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Inequalities in dementia incidence between six racial and ethnic groups over 14 years
Open accessAbstract
Introduction: Reducing racial/ethnic disparities is a primary objective of the National Alzheimer's Plan (NAPA), yet direct comparisons within large samples representing diversity of the United States are lacking. Methods: Dementia incidence from January 1, 2000 to December 31, 2013 and a 25‐year cumulative risk in 274,283 health care members aged 64+ (n = 18,778 African‐American, n = 4543 American Indian/Alaska Native [AIAN], n = 21,000 Latino, n = 440 Pacific Islander, n = 206,490 white, n = 23,032 Asian‐Americans). Cox proportional hazard models were adjusted for age, sex, medical utilization, and comorbidities. Results: Dementia incidence (n = 59,555) was highest for African‐Americans (26.6/1000 person‐years) and AIANs (22.2/1000 person‐years); intermediate for Latinos (19.6/1000 person‐years), Pacific Islanders (19.6/1000 person‐years), and whites (19.3/1000 person‐years) and lowest among Asian‐Americans (15.2/1000 person‐years). Risk was 65% greater for African‐Americans (hazard ratio = 1.65; 95% confidence interval = 1.58–1.72) versus Asian‐Americans. Cumulative 25‐year risk at age 65 was as follows: 38% African‐Americans, 35% AIANs, 32% Latino, 25% Pacific Islanders, 30% white, and 28% Asian‐Americans. Discussion: Dementia rates varied over 60% between groups, providing a comprehensive benchmark for the NAPA goal of reducing disparities.
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“Its findings indicated that dementia incidence — determined by the first presence of a dementia diagnosis in members’ medical records — was highest among African American older adults (the term used in the study for those who self‐reported as Black or African‐American); intermediate for Latino older adults (the term used in the study for those who self‐reported as Latino or Hispanic), American”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [347]
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“Studies examining ADRD incidence in Indian Country have estimated that incidence rates are higher in American Indians/Alaska Natives than in Whites and that one in three American Indians/Alaska Natives aged 65 and older will receive a dementia diagnosis during the next 25 years (47).”
BackgroundScherrer, J. F., Salas, J., Wiemken, T. L., Hoft, D. F., Jacobs, C. K., & Morley, J. E. (2021) · PLoS ONE · doi:10.1371/journal.pone.0257405 · Cited by 84
“Prior studies have shown black persons have a higher incidence of dementia [21].”
BackgroundKivimäki, M., Walker, K. A., Pentti, J., Nyberg, S. T., Mars, N., Vahtera, J., Suominen, S. B., Lallukka, T., Rahkonen, O., Pietiläinen, O., et al. (2021) · BMJ · doi:10.1136/bmj.n1804 · Cited by 99
What the Aducanumab Approval Reveals About Alzheimer Disease Research
Manly, J. J., & Glymour, M. M. (2021) · JAMA Neurology · doi:10.1001/jamaneurol.2021.3404 · Cited by 83
Self-citationAssociation Between Birth in a High Stroke Mortality State, Race, and Risk of Dementia
Gilsanz, P., Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., & Whitmer, R. A. (2017) · JAMA Neurology · doi:10.1001/jamaneurol.2017.1553 · Cited by 84
