Posted inPublic Health Alzheimer's / Dementia Health Equity

Impact of dementia in the Black community

May 16, 2021
Impact of dementia in the Black community

Dementia is the umbrella term for a collection of disorders or disabilities that affect a person’s ability to think, remember, or make decisions. According to research, people in the Black community face many obstacles to dementia treatment, including delays in diagnosis.

The most prevalent form of dementia is Alzheimer’s disease. Alzheimer’s disease affects 60–80 percent of people with dementia.

According to the Alzheimer’s Association, older Black people are twice as likely as older white people to develop dementia.

This article examines dementia statistics for Black, Indigenous, and People of Color (BIPOC). It also looks at healthcare disparities and how society and people can work together to address the health disparities that lead to an increased risk of dementia.

Statistical data

Black old woman

Alzheimer’s disease and other types of dementia are becoming more common, according to the Centers for Disease Control and Prevention (CDC). By 2060, nearly 14 million Americans will have these conditions. By 2060, there will be four times as many African Americans suffering from these illnesses as there are now.

According to the Alzheimer’s Association, African Americans are 14–100 percent more likely than white Americans to develop Alzheimer’s disease.

By 2030, the number of African Americans aged 65 and up is expected to more than double, from 2.7 million in 1997 to 6.9 million. About ten percent of people over the age of 65, of all races, suffer from Alzheimer’s disease.

Inequalities in the healthcare system

Dementia is caused by a number of health problems, with the following risk factors becoming more common in the Black community:

High blood pressure

High blood pressure is a major risk factor for dementia, especially vascular dementia, later in life.

According to the United States Department of Health and Human Services, 57.2 percent of Black males had high blood pressure in 2017–2018, compared to 50.2 percent of white males. Similarly, they discovered that 56.7 percent of Black females had high blood pressure, while only 43.6 percent of white females did.

According to a 2020 report, Black people could have higher blood pressure as a result of lifelong prejudice.

Stress and depression

The additional stress that Black people face on a daily basis can lead to high blood pressure and mental health issues like depression.

According to a 2015 systematic study, people who have encountered prejudice have higher rates of depression, which can lead to dementia later in life.

This increased stress among African-Americans may be due to a variety of factors, including:

  • everyday racism
  • residential segregation
  • additional socioeconomic barriers

Diabetes

Type 2 diabetes has clear ties to an increased risk of dementia, including Alzheimer’s disease and cognitive impairment, according to a study published in The Lancet in 2020.

According to the National Institutes of Health, African-Americans are twice as likely as whites to develop type 2 diabetes.

Some have speculated that the increased numbers of Black people may be due to a genetic factor. Biological, cultural, psychosocial, socioeconomic, and behavioural variables were all taken into account by researchers in a 2017 report. They discovered that the risk of developing diabetes is comparable in black and white people.

Stroke and heart attack

An individual who has had a stroke or has heart disease is twice as likely to develop vascular dementia, according to the Alzheimer’s Society.

In the United States, a Black person is around 1.5 times more likely than a white person to have a stroke. According to statistics from 2018, Black Americans were 30% more likely than white Americans to die from heart disease.

However, factors such as high blood pressure or a healthy diet can increase the risk of developing heart disease.

Poor nutrition may be the product of socioeconomic problems. According to the data from the 2019 census, 17.4 percent of African American families were living in poverty at the time. Just 5.5 percent of non-Hispanic white families had this experience.

Due to socioeconomic constraints, a person’s access to fresh food and opportunities to exercise may be limited.

Genetics

New DNA regions specific to African Americans with Alzheimer’s disease have been discovered in a 2020 genome review.

These new pathways may hold the key to understanding why BIPOC people are more likely to develop dementia, but more research is needed to find out.

Meanwhile, it’s critical to discuss the plethora of social factors that contribute to the increased incidence of dementia in the Black community.

Some disparities

Inequalities in healthcare can also make it more likely for doctors to misdiagnose or neglect early dementia.

BIPOC can also find it difficult to obtain health insurance or schedule appointments due to socioeconomic factors.

Many researchers have also criticised dementia cognitive assessments, claiming that they are unsuitable for traditionally disadvantaged populations and could lead to an inaccurate diagnosis.

Researchers develop cognitive assessments based on years of studies on white people and do not change them for educational disparities and inequality in BIPOC populations.

Overcoming inequality

Among other things, a 2019 study on ethnic and racial differences in Alzheimer’s disease and associated dementias found the following recommendations:

  • BIPOC should be targeted for inclusion in dementia studies and clinical trials, and researchers and clinicians should be trained to recognise and correct gaps in existing research.
  • To better understand if unusual life experiences, such as poverty, stigma, and conflict, play a role in the development of dementia, think about them.
  • Develop more advanced technologies and models that are more tailored to BIPOC communities.
  • Change frontline medical and public health approaches such that healthcare providers treat and evaluate BIPOC from a viewpoint that takes into account their unique risk factors based on ethnicity.

The Commonwealth Fund, which has pledged to become an anti-racist group, has also called for broader reforms to address the country’s broader health disparities, including:

  • Improving the way doctors assist BIPOC with chronic disorders including high blood pressure in managing their symptoms. Trust problems between healthcare practitioners and BIPOC must be addressed in this strategy.
  • Collecting and releasing data to make ethnic differences in the care of such conditions more apparent.
  • Understanding how systemic racism impacts BIPOC’s ability to interact with their treatment and healthcare providers, which is hampered by socioeconomic factors. Increased dependence on public transportation, for example, can result in missed appointments. A food desert is also described as a lack of supermarkets in a given region. This may indicate that a person’s diet is more limited, and that they depend on ready-to-eat meals and junk food because fresh food is more difficult to come by.

Methods for preventing dementia

Some risk factors, such as age, genetics, and socioeconomic status, are unchangeable.

As a country, we must take responsibility for addressing the systemic gaps in healthcare that result in missed diagnostic opportunities, inadequate research funding, and a lack of understanding of medical care.

Individuals should, however, take measures to reduce their own risk of dementia:

  • Eating a well-balanced, organic diet: The Mediterranean diet, which is high in fish and vegetables, has been shown to increase cognitive performance.
  • Physical activity should be increased: Regular physical activity and exercise can help to reduce the risk of dementia-related chronic conditions such as high blood pressure, diabetes, and depression.
  • Blood pressure management: Controlling high blood pressure can reduce the risk of stroke and heart disease, both of which have been linked to dementia.
  • Cognitive training: Reading, playing games or puzzles, and doing crafts, according to the National Institute of Aging, can reduce the risk of cognitive impairment.

Conclusion

Because of a complex mix of causes, such as prejudice, racial discrimination, and social barriers to high-quality healthcare, BIPOC are more likely than white people to develop dementia.

Organizations and governments can do a lot to minimise discrimination in science and healthcare, such as addressing the shortage of BIPOC participants in medical trials and addressing the residential segregation that many BIPOC face.

Individuals may be able to minimise their risk of developing dementia by maintaining a healthy diet and lifestyle, managing the symptoms of chronic illnesses, and keeping their brain alert and healthy by playing games and puzzles.

Sources

Last updated on May 16, 2021