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Alzheimer’s Disease: Why Black Families Are Affected At Disproportionate Rates And What Can Be Done

Staff

There’s a disturbing trend in the number of cases of the deadly neurological disorder known as Alzheimer’s disease in this country– according to the Alzheimer’s Association, Black Americans are twice as likely as their white counterparts to experience the brain changes associated with the disease.

The reasons for these disparities seem to be linked to a tapestry of socioeconomic inequalities such as lack of healthy food options, limited access to healthcare, and high rates of cardiovascular disease and diabetes, leading to delayed diagnosis and treatment.

Of those over the age of 65, about 14% of black people have Alzheimer’s compared to 10% of white people– and that number goes up to 21.3% of black Americans ages 70 and older who have the disease. And by 2060, cases are expected to increase fourfold among black Americans.

Alzheimer’s disease is a deadly brain disorder that gets worse over time where the brain shrinks and causes brain cells to eventually perish. It is the most common cause of dementia, or the gradual decline in memory, thinking, behavior and social skills, which affect a person’s ability to function.

The early signs of the disease include forgetting recent events or conversations, and over time it progresses to serious memory problems and loss of the ability to perform everyday tasks.

Early signs of Alzheimer’s include difficulty completing familiar tasks, confusion with time or place, trouble following or joining a conversation, increased poor judgment, and changes in mood and personality.

If any of these early detection symptoms are observed, it is critical to schedule an appointment with a doctor so that treatments may provide some relief of symptoms and help that person maintain a level of independence longer as well as increase their chances of participating in clinical drug trials that help advanced research– and it is in these areas that black people are falling behind.

According to a poll conducted by the Alzheimer’s Association, 65% of black Americans say they know somebody with Alzheimer’s or dementia, 55% of black Americans think that significant loss of cognitive abilities or memory is a natural part of aging rather than a disease and only 35% say they are concerned about Alzheimer’s.

Black people are more likely to face roadblocks when it comes to receiving medical treatment. Only 20% of black Americans say they have no barriers to excellent healthcare and support for Alzheimer’s, and 48% report being confident they can access culturally competent care.

Alarmingly, half of black Americans say they have experienced discrimination while seeking care for a person living with Alzheimer’s. 

“We know that many black Americans are fearful and distrustful of a healthcare system that has committed medical atrocities against them,” says Stephanie Monroe of the Alzheimer’s Clinical Trials Consortium. “It’s going to be great if we can get ahead of Alzheimer’s disease before it starts, but for that to happen, more people of color need to be comfortable talking about their brain health, especially with their doctor.”

Research is now suggesting that black people need more severe symptoms or be persistent to get diagnosed. Experts aren’t sure whether this is due to the fact that black people tend to seek treatment later or because of physician bias, but either way, it means the disease has more time to progress before treatment begins, and the few treatments that are available to slow progression tend to be effective at the early to middle stages of the disease.

A study done by the Boston Medical Center accessing the differences in age between races at which patients received MRI scans– which are considered the gold standard for assessing cognitive impairment linked to Alzheimer’s– had damning results. 72.5 years old is the average age black individuals received their first MRI compared to 67.8 years for their white counterparts.

Notably, the MRI’s that were used as a diagnostic tool on only 51% of black patients compared to 60% of white patients.

Black people are also missing out in participating in clinical trials, or research studies conducted with volunteers to determine whether treatments are safe and effective. Not only can clinical trials potentially slow down Alzheimer’s for someone experiencing symptoms but it also contributes to the future of Alzheimer’s disease prevention– and without them there can be no treatments, prevention or cure for the disease.

Stephanie Monroe of the Alzheimer’s Clinical Trials Consortium is a strong advocate for black people to participate in medical trials, so they can be part of the future of Alzheimer’s prevention.

“You’ve got to make patients feel that they can be their strongest and best advocate and ask questions and not be ashamed,” says Monroe, who urges patients diagnosed with dementia– especially in the black community– need to ask if they can be part of clinical trials.

“We also know if we don’t get African Americans participating in research that these drugs are going to be based on data from white European people that may not work for us.”

Yet, acknowledging the deep-seated mistrust stemming from historical medical injustices, such as the egregious Tuskegee syphilis study, is critical in understanding why Black Americans are underrepresented in medical trials.

This mistrust, rooted in a long history of medical discrimination, presents significant challenges in raising awareness and participation among Black communities about critical health issues that disproportionately affect them. To overcome these barriers, building trust through transparency, respect, and community engagement becomes imperative in addressing these health disparities.

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