Late Breaking News
Racial Disparities Among Alzheimer Patients Cause Concern
- Categorized in: April 2010
WASHINGTON, DC—African Americans and Hispanics have more to fear from Alzheimer’s than their Caucasian counterparts, according to a new report released by the Alzheimer’s Association. The report places the likelihood of developing AD and other dementias at two times more likely than whites for African Americans and one and one-half times more likely for Hispanics.
Racial Disparity in Disease Rates
The report used a compilation of national statistics on Alzheimer’s disease and dementia from across the country. One of the more striking examples of racial disparity is seen in 2006 data from the NIH-funded Washington Heights-Inwood Columbia Aging Project, which studies data from a random sampling of healthy Medicare beneficiaries over 65 living in Manhattan. Subjects were recruited between 1991 and 1996 and followed annually. Looking at 2,162 subjects, the report found that in those aged 75 to 84, 10.9% of whites had dementia, compared to 19.9% of African Americans and 27.9% of Hispanics. The disparity grows as age increases. In those 85 years and older, 30.2% of whites had dementia compared to 58.6% of African Americans and 62% of Hispanics.
As to why Hispanics were at more risk in this particular study than the national average would predict, the report notes that the majority of those Hispanics in the study were Caribbean-Hispanics, a group that is particularly hit hard by dementia at 85 years and older (62.9% compared to 26% of their Mexican-American peers).
Health and Socioeconomic Factors
According to the report, there are no known genetic factors that explain the greater prevalence of Alzheimer’s and other dementia in African Americans and Hispanics. However, conditions such as high blood pressure, heart disease, stroke and diabetes are known risk factors for AD and are more common in both groups than in whites.
Findings from the 2006 Health and Retirement Study show that high blood pressure was more common in people aged 55 and older with cognitive impairment than in those with normal cognition in each of the three broad racial and ethnic groups. The same relationship exists between cognitive status and heart disease, diabetes and stroke. “It is clear that high blood pressure is more common in African Americans overall and diabetes is more common in both African Americans and Hispanics,” the report contends. “And it is more likely that the greater prevalence of these conditions … accounts for at least some of the differences among these groups in the prevalence of Alzheimer’s.”
The report goes on to note that high BP and diabetes are treatable conditions that, if addressed early in life, could reduce the prevalence of Alzheimer’s later in life.
Also, socioeconomic factors play a role in the mental deterioration associated with aging. Findings from the HRS show that having a low level of education, having a low income and having lived in a rural area as a child, which the report suggests may be a proxy for a lower quality of education, are all more common in people with cognitive impairment than in people with normal cognition, regardless of race or ethnicity. Among whites with cognitive impairment, 47% had less than 12 years of education compared with only 11% of those with normal cognition. According to the report, African Americans and Hispanics make up a disproportionately large number of the socioeconomically disadvantaged people in the US, with both groups showing a lower income level and lower education level than their white counterparts.
“These groups are more likely to have Alzheimer’s, less likely to know it, and, as a result, less likely to receive available treatments and supportive services that can help them cope with the disease,” said Harry Johns, Alzheimer’s Association President, in a statement. “Greater understanding about the importance of proper management of diseases like high blood pressure and diabetes will allow individuals to make more informed health care decisions and adopt healthy lifestyle behaviors that can also help to reduce Alzheimer’s and dementia risk.”
Impact of the Disease
According to the report, there are 5.3 million Americans living with AD, and every 70 seconds someone in America develops Alzheimer’s. That rate is predicted to rise so that by mid-century someone will develop Alzheimer’s every 33 seconds. The report predicts there will be a half million new cases of Alzheimer’s this year, with the annual number of new cases rising until there will be nearly a million new cases a year by 2050.
Alzheimer’s was the seventh leading cause of death in the US in 2006, the latest year for which final death statistics are available, and the fifth leading cause of death among individuals aged 65 and older. It also has the ignominious distinction of being one of the few major diseases for which death rates have risen dramatically. From 2000-2006 death rates have declined for most major diseases
– heart disease (-11.1%), breast cancer (-2.6%), prostate cancer (-8.7%), stroke (-18.2%) and HIV/AIDS (-16.3%), while Alzheimer’s disease deaths rose 46.1%.
The Alzheimer’s Association estimates that total payments for health and long-term care services for people with these conditions will amount to $172 billion from all sources in 2010. Also, according to the report, most people with Alzheimer’s also have one or more additional serious medical conditions, such as diabetes or coronary heart disease. Their Alzheimer’s greatly complicates medical management for these other conditions, resulting in more hospitalizations and higher costs.