“This method of death ascertainment has previously been used in studies of this population.(12,25) Key Points”
BackgroundMethodSelf-citationDimensions of Religious Involvement Represent Positive Pathways in Cognitive Aging
Kraal, A. Z., Sharifian, N., Zaheed, A. B., Sol, K., & Zahodne, L. B. (2019) · Research on Aging · doi:10.1177/0164027519862745 · Cited by 82
Ethnic Differences in Dementia Risk: A Systematic Review and Meta-Analysis
Shiekh, S. I., Cadogan, S. L., Lin, L.-Y., Mathur, R., Smeeth, L. L., & Warren‐Gash, C. (2021) · Journal of Alzheimer s Disease · doi:10.3233/jad-201209 · Cited by 85
“…non-ambulatory status 1,168 White 817 Black unclear average follow-up of 3.9 years 1944 total, mean age of cohort at baseline 78.8 years, 39.3% male Mayeda 2016 [17] US, EHR Cohort 2000–2013 EHR English 65 years or older, included in KPNC database, no dementia diagnosis at study onset 274,283…”
BackgroundInfluentialOmura, J. D., McGuire, L. C., Patel, R., Baumgart, M., Lamb, R., Jeffers, E. M., Olivari, B. S., Croft, J. B., Thomas, C. W., & Hacker, K. A. (2022) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7120a2 · Cited by 82
Rizvi, B., Lao, P. J., Chesebro, A. G., Dworkin, J. D., Amarante, E., Beato, J. M., Gutierrez, J., Zahodne, L. B., Schupf, N., Manly, J. J., et al. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.25166 · Cited by 79
Race/Ethnic Disparities in Mild Cognitive Impairment and Dementia: The Northern Manhattan Study
Wright, C. B., DeRosa, J. T., Moon, M. P., Strobino, K., DeCarli, C. S., Cheung, Y. K., Assuras, S., Levin, B. E., Stern, Y., Sun, X., et al. (2021) · Journal of Alzheimer s Disease · doi:10.3233/jad-201370 · Cited by 81
Ford, E. M., Milne, R., & Curlewis, K. (2023) · Wiley Interdisciplinary Reviews Data Mining and Knowledge Discovery · doi:10.1002/widm.1492 · Cited by 81
“Hence, for example, in the United States, African-Americans are at greater risk of dementia than whites and Asian-Americans (Mayeda et al., 2016), as are those living in areas of the United Kingdom with higher levels of deprivation (Matthews et al.”
BackgroundGrant, W. B. (2016) · Journal of the American College of Nutrition · doi:10.1080/07315724.2016.1161566 · Cited by 79
“A recent paper presented findings on inequalities in dementia incidence between 6 racial and ethnic groups over 14 years [129].”
BackgroundCaunca, M. R., Odden, M. C., Glymour, M. M., Elfassy, T., Kershaw, K. N., Sidney, S., Yaffe, K., Launer, L., & Zeki Al Hazzouri, A. (2020) · JAMA Neurology · doi:10.1001/jamaneurol.2020.0860 · Cited by 73
“Body mass index, mean (SD)b 25 (6) 26 (6) 25 (5)”
Self-citationSocial Isolation: An Unequally Distributed Health Hazard
Umberson, D., & Donnelly, R. (2023) · Annual Review of Sociology · doi:10.1146/annurev-soc-031021-012001 · Cited by 90
Atri, A., Dickerson, B. C., Clevenger, C. K., Karlawish, J. H., Knopman, D. S., Lin, P., Norman, M., Onyike, C. U., Sano, M., Scanland, S., et al. (2024) · Alzheimer s & Dementia · doi:10.1002/alz.14333 · Cited by 84
“159,162 The prevalence rates are likely underestimated, and better data are needed, particularly in Native American, most Asian American, and Pacific Islander populations.”
