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Posted 11/4/2008

USC researchers to tie into existing major study based
at University of Alabama at Birmingham

Public health researchers in South Carolina and Alabama are joining forces to study the effects of physical activity on stroke and cognitive decline in a group of some 20,000 racially and geographically diverse men and women.

Steven Hooker

Dr. Steven P. Hooker, director of the USC Prevention Research Center and research associate professor in the Arnold School’s Department of Exercise Science, will lead the five-year $2.9 million study.

Hooker’s effort is an ancillary study to the Reasons for Geographic and Racial Differences in Stroke (REGARDS) – study, based at the University of Alabama at Birmingham.

REGARDS, which has enrolled more that 30,000 persons, aims to determine why the “stroke belt” — comprised of the Carolinas, Georgia, Tennessee, Alabama, Mississippi, Arkansas and Louisiana — has a stroke death rate one-and-a-half times the national average. African-Americans are particularly vulnerable with a stroke rate almost double that of Caucasians.

Hooker’s study is funded by the National Institute of Neurological Disorders and Stroke. Entitled REGARDS-PA, it will examine the relationship between objectively measured physical activity and risks of stroke and cognitive decline.

Studies on the relationship of physical activity to stroke and cognitive decline have been done before, says Hooker. However, those studies, which used self-reported information, left a wide margin for error. In addition, no other study on physical activity and stroke or cognitive function has as large a population of African Americans as does REGARDS-PA.

“The difference with REGARDS-PA is that for the first time, we’ll be using an objective measurement of physical activity which is much more accurate and yields more detailed information about a person’s physical activity patterns,” he said.

REGARDS-PA participants will wear a data collection device called an accelerometer, a small electromechanical instrument about the size of a quarter.

Attached to a belt around the waist, the waterproof, shockproof accelerometer measures a person’s movement across a wide range of activities – from sitting to vacuuming to walking.

The study calls for a participant to wear the device for a week, then mail it to REGARDS headquarters in Birmingham. Downloaded to a computer, the data can chart the full range of a person’s physical activity including frequency, intensity and duration.

“This knowledge will have important clinical and public health implications. We expect to enhance health-related physical activity recommendations and improve stroke prevention,” Hooker said in his application for the study.

The accelerometer data is expected to show with some precision the degree to which physical activity influences stroke and cognitive decline – “a dose-response relationship,” as Hooker describes it. “We will also be able to look at these relationships specifically for men, women, whites, African Americans, and persons living in various geographic regions,” he said.

Particularly interesting, he said, is testing the idea that even small amounts of physical activity can influence brain health and prevent stroke in mid-life and older adults.

Hooker said that the parent REGARDS study, which was renewed recently with a $20.8 million grant, is a cornucopia for stroke and brain health researchers. Participants in the study are made up of about one-half men and women, and the same proportion of whites and African-Americans. All of the participants are 45 years of age or older.

The parent REGARDS study already has a research infrastructure in place and Hooker will make use of its staff to help recruit participants, distribute the accelerometers, and assemble the data.

Hooker’s study also will have the support of Dr. Steven Blair of the Department of Exercise Science, Dr. Natalie Colabianchi of the Department of Epidemiology and Biostatistics, and Brent Hutto of the Prevention Research Center.

Two former Arnold School faculty members are also members of the REGARDS-PA research team. They are Dr. John Vena, now chair of the Department of Epidemiology and Biostatistics at the University of Georgia and Dr. Jim Laditka, associate professor of Public Health Sciences at the University of North Carolina at Charlotte.

REGARDS-PA is being funded by Hooker’s first NIH RO1 grant, an acknowledgment of his scholarship and a milestone in his career at USC. He earned his bachelor’s degree in physical education from California State University-Fresno in 1978, his master’s in physical education from California State University-Sacramento in 1984 and his doctorate in exercise science from Arizona State University in 1988.


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