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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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Funções cognitivas e memória em adultos com mais de 65 anos em Cumbayá, Quito DM, Equador
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“Our analysis has several strengths, including quantifying the association between CRP and incident dementia in a large (n=5,143) large and diverse sample of older adults in the United States.”
InfluentialWakawa, I. A., Musami, U. B., Kwairanga, S. H., Ogualili, P. N., Mahmood, M. Y., Fugu, M. A., Gimba, M. M., Allamin, M. M., Abbas, Z. U., Sunkani, M. K., et al. (2024) · medRxiv · doi:10.1101/2024.09.09.24313311 · Cited by 2
Ancestry-specific effects of APOE on Alzheimer Disease EndophenotypesPreprint
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“Given that Latinx adults develop dementia nearly seven years earlier than non-Latinx Whites (Clark et al., 2005), tend to live more years with dementia than non-Latinx Whites (Garcia et al., 2019) and that our sample was comprised of younger Latinx adults (58% 51 – 64 years, 42% 65 years and older) than the sample exa…”
InfluentialChen, A., Shea, D. W., & Daggett, V. (2024) · Scientific Reports · doi:10.1038/s41598-024-57107-w · Cited by 1
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Achieving Inclusion in Pharmacological Clinical Trials for Alzheimer’s Disease
Molina‐Henry, D. P., & Raman, R. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_522 · Cited by 1
Associations between APOE‐TOMM40 ‘523 haplotypes and limbic system white matter microstructure
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“In fact, about one in three AI/AN people aged 65 or older may be diagnosed with dementia during the next 25 years (Mayeda et al. 2016).”
Birth weight, incident dementia risk, and PET amyloid burden: The ARIC study
Emanuel, O. M., Lee, M. W., Lutsey, P. L., Sullivan, K., Groechel, R. C., Egle, M. S., Mosley, T. H., Schneider, A. L. C., Wong, D. F., & Gottesman, R. F. (2025) · Alzheimer s & Dementia · doi:10.1002/alz.70609 · Cited by 1
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Promoting risk reduction: increasing public health capacity to address dementia
Roberts, S. S., Lewis, M., Colcombe, C. W., Kline, C., Donnelly, J. M., Denno, B., Snyder, H. M., & Baumgart, M. (2025) · The Gerontologist · doi:10.1093/geront/gnaf227 · Cited by 1
Sex/gender differences in lifetime dementia risk among Asian American and White older adults
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Self-citationCulturally sensitive CLEAR guidelines on disclosing and communicating a diagnosis of dementia
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Preexisting cognitive impairment in patients with acute stroke
Kassir, S., & Béjot, Y. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1629461 · Cited by 1
“At the global level, evidence indicates disparities in the prevalence of cognitive disorders across ethnic group (60) and in stroke risk between low-and high-income countries (61, 62), thus emphasizing the importance of ethnically and socioeconomically inclusive research.”
Alzheimer's disease multi‐ancestry genome‐wide interaction and stratified study with smoking
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“32] African Americans often develop HTN earlier, with more severe progression and poorer control, heightening the risk of vascular dementia.”
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Estimated prevalence of underdiagnosed dementia in a multiethnic community-based study
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“In the same line of thought, African Americans aged 64 years and older experience an estimated 27 cases of all-cause dementia per 1000 person-years, compared with 19 cases per 1000 person-years for White Americans [21,22].”
Bevers, S. G., Issaian, A., Hay, A., Keele, G. R., Dzieciątkowska, M., Reisz, J. A., Haiman, Z. B., Nemkov, T. G., Stephenson, D., Moore, A. L., et al. (2026) · HemaSphere · doi:10.1002/hem3.70361 · Cited by 1
“…populations — despite similarly high frequencies of the PIMT I120 allele — experience a higher incidence of AD compared to white populations, 55 a disparity driven by a convergence of cardiovascular risk factors, systemic health inequities, and ancestry ‐ specific genetic variants (e.g.,…”
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Self-citationParticulate air pollution and domain‐specific cognition among Black adults
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Multiracial participants in Alzheimer's research: scoping review and recommendations
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“106,107 Results from the Strong Heart Study indicated that a cohort of older adult American Indianparticipantshada54%prevalencerateofcognitiveimpairment, largelyattributabletovascularcausesandAD.”
Functional Communication Assessment in Persons With Dementia: Wins, Gaps, and Challenges
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“25,26 31 Extrapolation of existing cutoffs without appropriate population-specific evaluation has the potential to skew enrollment of certainpopulationsinclinicaltrialsforpre-clinicalAD,offeringapoten-tial explanation for the disproportionate screen-fail rate observed in Black/Hispanic participants…”
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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