BRAIN HEALTH LAB
RESEARCH
BALTIMORE EXPERIENCE CORPS TRIAL (BECT)
Initiated in 2006, the Baltimore Experience Corps Trial (BECT) is a volunteer service program for persons 55 years and older, in which they actively participate as agents of learning within Baltimore City public school classrooms, aiding and assisting students in grades K-3.
The Baltimore Experience Corps Trial, a collaboration between Experience Corps, Johns Hopkins, and the Greater Homewood Community Corporation, is a research study aimed at determining if a new model of senior service improves the educational outcomes of children in elementary schools in Baltimore, as well as the health and functional status of older adults.
A follow-up study is currently underway to examine the long-term impact of the Baltimore City Experience Corps program on key outcomes related to functional independence, and risk for Alzheimer’s disease, frailty, and mortality as these individuals enter their 80th and 90th decades of life. Our goal is to determine whether increased social, physical and cognitive engagement in Experience Corps, examined in the BECT among participants enrolled from 2006-2009, led to long-term lower risk for Alzheimer’s disease, reductions in healthcare expenditures, maintained functional and financial independence, improved quality of life, less disability, and lower mortality up to approximately 10-12 years later. To achieve these goals, we will leverage a wide range of linked data, including Medicare and Medicaid Claims, National Death Index (NDI), financial records, and a low-cost 10-12-year follow-up telephone interview to assess cognition, function, health, lifestyle and social connectivity. This study will allow us to examine the long-term impact of a social volunteer program on key outcomes related to risk for Alzheimer’s disease and dementia risk.
Brain Health Substudy (BHS)
Initiated in 2006, the Baltimore Experience Corps Trial (BECT) is a volunteer service program for persons 55 years and older, in which they actively participate as agents of learning within Baltimore City public school classrooms, aiding and assisting students in grades K-3.
The Baltimore Experience Corps Trial, a collaboration between Experience Corps, Johns Hopkins, and the Greater Homewood Community Corporation, is a research study aimed at determining if a new model of senior service improves the educational outcomes of children in elementary schools in Baltimore, as well as the health and functional status of older adults.
A follow-up study is currently underway to examine the long-term impact of the Baltimore City Experience Corps program on key outcomes related to functional independence, and risk for Alzheimer’s disease, frailty, and mortality as these individuals enter their 80th and 90th decades of life. Our goal is to determine whether increased social, physical and cognitive engagement in Experience Corps, examined in the BECT among participants enrolled from 2006-2009, led to long-term lower risk for Alzheimer’s disease, reductions in healthcare expenditures, maintained functional and financial independence, improved quality of life, less disability, and lower mortality up to approximately 10-12 years later. To achieve these goals, we will leverage a wide range of linked data, including Medicare and Medicaid Claims, National Death Index (NDI), financial records, and a low-cost 10-12-year follow-up telephone interview to assess cognition, function, health, lifestyle and social connectivity. This study will allow us to examine the long-term impact of a social volunteer program on key outcomes related to risk for Alzheimer’s disease and dementia risk.
Stimulation With Intricate Movements (SWIM) Study
The aim of the Stimulation With Intricate Movements (SWIM) Study is to assess the feasibility and short-term impact of an immersive, interactive computer game, called Bandit the Dolphin, on the cognitive and functional health of aging adults living in the community. It was developed by the Kata Design Studio team in the Brain, Learning, Animation, and Movement Lab at Johns Hopkins for post-stroke rehabilitation. SWIM provides an oceanic environment in which the individual’s arm movements control a simulated dolphin.
Optimizing Cognitive, Environmental, and Neuromotor Stimulation in Traumatic Brain Injury (OCEANS-TBI) Study
Patients with a history of traumatic brain injury (TBI) are at elevated risk for Alzheimer’s disease and related dementias (ADRD). Improving treatments for TBI in older adults may decrease this risk. Interventions such as physical exercise and cognitive enrichment have been shown to be effective treatments for TBI. The OCEANS-TBI Study (Optimizing Cognitive, Environmental, and Neuromotor Stimulation in Traumatic Brain Injury) is seeking to determine the effectiveness of an immersive computer game (Bandit) that uses both physical and cognitive exercises. We think that complex motor activities involved in the Bandit video game may improve cognitive health in adults with a history of TBI.
