Ethnic Disparities: How Your Race Impacts Your Risk of Dementia

diverse people
Plume Creative/DigitalVision/Getty Images

Many conditions have been found to increase the risk of dementia, including diabetes, heart disease, an unhealthy diet, lack of physical activity and older age. Now, researchers have identified another factor in Alzheimer's and other kinds of dementia risk: our race.

We often say that dementia does not discriminate, meaning that it doesn't just skip over certain groups of people, only hitting those with certain characteristics.

However, when the numbers are looked at closely, dementia does indeed appear to hit some groups harder than others. Here's a summary of what multiple studies have concluded about race and dementia risk:

According to research published in 2016, African Americans have the highest risk of dementia – 38 percent over a 25-year period beginning at age 65. They were followed by the American Indian/Alaska Native group at 35 percent, Latinos at 32 percent, Pacific Islanders at 25 percent, whites at 30 percent, and Asian Americans at 28 percent.

Research published in 2013 concluded that, when compared to whites, African Americans were twice as likely to develop Alzheimer's, while Hispanics were one and a half times more likely.

Additionally, there appears to be uneven costs related to dementia for different ethnic groups. For example, the African American Network Against Alzheimer's states that "while African Americans make up 13.6 percent of the U.S.population, they bear one-third (33 percent) of the nation’s total costs of Alzheimer’s and other dementia" (African American Network Against Alzheimer's, 2013).

Why Do these Differences Exist?

While genetic factors can increase the risk of Alzheimer's, multiple studies have looked at race and genetics and have not found a clear correlation between these factors and dementia risk. Researchers have, however, found a connection between certain health conditions, race and risk of cognitive impairment.

These include:

Several studies have demonstrated a connection between high blood pressure and an increased risk of dementia. Other studies have concluded that African Americans are more likely than whites or Hispanics to have high blood pressure, thus placing them at greater risk of dementia.

Type 2 diabetes has repeatedly been correlated with a higher risk of dementia. In fact, there's such a strong connection that some researchers call Alzheimer's disease "Type 3 diabetes." Both African Americans and Hispanics have a higher prevalence of diabetes when compared to Whites.

Research has also found that African Americans and Native Americans with type 2 diabetes have a 40-60 percent higher risk of developing dementia than Asian Americans with type 2 diabetes.

African Americans are at a 2.7 times higher risk of stroke, which in turn is associated with an increased risk of dementia – often vascular in nature.

The Alzheimer's Association outlined three risks that were connected with increased risk of dementia including living in rural areas, a lower education level and having a lower income level.

They also found that African Americans and Hispanics were more likely to have a lower education and income level, thus placing them at increased risk for developing dementia.

What Can We Do about this Discrepancy?

1) Speak Up!

Raise awareness. Talk to your neighbor. Tell your story. Dementia is not something that should be hidden or hushed, and neither is this disparity in dementia risk based on ethnicity.

2) Volunteer for Clinical Trials

We need more people from minority backgrounds to participate in clinical trials and other research studies. Many studies consist of populations with limited diversity. You can see a list of clinical trials here at TrialMatch, a service of the Alzheimer's Association.

3) Go to Regular Screenings

Medicare covers – at no cost to you – an annual wellness exam, and this can include screening and testing of your cognition for symptoms of dementia. Be sure to tell your doctor if you're concerned about your memory (or that of your loved one). Early detection is very beneficial. It allows for the diagnosis and treatment of conditions that might cause memory loss and confusion but could be reversed if caught and treated. It also can allow for earlier (and possibly more effective) treatment of Alzheimer's and other types of dementia.

4) Advocate for Culturally Competent Services and Support Systems

Training in cultural competence helps ensure that healthcare services are provided in a way that honors diversity and encourages minority leadership and participation. 

Sources:

African American Network Against Alzheimer's. The Costs of Alzheimer’s and Other Dementia for African Americans. September 2013. http://www.usagainstalzheimers.org/sites/default/files/USA2_AAN_CostsReport.pdf

Alzheimer's Association. Alzheimer's and Public Health Spotlight: Race, Ethnicity and Alzheimer's Disease. April 2013. http://alz.org/documents_custom/public-health/spotlight-race-ethnicity.pdf

Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 11 February 2016. Inequalities in dementia incidence between six racial and ethnic groups over 14 years. http://www.alzheimersanddementia.com/article/S1552-5260%2815%2903031-9/abstract

Diabetes Care. April 2014. vol. 37 no. 4 1009-1015. Racial/Ethnic Differences in Dementia Risk Among Older Type 2 Diabetic Patients: The Diabetes and Aging Study. http://care.diabetesjournals.org/content/37/4/1009.full

Neurology. February 16, 2016. Differences in the role of black race and stroke risk factors for first vs recurrent stroke. http://www.neurology.org/content/86/7/637.short?sid=01feb468-c3f9-4ca0-ba19-a715ef9f09ea

US Against Alzheimer's. African Americans against Alzheimer's. Accessed March 6, 2016. http://www.usagainstalzheimers.org/networks/african-americans

US Department of Health and Human Services. Racial and ethnic disparities in Alzheimer's disease: A literature review. February 1, 2014. https://aspe.hhs.gov/report/racial-and-ethnic-disparities-alzheimers-disease-literature-review

Continue Reading