Beyond the Lab

Thursday, April 2, 2015

Field work is critical for studying chronic diseases of aging

For some researchers, helping patients means hitting the road.

Lisa Barnes, PhD, a cognitive neuropsychologist in the Rush Alzheimer’s Disease Center, has run the Minority Aging Research Study (MARS) since 2004. The study enrolls older African-Americans without Alzheimer’s or dementia to identify risk factors for cognitive decline and the development of dementia over the course of years.

A big part of Barnes’ work is going to organizations that cater to older minorities in the Chicago area, including church and community groups and senior living centers. Barnes and her team give education presentations on healthy aging and solicit volunteers for the study.

Building trust is critical, said Barnes. African-Americans as a group are under-represented in Alzheimer’s studies, though the disease affects them two to three times more than other groups, Barnes said. Since coming to Rush in 1999, she’s dedicated her work to determining the factors that might cause this disparity.

The MARS study has received two grants from the National Institutes of Health (NIH) and is up for a third this year. Many of the people who volunteered in 2004 are still in the study, she said.

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A Rush team visits MARS subjects in their homes once a year. They get a full battery of 19 cognitive tests, give a blood sample for genetic testing and receive a clinical evaluation from a nurse. The team gives the volunteers a risk factor assessment, documenting behavioral factors such as reading habits, stress and social connections, among others.

Over time, Barnes said she expanded her research to not only Alzheimer’s but other chronic diseases of aging. She has worked with the Rush Department of Immunology to look at the aging immune system and has collaborated with colleagues in behavioral sciences and preventive medicine.

“All of these people who come from different disciplines really make the research richer because you’re able to look at a question from different perspectives,” she said.

Through such collaborations, Barnes and her colleagues have discovered that HIV has become a chronic disease of aging. Patients are living longer with the disease due to the effectiveness of medications, she said, but are suffering other afflictions — stroke, cancer, diabetes — sometimes 15 to 20 years earlier than those without HIV.

Rush’s Center of Excellence on Disparities in HIV and Aging (CEDHA) looks at the underlying factors for these earlier morbidities in older HIV patients. First funded in 2012, it operates much like MARS and has recruited a cohort of people older than 50, half with HIV and half without, to follow and compare them to other studies of older uninfected adults at the Rush Alzheimer’s Disease Center.

Barnes also oversees the Rush Alzheimer’s Disease Clinical Core study, which gathers data similar to MARS on older African-Americans and their study partners. Results from this study are sent to the National Alzheimer’s Coordinating Center to be part of a large database of standardized clinical and neuropathological research data from 27 NIA-funded Alzheimer’s disease centers across the U.S.

Participants in the MARS and Clinical Core studies can also sign a legal document to donate their brain to Rush after their death. The Rush Alzheimer’s Disease Center has one of the largest collections of brain samples and spinal tissue in the world.

Barnes was lead investigator on a recent study that showed Alzheimer’s disease may cause different changes in the brains of black patients than those of white patients.

The study included 41 African-American patients with a clinical diagnosis of Alzheimer’s dementia, who had an autopsy of their brain performed after death. The autopsy results then were compared to those of 81 deceased white patients who had Alzheimer’s dementia with the same level of disease severity and were of the same age, sex and education level.

Barnes said she hopes her work can play a part in the larger effort against diseases of aging. If researchers can isolate risk factors for disease, patients can lead longer, healthier lives, she said.

“Knowing that I’m really making a difference, even in a single person’s life, is what keeps me going.”

— Mark Donahue