Mayo Advancing Research Engagement in ADRD Study (MAREAS Jax) - Important health disparities exist in the burden of Alzheimer’s disease and related dementias (ADRD) across US population. Compared to non-Hispanic White Americans (NHW), a higher ADRD burden is experienced by Hispanic & Latino (HL; 1.5X) and Black & African American (BA; 2X) individuals. These ADRD high-risk populations (HRP) comprise 1/3 of the US population (18.7% HL, 12.4% BA - US 2020 Census) and are projected to increase yet remain critically underrepresented in ADRD research. This underrepresentation exacerbates health disparities and challenges the development and implementation of efficacious and safe risk-reduction strategies. Genetics do not fully explain disparate ADRD risk, highlighting a fundamental knowledge gap concerning how genomic factors interact with comorbidities and lifespan exposures to social risk factors (the “exposome”) to modify ADRD risk. There is a critical need to identify clinical, social risk factors, and biological factors that contribute to disparate risk in HRP; establish the relationship between exposures underlying ADRD outcomes; use this information to mitigate disparities in ADRD burden through education and risk factor modification; and broadly disseminate this information to inform the development of effective biomarkers and therapies. The Mayo Advancing Research Engagement in ADRD Study in Jacksonville (MAREAS; Spanish for tides) will address this need. Aim 1 will advance recruitment of HRP cohorts (UH2) by developing/deploying outreach, recruitment, and engagement best practices for HRP in Jacksonville, Florida, through a bilingual (English-Spanish) research team, supported by community ambassador teams (CAT) and an external advisory board (EAB) including experts in social risk factors and ADRD research. Aim 2 will identify relevant measures of ADRD burden (UH2►UH3). Social risk factors, cognitive, clinical, and blood-based biomarker measures associated with cerebrovascular, amyloid, and tau burden, will be collected through comprehensive/culturally appropriate annual assessments and integrated with multi-omics data, structural (MR) and molecular (amyloid and tau) PET neuroimaging obtained at study entry, and every 2 years thereafter to identify modifiable dementia risk factors, blood-based biomarkers, and molecular signatures of ADRD burden. Data collection will be standardized with input from EAB members to optimize scalability and promote sample/data sharing. Aim 3 will provide meaningful individualized feedback (UH3) to participants through a Brain Health Report detailing actionable risk factors and recommendations to mitigate intraindividual ADRD burden. Aim 4 will use multi-omics measures to identify molecular signatures that interact with the exposome and associate with ADRD burden in HRP (UH3), following NIH’s findability, accessibility, interoperability, and reusability guidelines for broad data sharing. In this way, MAREAS Jax will chart the currents that drive disproportionate participation in ADRD research and disparate ADRD burden and will inform the design and implementation of strategies to shift these tides in Northeast Florida and beyond.
