was far from the only Alzheimer’s patient to benefit from APMC, made with aloe vera powder containing a minimum of 15% poly acetyl mannose (BiAloe®), according to John E. Lewis, Ph.D., associate professor of psychiatry and behavioral sciences, who led the team of Miller School and Miami Jewish Health Systems researchers.

“A female participant in her 90s was confined to a wheelchair and could not speak,” said Lewis. “Within six months of taking the dietary supplement, she was walking and talking again, and called one of our clinical coordinators by name, much to his surprise.”

“An architect who had Alzheimer’s for eight years, was barely able to speak, and required total care, took the APMC supplement and within a few months remembered his son’s name and carried on a conversation with his wife. She called me in tears to say that it felt like she got her husband back,” Lewis said.

The study of 34 adults with moderate to severe Alzheimer’s disease showed significant improvements in cognitive and immune functioning and stem cell proliferation after consuming 4 teaspoons of APMC per day for a twelve-month period. The study, “The Effect of an Aloe Polymannose Multinutrient Complex on Cognitive and Immune Functioning in Alzheimer’s Disease,” was published last year in The Journal of Alzheimer’s Disease. Miller School co-authors were David A. Loewenstein, PhD., Dahlia Abreu, B.S., Janet Konefal, Ph.D., and Judi M. Woolger, M.D.