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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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Clinical investigation cases studies and critical thinking problem approaches
ZEIDAN, H. M., & ZEIDAN, I. H. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-21632-9.00010-8
Lapcinski, I. P., Petersen, A. J., Ashe, K. H., & Liu, P. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.04.11.648457
Hu, Y., Elliott, M. R., Meier, H. C. S., Chen, L., Walters, M. E., Sol, K., & Zahodne, L. B. (2025) · American Journal of Epidemiology · doi:10.1093/aje/kwaf131
Uddin, J., Blasco, D., Grigsby, T. J., John, S. E., Cross, C. L., & Flatt, J. D. (2025) · Journal of Palliative Medicine · doi:10.1089/jpm.2025.0039 · Cited by 1
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Sapkota, S., Maillard, P., Fletcher, E. M., Harvey, D. J., Olichney, J., Farias, S. T., Gilsanz, P., Mungas, D., Whitmer, R. A., & DeCarli, C. S. (2025) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2025.07.002
“Future work with larger sample sizes and longer follow-ups should consider examining the importance of lifestyle risk factors in Asians as well as other ethnic and racial minorities.”
InfluentialSelf-citationGooding, D. C., Boykin, C. M., Hulle, C. A. V., Bouges, S., Lewis, J., Benton, S. F., Carter, F. P., & Gleason, C. E. (2025) · Journal of Alzheimer s Disease Reports · doi:10.1177/25424823251361513
“…dementia (ADRD) among minoritized (e.g., African Americans, American Indian/Alaska Natives, and Latinx) groups and their inclusion in dementia studies, especially clinical trials, 5,10 – 12 there has been increasing focus on understanding minoritized groups ’ openness to engage in ADRD research.”
Fong, J. C., Chavez, F. I., Silos, K., Arroyo‐Miranda, M. L., Castro, G. C., Kunik, M. E., Shulman, J. M., & Medina, L. D. (2025) · medRxiv · doi:10.1101/2025.08.19.25334002
“However, most AD research studies and trials have included predominantly NHW adults, 13,14 and programs serving as national resources for AD research have not yet achieved inclusion of a H/L cohort representative of the national U.S. population.”
Ahmmad, M. R., Hossain, M. E., Khan, M. T. F., & Paudel, S. (2025) · Journal of Alzheimer s Disease Reports · doi:10.1177/25424823251377691
Ahmed, M. M., Shahzad, U. B., Aiman, U., Nabi, R., Nadeem, M., Saleem, M. F., Ansab, M., Zaide, D. B., Ahmed, S., Farhan, M., et al. (2025) · Research Square · doi:10.21203/rs.3.rs-7566108/v1
Akter, S., Bawa, E. M., Riccardi, N., Amoatika, D. A., Miller, M. C., Owens, O. L., Donelle, L., Murphy, E. A., Fan, D., Moss, M. A., et al. (2025) · Journal of Alzheimer s Disease Reports · doi:10.1177/25424823251385902
“12,20,21 The University of South Carolina (USC) Alzheimer ’ s disease research group USC contributes to a statewide initiative to address ADRD through the South Carolina Alzheimer ’ s Disease Research Center (ADRC) with funding from the South Carolina Department of Health and Human Services to…”
Communication disorders in neurodegenerative disease
Mueller, K. D. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780198888482.013.0001
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Dintica, C. S., & Yaffe, K. S. (2025) · Cambridge University Press eBooks · doi:10.1017/9781108985055.008
Oxidative stress in brain accelerates the onset of neurodegeneration in hyperglycemic individuals
Rios-Dávila, A. A., Pérez‐Capistran, T., Rodríguez-Vera, D., Mera-Jiménez, E., Rodríguez, M. H., & Soriano-Ursua, M. A. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-33355-2.00004-9
The effects of nicotine on neurocognitive outcomes: evidence from a polygenic risk score analysisPreprint
Khatun, T., Bothongo, P. L., Williams, D. M., Khouja, J. N., & Anderson, E. L. (2025) · medRxiv · doi:10.64898/2025.11.27.25341175
Sofer, T., Kurniansyah, N., Granot‐Hershkovitz, E., Goodman, M. O., Tarraf, W., Broce, I., Lipton, R. B., Daviglus, M., Lamar, M., Wassertheil-Smoller, S., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26613895
Liu, B., Ornstein, K. A., Frydman, J. L., Kelley, A., Benn, E. K. T., & Siu, A. L. (2022) · Figshare · doi:10.6084/m9.figshare.20472486
Miller, M. W., Wolf, E. J., Zhao, X., Logue, M. W., & Hawn, S. E. (2024) · Figshare · doi:10.6084/m9.figshare.26687882
Ribeiro, F. S., Duarte, Y. A. D. O., Santos, J. L. F., & Leist, A. K. (2021) · Figshare · doi:10.6084/m9.figshare.16892973
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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