What race gets dementia the most?
Among people ages 65 and older, African Americans have the highest prevalence of Alzheimer’s disease and related dementias (13.8 percent), followed by Hispanics (12.2 percent), and non-Hispanic whites (10.3 percent), American Indian and Alaska Natives (9.1 percent), and Asian and Pacific Islanders (8.4 percent).
Dementia in the Black community
Alzheimer’s disease is the most common type of dementia. Around 60–80%Trusted Source of people with dementia have Alzheimer’s.
According to the Alzheimer’s Association, older Black Americans are twice as likely to have dementia than older white Americans.
This article looks at the statistics around Black, Indigenous, and People of Color (BIPOC) and dementia. It also looks at inequalities regarding healthcare and ways society and individuals may be able to overcome the health inequalities that lead to an increased chance of dementia.
According to the Centers for Disease Control and Prevention (CDC), Alzheimer’s and other forms of dementia are increasing in prevalence. There may be almost 14 million Americans Trusted Source with these conditions by 2060. There will be four times as many African Americans with these conditions by 2060 than there are now.
According to a report from the Alzheimer’s Association, Alzheimer’s can affect anywhere from 14–100% more African Americans than white Americans.
The number of African Americans over 65 is likely to more than double by 2030, from 2.7 million people in 1997 to 6.9 million people. Alzheimer’s affects over 10% of people of all races over 65.
Inequalities regarding healthcare
Certain health conditions increase the risk of developing dementia, with the following risk factors being more prevalent in the Black community:
High blood pressure
High blood pressure is a key risk factor for developing dementia in later life, particularly vascular dementia.
In 2017–2018, the U.S. Department of Health and Human Services found that 57.2% of Black males had high blood pressure, compared with 50.2% in white males. Similarly, they found that 56.7% of Black females had high blood pressure, compared with just 43.6% of white females.
Stress and depression
The added stress that Black people face every day can lead to high blood pressure as well as mental health conditions such as depression.
A 2015 systematic review Trusted Source found that people who experienced racism had higher rates of depression, which can lead to an increased risk of dementia in later life.
This extra stress may have many causes among people in the Black community, including:
- everyday racism
- residential segregation
- additional socioeconomic barriers
According to a 2020 report Trusted Source in The Lancet, type 2 diabetes has strong links to an increased risk of dementia, including Alzheimer’s disease and cognitive decline.
The National Institutes of Health states that Black people are twice as likely Trusted Source as white people to develop type 2 diabetes.
Some people have linked these elevated numbers among Black people to a possible genetic cause. But researchers in a 2017 study Trusted Source took into account biological, environmental, psychosocial, socioeconomic, and behavioral factors among participants. They found that Black people and white people have a similar likelihood of developing diabetes.
heart disease and stroke
According to the Alzheimer’s Society, a person who has had a stroke or has heart disease is twice as likely to develop vascular dementia.
In the United States, a Black person is around one and a half times more likely to have a stroke than a white person. Data from 2018 suggests Black Americans were 30% more likely than white Americans to die from heart disease.
But a raised risk of developing heart disease may due to factors such as high blood pressure or poor diet.
Poor diet can be the result of socioeconomic difficulties. Data from the 2019 census shows that 17.4% of African American families were living under the poverty line at that time. Just 5.5% of non-Hispanic white families were living in the same situation.
Socioeconomic difficulties may mean a person has limited access to fresh food and fewer opportunities to exercise.
A 2020 genome study Trusted Source has identified new DNA regions that are unique to African Americans with Alzheimer’s disease.
These new pathways could provide a clue as to why BIPOC are more likely to develop dementia, but scientists have called for more research to explore this further.
In the meantime, it is crucial to address the many social causes of the increased prevalence of dementia among the Black community.
Inequalities in healthcare can also increase the risk of doctors misdiagnosing or overlooking early dementia.
Socioeconomic factors may also make it harder for BIPOC to gain health insurance or easily access health appointments.
Many experts have also criticized cognitive tests for dementia as being unsuitable for historically marginalized groups, potentially leading to an incorrect diagnosis.
Researchers create cognitive tests from years of research on white people, and they do not adjust them to take account of educational disparity and discrimination in BIPOC communities.
Ways to overcome these inequalities
A 2019 report Trusted Source into ethnic and racial disparities within Alzheimer’s and related dementias made the following recommendations, among others:
- Target and recruit BIPOC into studies and clinical trials on dementia and train researchers and practitioners to identify and address gaps in current research.
- Consider unique life experiences, such as poverty, stigma, and conflict, to more fully understand whether they play a role in the development of dementia.
- Develop more sophisticated tools and models that are more specific to BIPOC groups.
- Change frontline medical and public health approaches so that healthcare professionals treat and assess BIPOC from a perspective that considers their specific risk, depending on ethnicity.
The Commonwealth Fund, which has committed to becoming an antiracist organization, has also called for wider changes to overcome more general health inequalities in the U.S., including:
- Improving how doctors help BIPOC with chronic conditions, such as high blood pressure, to control their symptoms. This strategy must address issues of trust between healthcare professionals and BIPOC.
- Being more transparent about racial disparities in the treatment of certain conditions by collating and publishing data.
- Understanding how structural racism affects how BIPOC, limited by socioeconomic factors, can engage with their treatment and healthcare professionals. For example, increased reliance on public transport may mean missed appointments. Also, having fewer supermarkets in the local area is known as a food desert. This may mean a person has a more limited diet, and may rely on ready meals and junk food since fresh food is harder to come by.