Avila, J. F., Rentería, M. A., Witkiewitz, K. A., Verney, S. P., Vonk, J. M. J., & Manly, J. J. (2019) · Neuropsychology · doi:10.1037/neu0000584 · Cited by 76
Portacolone, E., Chodos, A. H., Halpern, J., Covinsky, K. E., Keiser, S., Fung, J., Rivera, E., Tran, T., Bykhovsky, C., & Johnson, J. K. (2020) · The Gerontologist · doi:10.1093/geront/gnaa201 · Cited by 72
Heterogeneity in 14-year Dementia Incidence Between Asian American Subgroups
Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., & Whitmer, R. A. (2017) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000189 · Cited by 70
Self-citationStressors in Midlife and Risk of Dementia
Gilsanz, P., Quesenberry, C. P., Mayeda, E. R., Glymour, M. M., Farias, S. T., & Whitmer, R. A. (2019) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000313 · Cited by 74
Self-citationRepresentativeness of samples enrolled in Alzheimer's disease research centers
Rentería, M. A., Mobley, T. M., Evangelista, N. D., Medina, L. D., Deters, K., Fox‐Fuller, J. T., Minto, L. R., Avila‐Rieger, J. F., & Bettcher, B. M. (2023) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1002/dad2.12450 · Cited by 72
Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review
Ding, Z., Lee, T., & Chan, A. S.-Y. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11144191 · Cited by 69
Sex/gender differences in cognitive trajectories vary as a function of race/ethnicity
Avila, J. F., Vonk, J. M. J., Verney, S. P., Witkiewitz, K. A., Rentería, M. A., Schupf, N., Mayeux, R. P., & Manly, J. J. (2019) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2019.04.006 · Cited by 76
“Consistent with recent literature among racial/ethnic groups in the United States [44], there were no within racial/ethnic group sex/gender differences in incidence rates for NHWs and Blacks.”
BackgroundAfrican ancestry GWAS of dementia in a large military cohort identifies significant risk loci
Sherva, R., Zhang, R., Sahelijo, N., Jun, G., Anglin, T., Chanfreau, C., Cho, K., Fonda, J. R., Gaziano, J. M., Harrington, K. M., et al. (2023) · Molecular Psychiatry · doi:10.1038/s41380-022-01890-3 · Cited by 68
Predicting Cognitive Impairment and Dementia: A Machine Learning Approach
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“Likewise, Hispanics were associated with 65% greater chance to develop cognitive impairment.”
Shaw, A. R., Perales‐Puchalt, J., Johnson, E., Espinoza-Kissell, P., Acosta-Rullán, M., Frederick, S., Lewis, A., Chang, H., Mahnken, J. D., & Vidoni, E. D. (2021) · The Journal of Prevention of Alzheimer s Disease · doi:10.14283/jpad.2021.49 · Cited by 67
Edwards, R. D., Brenowitz, W. D., Portacolone, E., Covinsky, K. E., Bindman, A. B., Glymour, M. M., & Torres, J. M. (2020) · Alzheimer s & Dementia · doi:10.1002/alz.12102 · Cited by 64
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“Racial disparities in ADRD in the United States are widely documented, with prior research showing that Black Americans are more likely to develop ADRD than their White counterparts (2,3).”
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Neuroimaging of Cerebral Small Vessel Disease and Age-Related Cognitive Changes
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Time, Sex, Gender, History, and Dementia
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Health Disparities in Dementia
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Association of Sleep Electroencephalography-Based Brain Age Index With Dementia
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Donanemab for Alzheimer Disease—Who Benefits and Who Is Harmed?
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Shaw, C., Hayes-Larson, E., Glymour, M. M., Dufouil, C., Hohman, T. J., Whitmer, R. A., Kobayashi, L. C., Brookmeyer, R., & Mayeda, E. R. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.1001 · Cited by 60
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Atrial Fibrillation and Cognitive Impairment: New Insights and Future Directions
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Metadata
- Authors
- Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., & Whitmer, R. A.
- Affiliations
- University of California, San Francisco (US)
- Kaiser Permanente (US)
- Corresponding author
- Whitmer, Rachel A.
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2016-02-10
- Volume
- 12
- Issue
- 3
- Pages
- 216-224
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC4969071
- OpenAlex
- W2266863819
- Cited by
- 883
- References
- 51
- Citations by year
- 2026: 98 · 2025: 109 · 2024: 112 · 2023: 113 · 2022: 113 · 2021: 100 · 2020: 96 · 2019: 66 · 2018: 41 · 2017: 27 · 2016: 7
- FWCI
- 41.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- dementia incidence, racial and ethnic disparities
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Black or African American, Delivery of Health Care, Dementia, Ethnicity, Female, Hispanic or Latino, Humans, Indians, North American, Longitudinal Studies, Male, Middle Aged, Sex Factors, Socioeconomic Factors, United States, Incidence, Proportional Hazards Models, White People
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