African American people may experience Alzheimer’s disease and related dementias at higher rates than white people. Many studies of Alzheimer’s disease have not included African American people in adequate numbers or explored the underlying reason for this disparity. Consequently, scientists have a poor understanding of the condition in this population.

Alzheimer’s disease is a form of dementia that affects more than 6 million people in the United States. This number is growing fast. As the U.S. population ages, these increasing numbers will lead to a public health challenge.

This condition disproportionately affects African American people for a number of reasons. They are more likely to have Alzheimer’s disease and other dementias than white people, and the main reason for this is the healthcare disparities that exist due to discrimination.

This article will explore the statistics behind African American people and Alzheimer’s disease. It will also explain the inequities that lead to these statistics and list some steps to take to overcome these disparities.

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Here are some fast facts on Alzheimer’s disease in African American people:

Fast facts

  • Alzheimer’s disease can affect 14–100% more African American people than white American people.
  • More than 10% of people of all races who are aged over 65 years experience Alzheimer’s disease. The African American population aged over 65 years may grow from 2.7 million people to 6.9 million people by 2030.
  • The risk of an African American person developing Alzheimer’s disease if a first degree relative such as a parent or sibling had it is nearly 44%.
  • When asked why they were hesitant to participate in clinical trials for Alzheimer’s disease, 22% of African American people said that it was because they believed that they would not be treated fairly, and 24% did not trust medical research. Among the white population, these figures were 3% and 10%, respectively.
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Learn about other racial inequities that can affect people with dementia here.

Many factors have led to these statistics, and they all center on inequities and discrimination, both in healthcare and in wider life.

Genetics

There is an ongoing debate about the role of various factors in the development of Alzheimer’s disease among African American people. Although some researchers have speculated that genetic differences might help explain the difference in rates between African American people and white people, some research undermines this claim.

During a 2020 study, researchers found that African American people with Alzheimer’s disease did have some unique DNA regions. 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 in the Black population.

While research develops in this field, it is important to address the other, more concrete factors that lead to a higher prevalence of Alzheimer’s disease among African American people.

High blood pressure

Having high blood pressure is a risk factor for developing dementia.

According to one 2020 study, the everyday discrimination that Black people experience can lead to higher blood pressure.

A 2014 review focused on the effects of discrimination and cardiovascular diseases. Experiencing racial aggressions can be extremely stressful and may harm cardiovascular health over time.

Learn more about high blood pressure in African American people here.

Access to healthcare

A lack of access to quality healthcare also plays a crucial role in diagnosis delays and treatment quality.

There are many possible reasons that African American people have less access to healthcare than white people, including socioeconomic difficulties.

In 2019, 17.4% of African American families were living under the poverty line, in comparison with 5.5% of non-Hispanic white families. Limited transport to facilities and a lack of health insurance are just two factors that socioeconomic difficulties can cause.

A small 2005 study looked at Alzheimer’s disease in African American people. It found that caregivers often delayed seeking treatment for many years. Also, when they did seek treatment, it was often at lower quality clinics where people received lower quality care or did not get a prompt diagnosis.

Learn more about racism in healthcare here.

Diabetes

One 2020 report showed that type 2 diabetes can lead to an increased risk of dementia. This includes Alzheimer’s disease.

According to the National Institutes of Health (NIH), Black people have double the likelihood of white people of developing type 2 diabetes.

Some believe that this increased likelihood is due to genetics. However, a 2017 study showed that when researchers considered biological, environmental, psychosocial, socioeconomic, and behavioral factors among the participants, there were no differences between Black people and white people in terms of their risk of developing diabetes.

Learn more about type 2 diabetes in People of Color here.

Screening

African American people may not get access to the same screening tools as white people. Racial disparities may delay or limit access to medical care, and white doctors may not screen for dementia in Black people.

People may therefore receive a diagnosis at a later stage, when the symptoms are more severe and life expectancy is shorter. In addition, a 2011 paper argued that racial biases in cognitive screening tools may miss signs of dementia in African American people.

Clinicians

Several studies have suggested that racism is still widespread in medicine. This may affect how clinicians view African American people and the quality of care they offer.

A 2016 study involving medical students and residents found that about half believed at least one racist myth about Black people, such as the myth that they feel less pain than white people.

According to one 2014 review, African American people may develop Alzheimer’s disease at a younger age, due in part to having other risk factors at a younger age. The review also mentioned that doctors are also less likely to give this group Alzheimer’s disease medications.

Medical research

Experts have criticized cognitive studies for only considering white communities.

For generations, Alzheimer’s disease research has focused primarily on white people. This means that some data may not apply to African American people and other Black, Indigenous, and People of Color (BIPOC) groups, as the studies do not make adjustments for the discrimination that these groups face.

One 2019 report considered different types of dementia, including Alzheimer’s disease, and examined the racial disparities that affect people with these conditions.

The following are just a few tips that these researchers have suggested to help overcome inequities in healthcare for African American people with Alzheimer’s disease:

  • Studies and clinical trials: Medical research must take BIPOC groups into account, and practitioners must consider shortcomings in current and historical research.
  • Viewpoints: Researchers must identify the different viewpoints and opinions of different ethnic and racial groups and use these to create ways to overcome disparities.
  • Education: Informative material can support caregivers and those in BIPOC groups. Research for this material must draw from material that has focused on people from these groups.
  • Tools: Researchers must develop more sophisticated tools and models that consider BIPOC groups.
  • Training: Practitioners and researchers from all racial and ethnic groups must receive training to implement these inclusive models of research and practice.
  • Other factors: Healthcare professionals must take into account a wider range of factors to understand risk factors and causes associated with dementia. These factors may include:
    • poverty
    • stigma
    • conflict

Learn more about health inequity here.

A number of factors play a role in Alzheimer’s disease in African American people, and researchers have not conclusively identified the specific role that each factor plays.

Discrimination in healthcare is not the responsibility or fault of the person facing the discrimination.