What Causes Racial Disparities in Alzheimer's Disease and Dementia Care?

 What Causes Racial Disparities in Alzheimer's Disease and Dementia Care?

Nearly 7 million individuals in the United States grapple with Alzheimer’s disease, yet the weight of this diagnosis isn't distributed evenly among the nation's racial demographics.1 Black individuals bear the greatest risk of developing dementia, followed by Indigenous Americans, and people of Hispanic and Latino heritage.2 Despite this heightened risk, these communities are frequently underrepresented in research and clinical trials, encountering greater obstacles in accessing quality care and essential resources such as nutritious foods and clean air.

Dementia Risk Across Racial Identities:

• Black: 38%
• American Indian/Alaskan Native: 35%
• Latino: 32%
• White: 30%
• Asian: 28%
• Pacific Islander: 25%
• 
  

• The underlying risk factors of dementia, such as hypertension, diabetes, air pollution, poor nutrition, and lack of physical activity, are all linked to the inequalities experienced by communities of color and individuals with lower incomes.

  As our nation becomes increasingly diverse, there is a pressing need to establish a more equitable system that fosters improved health outcomes for all communities. In this series, Health delves into the controllable risk factors for dementia, the delayed Alzheimer's disease diagnoses among people of color, symptoms to be vigilant about, and the obstacles marginalized communities encounter when seeking memory care.

  While dementia and Alzheimer’s disease typically emerge with aging, prevention commences with the resources available to us early in life. Something as basic as access to clean air and fresh, nutritious food could not only enhance individual health outcomes but also contribute to the well-being of future generations.

• 
  

• Why Some Delay Seeking a Dementia Diagnosis:

  Evidence suggests that racial bias has led to significant healthcare disparities for people of color. Research indicates that healthcare providers are more likely to overlook symptoms in individuals from these communities, and Black and Latino individuals are less likely to receive appropriate and advanced treatment options for their health conditions.4

  When it comes to obtaining a dementia diagnosis, studies have found that it takes an average of four months longer for Black individuals and over a year longer for Hispanic individuals to receive a diagnosis. Consequently, by the time people from these communities are diagnosed, they are more likely to experience significant cognitive and functional impairments due to the delay in diagnosis.3

  For optimal outcomes, it's crucial to address dementia symptoms as soon as they emerge. Below, Health editor Sukhman Rekhi outlines the early warning signs of dementia to watch out for in yourself or a loved one.

• 
  

• The Financial Strain of Dementia Care:

  Moreover, individuals of color are more likely to lack health insurance compared to their white counterparts. Data from the 2021 U.S. Census Bureau underscored the disparities in healthcare coverage across racial groups. They found that 18.8% of American Indian and Alaska Native (AIAN) communities, 17.7% of Latinos, 10.1% of Pacific Islanders, and 9.6% of Black individuals are uninsured, compared to only 5.7% of white individuals.11

  The cost of dementia treatment under Medicaid is projected to escalate significantly by 2050. With the rising prevalence of the disease, affordable healthcare programs will be crucial to accommodate a growing population of individuals with dementia.12

  Given the financial strain of dementia care, many individuals cannot afford professional assistance and instead undertake the responsibility of caring for their loved ones themselves. If you're a caregiver for someone with dementia, continue reading for some practical tips on how to support your loved one.

• Providing care for a family member with dementia can pose significant financial challenges. A study from 2015 revealed that the cost of caring for an individual with Alzheimer’s disease can reach up to $287,000. This financial burden is particularly daunting for uninsured families and those residing in areas with limited resources.10

• Overcoming Barriers to Dementia Care:

Dementia stands as a leading cause of death among Black Americans and remains a significant concern for Latino, Indigenous, and Asian communities across the United States.673

Recent data reveals that approximately 40% of primary care providers, who serve as frontline resources in dementia care, hail from diverse racial and ethnic backgrounds. Given the prevalence of racial discrimination in healthcare systems experienced by communities of color, there is a preference for working with providers who understand their cultural nuances or speak their language.8

Moreover, discriminatory practices in research have historically led to the exclusion of people of color from drug trials testing new medical treatments. However, there's a new concern: Black individuals are now being excluded from dementia clinical trials for different reasons.

Health reporter Julia Landwehr delves into the obstacles faced by Black Americans and residents of less affluent neighborhoods in accessing dementia care, including the latest drugs for Alzheimer's disease, and explores actionable steps to address these disparities.