Memory Keepers assembles dementia, diabetes researchers in Duluth

Dr. Neil Henderson

A fire is kept burning at the Memory Keepers Discovery Team facility as a constant reminder of traditional American Indian values, and the hope in discoveries that will better the lives of Minnesotans.

“Back home, we build a fire for gatherings with the belief that virtually everything comes from the sun, so a fire is like bringing a little piece of sun to where you are so the power from it radiates into the special occasion. We want to keep this fire highly visible in the hope that we are doing something important here,” said Dr. Neil Henderson.

Set at shoulder height into a prominent wall of the research facility, a gas fireplace is kept lit, part of the tradition that Henderson brings from his Oklahoma Choctaw heritage. Executive Director of Memory Keepers, Henderson is a professor in the department of biobehavioral health and population sciences on the Medical School’s Duluth campus.

The first of four initiatives launched out of a state budget surplus in 2015, Memory Keepers funding is being used to recruit top researchers from around the country to investigate health equity in tribal and rural communities. The University of Minnesota Medical School was awarded $15 million to develop the four programs, and other initiatives will address the biology of aging, optical imaging and addiction.

Transforming the building at 7th Avenue and First Street in downtown Duluth from an automotive repair garage into a specialized research facility within a cultural context was a special challenge for the architectural design. With Memory Keepers on the ground floor, apartments above, and parking space below, DSGW Architects dove into the creative development process.

“They had such an awesome vision of what they wanted to achieve with the space visually and psychologically. Our role was to figure out how to capture the Native American aspects and interpret that in the design,” said Julie Spiering, DSGW Architects’ director of interior design.

Despite the cold industrial feel of concrete and brick from an upcycled car garage, Spiering says that the character of the building eventually lent itself to inspiration. First impressions were key, with DSGW focusing on the main entryway, which by its nature and alignment to the street and the lakeshore is at a northwest angle. Finding a way to tune that into the “Four Directions,” a tenet of American Indian spiritual teachings, was vital.

“We reset that space by putting a compass on the entryway floor. It allows people to recenter themselves to the cardinal directions,” Spiering said.

Turning a space intended for scientific investigation into one that was relatable and comfortable was another hurdle. Making the large open space multifunctional while maintaining warmth was achieved by incorporating different levels and culturally specific appointments.

“The ‘wow’ factor of the lake was particularly important to reconnect to the natural element, and the secret was using the existing windows to the best advantage, giving you a glimpse of the water as you enter and that draws you toward it,” Spiering said.

The conference space, lounge seating and kitchen remains one great room so that it can still be used for large events, with a central round table in medicine wheel colors and cedar wood paneling.

Concurrent with building renovation has been Henderson’s search for a elite team of scientists using unique funding that allows for hiring at full salary prior to grant dollars being in place. Two more positions remain for the total of five senior researchers with extensive experience who will ultimately make up the Memory Keepers team.

Henderson comes to the lead position with years of career experience in diabetes and dementia in Native Americans and rural residents. How those two conditions are related is complex, and at the heart of the question for the research team: how best to intervene when someone at risk of developing diabetes is asymptomatic to forestall the development of symptoms and potentially dementia.

“Diabetes and dementia are multifactorial. It’s a much wider set of targets than just two medical conditions,” Henderson stated.

Diabetes can contribute to cardiovascular disease and Alzheimer’s progression, and has components of social behavior such as inactivity related to obesity. It’s also correlated to lower educational levels and socioeconomic status.

Given both conditions in one individual, Henderson says they interact, with diabetes raising the risk for developing vascular dementia. Poorly controlled diabetes, which is not uncommon, creates a hyperglycemic environment in the vascular system that over time damages the interior of blood vessel walls, weakening them to increase the likelihood of a hemorrhagic stroke when tiny capillaries burst.

“Rates of diabetes and cognitive impairment are increasing across all populations with both on the Top 10 Killers List in the U.S., and when you look them then operating concurrently, there is an even higher risk of health status and dysfunction,” Henderson said. However, he points out that many causes of dementia from vascular dementia, to Lewy body dementia, frontotemporal dementia and even Alzheimer’s eventually have much in common.

“Back at home, these patients look pretty much the same with cognitive impairments, a long list of physical and motor effects, and whatever the source, dementia is a disruption to their lives, families and communities,” Henderson said.

In American Indians, diabetes rates are three times higher than for whites, and for dementias collectively, American Indians have the second highest prevalence rate across five different population groups. Henderson said these alarmingly high rates of diabetes and dementia have nothing to do with genetics and everything to do with life vulnerabilities. 

“For American Indians as a population, we are talking about toxic stress at a higher magnitude than normal that is related to life experience vulnerabilities that include higher rates of low socioeconomic status with more serious health outcomes,” he said.

To illustrate the point, Henderson noted a recent study compared the telomeres of two groups of children between the ages of four and 12, one group from an impoverished neighborhoods, the other from affluent ones. Telomeres are the end caps on our chromosomes, and their condition can reflect our health status (think of the plastic tips on the end of shoelaces). Shortened telomeres predict DNA damage and resulting health impacts.

Kids from the impoverished neighborhoods had shorter telomeres than those from affluent neighborhoods.

“Stress and poor diet already shows up as a biological effect at those young ages. Let the clock run for a few years and we begin to understand why poor people have more chronic disease and die sooner,” Henderson said.

Over time, Henderson he said vulnerable populations such as American Indians accumulate social traumas that eventually convert to physical diseases, such as diabetes, vascular weakness and dementia.

An uncommon research “lab,” the Memory Keepers ceremonial room has a cabinet with native medicines, and importantly, exhaust fans so that ceremonial burning of sage, sweetgrass and tobacco can occur free of fire alarms.

“It’s a space made uniquely for native people as part of the University of Minnesota Medical School, and yet we can use these traditional medicines on special occasions,” Henderson said.

Memory Keepers’ first research grant has just been approved to begin in January 2019, with Memory Keepers receiving $10 million for a highly competitive National Institute on Aging grant. Design of the first research project includes focusing on dementia in American Indians and has taken on an international component. A combination of tribal affiliations will be represented, from Wisconsin Oneida to regional and Canadian Anishinabe tribes.

Kitty Mayo is a North Shore-based freelance writer.