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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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“…to an increased prevalence of health conditions, such as cardiovascular diseases, chronic stress, kidney disease, obesity, and diabetes [3,4,7,10 – 15], all of which are either well-established risk-factors for ADRD or comorbid conditions with ADRD due to shared biological pathways such as…”
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“47,48 Likewise, related studies investigating sex and race differences are needed to support both intervention efforts and diversity, equity, and inclusion (DEI)research.”
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“55,56 For instance, the number of primary healthcare providersandspecialistsper1000olderadultswas6.”
Financial Incentives to Increase Diversity of Older Participants in a Memory Concerns Registry
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Social Inequalities in Dementia Care, Cure, and Research
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Associations Between Parity and Cognition: Race/Ethnic Differences
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Contribution of life course cardiovascular risk factors to racial disparities in dementia incidence
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“Disparities in dementia incidence and treatment are documented among other racial groups such as Hispanic and Asian individuals (Mayeda et al., 2016; Chen and Zissimopoulos, 2018; Kawas et al., 2021).”
BackgroundGooding, D. C., Carter, F. P., Umucu, E., Hulle, C. A. V., Lewis, J., Zuelsdorff, M. L., Bouges, S., James, T. T., Salazar, H., Floyd, L., et al. (2024) · Biomarkers in Neuropsychiatry · doi:10.1016/j.bionps.2024.100090 · Cited by 6
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Health System Readiness for Disease-Modifying Therapies for Alzheimer Disease
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College Selectivity and Later-Life Memory Function: Evidence From the Wisconsin Longitudinal Study
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“The inability to study other racial and ethnic groups is particularly challenging given racial and ethnic disparities in dementia incidence (Mayeda et al., 2016) and low rates of access to selective colleges (Reardon et al., 2012).”
BackgroundVascular Dementia and Cognitive Impairment
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“[13-15] As such, the resounding under-36 representation and under-inclusion of Black and Latino adults in ADRD research severely impedes the field’s advancement.”
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“3,4 7 For instance, understanding why marked disparities in rates of cognitive impairment exist across different racial and ethnic groups 8 requiresrecruitmentofdiverseindividuals—manyofwhomdo not speak English—into longitudinal studies of cognitive aging.”
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“…attention to an often excluded ethnic group by examining within-group factors associated with cognitive function among Indigenous older adults, and 4) demonstrate that longitudinal analyses of modifiable factors associated with Indigenous cognitive health are viable despite “small sample sizes.””
Palliative Care Resource Utilization in Patients With Prion Disease
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“Racial and ethnic minorities, such as Black/African American (Black/ AA) participants, have been historically underrepresented in studies of ADRD, 14 despite their disproportionately higher risk 15 and greater disease prevalence of ADRD 16 relative to non-Hispanic Whites.”
Disparity of Prescribed Psychotropics in Alzheimer’s Disease with Neuropsychiatric Symptoms
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“NHB adults experience a higher prevalence of AD and related dementias and exhibit a greater burden of vascular comorbidities that contribute to mixed neuropathology and atypical clinical presentations [35].”
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Structural Disadvantage in Adolescence and Biological Aging in Early Midlife
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Body Mass Index and Memory Across 18 Years in the Wisconsin Longitudinal Study
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“Alzheimer’s Disease (AD) is a dominant degenerative brain disease among elderly people, and it will increase in prevalence and cost at unsustainable levels [1].”
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“Whilst this cohort offered a fairly homogeneous foundation population for determining exposure influence, there exists an inequality in the dementia incidence across racial and ethnic groups which could not be assessed due to the lack of diversity within this regional birth cohort 56 .”
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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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