By Mary Brophy Marcus
JACKSONVILLE, N.C. — In the same way the wrinkles and stoop of an old gentleman can sometimes mask a feisty personality, the faded sign out front of the First Baptist Church here and its weathered exterior belie the vibrant doings within.
Pop your head inside the church’s foyer on any given day and you’ll hear 72-year-old trumpeter Frank Hart improvising Wilson Pickett’s In the Midnight Hour with a crew of other elderly musicians. Or swing around back and you’ll likely find the church’s head pastor, the Rev. James Brown, picking grapes in the organic orchard, laughing and talking with some of his congregants, in his deep, gravelly voice, about the importance of eating fresh foods to keep the mind and body strong. The church’s freshwater fish farm — teeming with tilapia — bubbles nearby. Later, some will be cooked up in a cornmeal batter for church suppers.
Brown waves to a group of elderly walkers passing briskly by who exercise regularly to improve their health. “I love you guys,” he calls out.
The music, agriculture, exercise, foreign language and horse-therapy programs, or “ministries” as Brown refers to them at First Baptist, are part of a multi-pronged effort he has developed in collaboration with researchers from Duke Medical Center’s Joseph and Kathleen Bryan Alzheimer’s Disease Research Center to help his church and surrounding community, especially the elderly, fend off cognitive decline and lead richer, more productive lives. Alzheimer’s experts believe that physical activity and engaging the mind can boost brain health.
Brown is motivated by his now-deceased mother’s long struggle with brain-degenerating Alzheimer’s disease, as well as statistics that indicate the incidence of Alzheimer’s is significantly higher among African Americans. The reason for this is not clear, but may be linked independently to the higher rates of cardiovascular disease and diabetes in the population, says Kathleen Welsh-Bohmer, director of the Alzheimer’s research center at Duke.
The Duke researchers, Brown and his community say their efforts are a work in progress, but they’re beginning to see the first inklings of positive results.
Brown says all of the activities are designed for social and cognitive engagement, and to build confidence in the elderly. “We want to work the feet, the fingers, the brain — we want to get them thinking and gain a sense of well-being,” he says. “I see my mom in each one of those persons.”
Getting blacks to participate
The leader of his church for 26 years, Brown met Duke aging expert Welsh-Bohmer in 1995, when she and colleagues from the school’s Alzheimer’s disease center responded to a National Institute on Aging initiative that asked medical researchers to diversify the populations in their aging studies.
With the help of a grant from the institute, Welsh-Bohmer’s team connected with influential black leaders from across North Carolina, including Brown, and formed the African-American Community Outreach Program with the goal of educating people about Alzheimer’s disease and encouraging participation in medical care and studies.
Though Alzheimer’s disease incidence is higher among African Americans — ranging widely from 14% to 100% higher than among whites — much fewer blacks are involved in research studies than whites, says Peggye Dilworth-Anderson, professor of Health Policy & Management at the University of North Carolina-Chapel Hill. “We know there are both genetic and environmental factors at play. We need more research,” she says, but researchers can’t get there without the study participants.
In the mid-1990s, only 11% of Duke’s Alzheimer’s study participants were African American, even though the African-American population in Duke’s hometown, Durham, N.C., is 38%, Welsh-Bohmer says. As a result of the partnership, that figure now tops 20%, she says. “To really understand Alzheimer’s disease, we want our research to be more representative of real life.”
Mistrust of the health care system plays a role in why historically fewer blacks than whites get involved in medical research, says Scott Turner, director of the Memory Disorders Program at Georgetown University Medical Center. “The specter of the Tuskegee experiment still lingers,” he says, referring to the unethical study conducted more than 40 years starting in 1932. In it, hundreds of African-American male participants were not told they had syphilis and were not given antibiotics.
“In Tuskegee, they were really used in a very brutal way,” says Sandra Weintraub, director of the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University. She says part of her center’s work on the South Side of Chicago is reversing the misconceptions blacks have about research — that much of her research on aging has nothing to do with needles and medications, but simply listening to people’s stories.
Brown says the relationship is working between the Duke researchers and his community because instead of being studied, “We are active participants in the research. We are partners with the scientists.”
Hopeful that there will be more effective treatments for Alzheimer’s within his lifetime and that of his community, Brown spoke two years ago with Welsh-Bohmer about taking his church’s relationship with the Duke researchers to a higher level. They began holding an annual health fair together, where blood pressure screenings, memory tests and other health data are gathered. Brown also decided to ramp up his health-related ministries, assigning leaders to each program. Most are seniors.
Among them, William McCoy, 58, a retired marine and teacher, and James Wyatt, 58, run the agricultural program — the orchard, garden and aquaculture. Gwendolyn Shorter, 70, a retired schoolteacher whose husband had Alzheimer’s, heads up the fitness and walking ministry. Brown’s oldest son, Vick, leads the music program.
Back in the saddle, years later
And Brown himself is enamored with First Baptist’s horse barn about 5 miles outside town, where he encourages older folks (and youngsters) to climb up on a horse and forget the outside world for a while.
“Henry Moss is 88. He hadn’t been up on a horse in 60 years. He got on — we have a ramp for getting the elderly on the horses — and he acts like he’s never been off a horse,” Brown says.
To date, there have been two health fairs at the church. The second one was last month. “That we had so many attending the health fairs and signing up for our research study was remarkable,” Welsh-Bohmer says.
In its first year, the health fair brought in 127 people, and the researchers conducted 80 memory screenings. Twenty-three seniors from the Jacksonville community agreed to participate in Duke’s larger aging and Alzheimer’s study. This September, 61 memory screenings were performed, and 14 new seniors enrolled in the Duke research.
Across the board, blood pressure readings dropped significantly since last year’s health fair, Welsh-Bohmer says. She believes the church’s focus on health is probably having an effect.
More and more, other Alzheimer’s researchers around the country are also partnering with local African-American institutions and leaders to clarify perceptions of Alzheimer’s disease and help minorities seek earlier treatment.
Northwestern Medical Center health experts visit the Francis J. Atlas Regional Senior Center on Chicago’s South Side once a month to conduct Alzheimer’s education and health and memory screenings for interested seniors, says Northwestern’s Weintraub.
Dilworth-Anderson says working at the family and community level is a start, but there’s a whole mountain to climb to erase health disparities, including revamping the health-care system, insurance and access to care for minorities.
“Health disparities are structural in both a macro sense, at the health care system level, and at the micro, family level,” she says.
For now, Brown and his community are committed to working in their hometown to fight Alzheimer’s, but they hope their efforts will influence others.
“What we are doing is meaningful,” he says. “And it can be replicated in any community. We want to say to others in our shoes, ‘We did, and you can.'” (c) Copyright 2008 USA TODAY, a division of Gannett Co. Inc. <>
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