Reducing the risk of Alzheimer’s Disease and other related dementias in Native Hawaiians and Pacific Islanders through a hula-based intervention

Abstract

Background: In Hawai`i it is projected that 10% of people aged 65+ will be diagnosed with Alzheimer’s disease and related dementias (ADRD) by 2025. Nationwide, Native Hawaiians and Pacific Islanders (NHPIs) are more likely to experience early-onset ADRD than other racial and ethnic groups. NHPIs also have a higher prevalence of hypertension, obesity, diabetes, and dyslipidemia than other US racial/ethnic groups, increasing the likelihood of ADRD. Interventions that promote physical activity, healthy diet, and social and cognitive activities can prevent or slow cognitive decline. Notably, dancing can preserve or improve cognitive functioning and neuroimaging parameters, while reducing vascular risk factors.

Objective: To adapt our existing hula-based intervention to target vascular risk factors for dementia and cognitive functioning as well as to optimize its salience, implementation, and adherence in NHPIs with subjective or mild cognitive impairment by modifying an ADRD resiliency questionnaire.

Methods: During the pending University of Hawaii Institutional Review Board review, we conducted focus group training as well as expert and hula instructor interview training with mentors. An ADRD resiliency questionnaire was pilot tested with a convenience sample (N=16) of Native Hawaiians ≥ 50 years of age to ensure face validity, clarity, readability, and timing of potential participants taking the questionnaire.

Results: Study participants had common concerns regarding the applicability of some questions, the impact of COVID-19 on daily activities, and minor formatting recommendations. The feedback received from the pilot test of the questionnaire will be used to modify the questionnaire for our ‘IKE Kupuna project while awaiting IRB approval.

Conclusions: Pilot testing of research instruments and procedures with those who are of similar background to our target population are essential to culturally adapt and tailor our methods and strategies using community feedback and opinions.