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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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Zhu, C. W., & Sano, M. C. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.610334 · Cited by 38
“3/1,000 among non-Hispanic whites (31).”
Wright, A. C., Lin, G. A., Whittington, M. D., Agboola, F. O., Herron-Smith, S., Rind, D. M., & Pearson, S. D. (2023) · Journal of Managed Care & Specialty Pharmacy · doi:10.18553/jmcp.2023.29.9.1078 · Cited by 37
Diabetic Retinopathy and Dementia in Type 1 Diabetes
Rodill, L. G., Exalto, L. G., Gilsanz, P., Biessels, G. J., Quesenberry, C. P., & Whitmer, R. A. (2017) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000230 · Cited by 36
Self-citationSchool Context in Adolescence and Cognitive Functioning 50 Years Later
Moorman, S. M., Greenfield, E. A., & García, S. (2019) · Journal of Health and Social Behavior · doi:10.1177/0022146519887354 · Cited by 37
“Second, the study’s lack of inclusion of older adults of color is especially problematic given dramatic racial-ethnic disparities in Alzheimer’s disease and other aspects of cognitive aging (Carvalho et al. 2015), which likely parallel inequalities in secondary school advantage (Mayeda et al. 2016).”
BackgroundRoche, M., HIGGS, P. F. D., Aworinde, J., & Cooper, C. (2020) · The Gerontologist · doi:10.1093/geront/gnaa004 · Cited by 37
“Dementia age-standardized rates are observed to be consistently higher in BAC ethnic groups than in other minority populations (Mehta & Yeo, 2017) and the majority population (Adelman, Blanchard, Rait, Leavey, & Livingston, 2011; Mayeda, Glymour, Quesenberry, & Whitmer, 2016).”
APOE and immunity: Research highlights
Kloske, C. M., Barnum, C. J., Batista, A. F., Bradshaw, E. M., Brickman, A. M., Bu, G., Dennison, J. L., Gearon, M. D., Goate, A., Haass, C., et al. (2023) · Alzheimer s & Dementia · doi:10.1002/alz.13020 · Cited by 38
Racial Discrimination, Neural Connectivity, and Epigenetic Aging Among Black Women
Elbasheir, A., Katrinli, S., Kearney, B. E., Lanius, R. A., Harnett, N., Carter, S. E., Ely, T., Bradley, B., Gillespie, C. F., Stevens, J. S., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.16588 · Cited by 23
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“African American older adults are disproportionately more likely to be afflicted by age-related cognitive declines and diseases (Mayeda et al., 2016; Tang et al., 2001).”
Abramsohn, E., Jerome, J. S., Paradise, K., Kostas, T., Spacht, W. A., & Lindau, S. T. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1341-6 · Cited by 36
“This recommendation is particularly pertinent for African Americans, who bear a higher disease burden, may be less likely to access endof-life care options and are more likely to rely on informal caregivers for support [41, 43].”
BackgroundZlatar, Z. Z., Tarraf, W., González, K. A., Vásquez, P. M., Marquine, M. J., Lipton, R. B., Gallo, L. C., Khambaty, T., Zeng, D., Youngblood, M., et al. (2021) · Alzheimer s & Dementia · doi:10.1002/alz.12381 · Cited by 34
Interventions to promote dementia knowledge among racial/ethnic minority groups: A systematic review
Huggins, L. K. L., Min, S. H., Dennis, C., Østbye, T., Johnson, K. S., & Xu, H. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17495 · Cited by 35
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“9 However, population-based research has suggested, based on application of conventional thresholds for standardized cognitive tests, that approximately half of American Indians over age 65 may have detectable cognitive impairment and dementia.”
BackgroundAkarsu, N., Prince, M. J., Lawrence, V. C., & Das‐Munshi, J. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5070 · Cited by 34
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Incidence of dementia after age 90 in a multiracial cohort
Gilsanz, P., Corrada, M. M., Kawas, C. H., Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., Lee, C., & Whitmer, R. A. (2019) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2018.12.006 · Cited by 34
“The study showed an elevated relative risk of dementia among blacks, American Indian and Alaska Natives, Latinos, and whites compared with Asians adjusting for age and sex [6].”
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Racial/Ethnic Differences in Health‐Related Quality of Life in Persons With and Without Dementia
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Mobley, T. M., Shaw, C. L., Hayes‐Larson, E., Fong, J., Gilsanz, P., Gee, G. C., Brookmeyer, R., Whitmer, R. A., Casey, J. A., & Mayeda, E. R. (2022) · Alzheimer s & Dementia · doi:10.1002/alz.12660 · Cited by 34
Self-citationThe role of nutrition and the Mediterranean diet on the trajectories of cognitive decline
Maggi, S., Ticinesi, A., Limongi, F., Noale, M., & Ecarnot, F. (2023) · Experimental Gerontology · doi:10.1016/j.exger.2023.112110 · Cited by 35
“Minority populations are also disproportionately affected, with African-Americans shown to have a 65 % higher risk of dementia than Asian-Americans (Mayeda et al., 2016).”
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“Women (Mazure and Swendsen, 2016), people of color (Mayeda et al., 2016), older age groups (Xia et al.”
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Disparities in Diffuse Cortical White Matter Integrity Between Socioeconomic Groups
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“Recent studies also find that they often have dementia at earlier ages and face two to three times higher dementia risk than Whites (Mayeda et al., 2016; Umberson et al., 2019; Zhang et al., 2016).”
BackgroundThe Relationship of APOE ε4, Race, and Sex on the Age of Onset and Risk of Dementia
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Intersectional Approaches to Minority Aging Research
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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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