Alzheimer disease in African American individuals: increased incidence or not enough data?
Open accessAbstract
Research on racial differences in Alzheimer disease (AD) dementia has increased in recent years. Older African American individuals bear a disproportionate burden of AD and cognitive impairment compared with non-Latino white individuals. Tremendous progress has been made over the past two decades in our understanding of the neurobiological substrates of AD. However, owing to well-documented challenges of study participant recruitment and a persistent lack of biological data in the African American population, knowledge of the drivers of these racial disparities has lagged behind. Therapeutic targets and effective interventions for AD are increasingly sought, but without a better understanding of the disease in African American individuals, any identified treatments and/or cures will evade this rapidly growing at-risk population. In this Perspective, I introduce three key obstacles to progress in understanding racial differences in AD: uncertainty about diagnostic criteria, disparate cross-sectional and longitudinal findings; and a dearth of neuropathological data. I also highlight evidence-informed strategies to move the field forward.
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Accurately measuring the current and future Alzheimer's burden in the United States requires adequate data from Asian, Black, Hispanic, Native American, Alaska Native, and Native Hawaiian and other Pacific Islander communities.
“accurately measuring the current and future burden of Alzheimer's disease in the United States requires adequate data from Asian, Black, Hispanic, Native American, Alaska Native, and Native Hawaiian and other Pacific Islander communities.214”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [214]
The Introduction says the older US population is becoming more racially and ethnically diverse and that African American individuals are under-represented in Alzheimer’s research. The Recruitment of study cohorts section calls for diverse, representative study samples. The paper does not specifically say that data from every community listed are required to measure the current and future US burden accurately; its argument focuses chiefly on African American individuals. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWithout adequate data from diverse racial and ethnic groups, the current and future burden of Alzheimer's disease and Alzheimer's dementia in the United States cannot be accurately measured.
“First, without adequate data from diverse racial and ethnic groups, the current and future burden of Alzheimer's disease and Alzheimer's dementia in the United States cannot be accurately measured.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [234]
The Conclusion (page unavailable) says gaps and inconsistencies in data prevent confidence in estimates of how much higher Alzheimer disease incidence is among African American individuals. The Introduction (page unavailable) gives current and projected US figures, but the paper does not say that the overall current and future US burden cannot be accurately measured across diverse racial and ethnic groups. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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Kumar, V. V., Huang, H., Zhao, L., Verble, D. D., Nutaitis, A. C., Tharwani, S. D., Brown, A. L., Zetterberg, H., Hu, W. T., Shin, R. J., et al. (2020) · Journal of Alzheimer s Disease · doi:10.3233/jad-191103 · Cited by 26 · see citing works
Child, S. T., Kaczynski, A. T., Fair, M. L., Stowe, E. W., Hughey, S. M., Boeckermann, L. M., Wills, S., & Reeder, Y. (2017) · Ethnicity and Health · doi:10.1080/13557858.2017.1351923 · Cited by 22 · see citing works
Croff, R. L., Witter, P., Walker, M. L., Francois, E., Quinn, C., Riley, T., Sharma, N., & Kaye, J. A. (2018) · The Gerontologist · doi:10.1093/geront/gny069 · Cited by 22 · see citing works
Robinson, R. A. S., Williams, I. C., Cameron, J. L., Ward, K., Knox, M. L., Terry, M. H., Tamres, L. K., Mbawuike, U., Garrett, M., & Lingler, J. H. (2020) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.12076 · Cited by 21 · see citing works
Glover, C. M., Shah, R. C., Bennett, D. A., Wilson, R. S., & Barnes, L. L. (2020) · Ethnicity & Disease · doi:10.18865/ed.30.s2.709 · Cited by 20 · see citing works
Self-citationCaveats in the neuropsychological assessment of African Americans.
Campbell, A. L., Ocampo, C., Rorie, K. D., Lewis, S. A., Combs, S., Ford-Booker, P., Briscoe, J., Lewis-Jack, O., Brown, A., Wood, D., et al. (2002) · PubMed Central · Cited by 16 · see citing works
Multiple Influences on Cognitive Function Among Urban-Dwelling African Americans
Wright, R. S., Waldstein, S. R., Gerassimakis, C., Sprung, M. R., Moody, D. L. B., Taylor, A. D., Al-Najjar, E., McNeely, J. M., Zhang, Z., Evans, M. K., et al. (2019) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-019-00584-x · Cited by 16 · see citing works
Glover, C. M., Shah, R. C., Bennett, D. A., Wilson, R. S., & Barnes, L. L. (2020) · Experimental Aging Research · doi:10.1080/0361073x.2020.1747266 · Cited by 15 · see citing works
Self-citationVascular and Alzheimer-type pathology in an autopsy study of African-Americans
Pytel, P., Cochran, E. J., Bonner, G., et al. (2006) · Neurology · doi:10.1212/01.wnl.0000196472.93744.57 · Cited by 13 · see citing works
Black-white mental status trajectories: What ages do differences emerge?
Byrd, D. R., Gee, G. C., & Tarraf, W. (2018) · SSM - Population Health · doi:10.1016/j.ssmph.2018.09.008 · Cited by 13 · see citing works
Effect of Medicare Part D on Ethnoracial Disparities in Antidementia Medication Use
Lind, K. E., Hildreth, K. L., Lindrooth, R. C., et al. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15494 · Cited by 9 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [9]Zuelsdorff, M., Barnes, L. L., & Okonkwo, O. C. In Clinical Cultural Neuroscience: An Integrative Approach to Cross-Cultural Neuropsychology (ed. Pedraza, O.) 233–251 (Oxford Univ. Press, 2020).
- [82]Massey, D. S. & Denton, N. A. American Apartheid: Segregation and the Making of the Underclass (Harvard Univ. Press, 1993).
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2023 Alzheimer's disease facts and figures
(2023) · Alzheimer's & Dementia · doi:10.1002/alz.13016 · Cited by 3,212 · see citing works
2024 Alzheimer's disease facts and figures
(2024) · Alzheimer's & Dementia · doi:10.1002/alz.13809 · Cited by 2,536 · see citing works
Cicero, E. C., Lett, E., Flatt, J. D., Benson, G. P., & Epps, F. (2023) · The Journals of Gerontology: Series B · doi:10.1093/geronb/gbad012 · Cited by 23 · see citing works
- Authors
- Barnes, L. L.
- Affiliations
- Rush University Medical Center (US)
- Corresponding author
- Barnes, Lisa L.
- ORCID
- Barnes, Lisa L.
- Venue
- Nature Reviews Neurology
- Published
- 2021-12-06
- Volume
- 18
- Issue
- 1
- Pages
- 56-62
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- PMC
- PMC8647782
- OpenAlex
- W4200594722
- Cited by
- 142
- References
- 92
- Citations by year
- 2026: 14 · 2025: 33 · 2024: 50 · 2023: 32 · 2022: 13
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- Alzheimer's disease, African Americans, racial disparities, dementia incidence, cognitive impairment, participant recruitment, neuropathology, diagnostic criteria, neural correlates, underrepresented populations in research
- MeSH terms
- Aged, Alzheimer Disease, Black or African American, Data Collection, Ethnicity, Humans, Middle Aged, United States, Incidence
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