This research is being done to: 1) determine the effect of the complex cognitive-motor exergame, Bandit the Dolphin, on cognition, brain biomarkers, lifestyle, and independent activities of daily living in patients with past TBI compared to a similar group receiving a control intervention, and 2) examine mechanistic brain biomarkers of ADRD before and after 3 months of using the Bandit video game.
WAVES (Validity of Commercial-Grade Accelerometry and GPS Data)
The WAVES (Validity of Commercial-Grade Accelerometry and GPS Data) study aims to understand the differences and similarities in data between commercially available consumer-grade activity trackers and research-grade wearables in younger adults aged 18-40. We would like to see how closely the data from commercial products (e.g., Apple Watch, iPhone) are to the research-grade devices commonly used to study activity (e.g., ActiGraph). This study will compare activity metrics to evaluate how accurate the data are across devices in a two-week data collection period.
CARDIOVASCULAR HEALTH STUDY (CHS)
The Cardiovascular Health Study (CHS) is a prospective population-based cohort study of risk factors for CHD and stroke in adults 65 years and older. In June 1990, four Field Centers completed the recruitment of 5201 participants. Between November 1992 and June 1993, an additional 687 African Americans were recruited using similar methods. The Field Centers are located in Forsyth County, NC; Sacramento County, CA; Washington County, MD; and Pittsburgh, PA. The baseline examinations consisted of a home interview and a clinic examination that assessed not only traditional risk factors but also measures of subclinical disease, including carotid ultrasound, echocardiography, electrocardiography, and pulmonary function. Since 1999, participants have been contacted twice a year by telephone to collect limited data, including medication data, and to identify all hospitalizations and potential cardiovascular events. CHS currently plans to follow participants for events that occur through 2006. Participants have also been invited to participate in a clinic or home visit as part of the CHS All Stars Study which begins the seventeenth year of data collection and includes follow-up for events. The six-month contact of this current data collection cycle is also underway.
MOBILE TECHNOLOGY TO MODEL LIFE SPACE
The goal of this study is to pilot, test, and validate real-time survey methods of lifestyle activities in day-to-day life using mobile Smartphone and GPS devices in neurocognitively well characterized older adults at risk for Dementia; the ultimate goal is to link in- and out-of-home activity patterns to neuro-cognitive and functional health.
We are working in collaboration with Ciprian Crainiceanu and John Muschelli from the SMART group to pilot commercially available and cost-effective smartphone and wearable GPS technology to yield valid and reliable methods to unobtrusively gather real-time-data on everyday social, physical, and functional activity outside participants home in their social environment.
GINKGO EVAULATION OF MEMORY (GEM) STUDY
The Ginkgo Evaluation of Memory (GEM) Study was conducted primarily to determine if ginkgo would decrease the incidence of all types of dementia and, more specifically, reduce the incidence of Alzheimer’s disease. Secondarily, the study evaluated ginkgo for its effects on overall cognitive decline, functional disability, incidence of cardiovascular disease and stroke, and total mortality. The primary endpoint was the diagnosis of dementia as determined by an expert panel of clinicians using standard criteria for diagnosis. The patients with a diagnosis of dementia underwent magnetic resonance imaging scans to determine their dementia type.
Study participants were followed for an average of approximately 6 years (maximum of just over 7 years). During the study, 523 of the 3,069 enrolled participants were diagnosed with dementia, 246 in the placebo group and 277 in the ginkgo group. Thus, ginkgo showed no overall effect for reducing all types of dementia or Alzheimer’s disease. In addition, in analyzing safety data, the GEM study did not find significant adverse effects from ginkgo, in particular there was no evidence for increased bleeding risk in persons taking ginkgo.
The GEM results will prove useful in determining how many participants are needed in future trials to provide clinically significant measures on outcomes such as occurrence of dementia. Future analysis of this study may also identify subgroups of these participants who may be at greater risk for developing dementia.