Abstract B151: Frailty and cognitive impairment among midlife and older Black adults residing in a persistent poverty area

Abstract

Physical activity improves cognitive and physical function and reduces the risk of obesity-related cancers and Alzheimer’s disease and related dementias (ADRDs). Yet, Black adults are less likely to be physically active and are more likely to be sedentary, an independent risk factor for cancer and ADRDs. The purpose of this cross-sectional pilot study was to identify physical activity-related risk factors for cancer and ADRDs among Black adults residing in a persistent poverty community to inform intervention development. The Partnering to Prevent Cancer and Alzheimer’s Disease (PPCAD) study sought to explore behavioral and non-medical determinants of cancer and ADRD risk. Black adults who were ≥45 years, have overweight or obesity (body mass index [BMI] ≥25.0 kg/m2), and were sedentary (self-report sitting ≥6 hours/day) were recruited through community partnerships developed as part of the Acres Homes Cancer Prevention Collaboration. Participants completed an in-person physical assessment to assess cognitive impairment (Mini-cog) and frailty (unintentional weight loss, exhaustion, walk time, grip strength) and completed interviewer- or self-administered questionnaires to assess weekly leisure-time physical activity (WLA), sedentary behavior, subjective cognitive decline (SCD), and physical and mental health-related quality of life (QOL). Participants (N=50) were mostly women (78.0%) in their 60s (M age=66.6±9.0 years). Less than half (40.0%) completed college, and 34% reported a household income below the federal poverty level. Roughly one-third (34.0%) of participants met physical activity recommendations (M WLA score=27.3±62.4), and participants engaged in sedentary behaviors for 11.0 hours/day (SD=4.7). Twenty percent of participants were cognitively impaired based on the Mini-cog (M score=3.6±1.2), and 19.1% self-reported SCD. All participants were either at-risk (66.0%) or frail (34.0%) based on frailty assessments (M score=2.3±1.1), and participants reported poor physical (100.0%) and mental (87.8%) health-related quality of life, well-below the population mean. Greater sedentary time, but not WLA, was associated with cognitive impairment (B=.086, p=.022). SCD was associated with frailty (B=1.042, p=.011), and frailty was associated with poor physical (B=-2.425, p<.001) and mental QOL (B=-3.060, p<.001). Midlife and older Black adults in this study reported physical inactivity, cognitive impairment, high levels of frailty, and poor QOL. Findings point to the need for interventions that reduce sedentary behavior to improve physical and cognitive function and QOL among midlife and older Black adults to reduce cancer and ADRDs risk and improve health outcomes in this vulnerable population. Scherezade K. Mama, Xavier Garcia, Melisa Campos, Lisa M. Lowenstein, Karen Basen-Engquist, Lorna H. McNeill. Frailty and cognitive impairment among midlife and older Black adults residing in a persistent poverty area [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B151.