Diversity and Disparity in Dementia: The Impact of Ethnoracial Differences in Alzheimer Disease
Open accessAbstract
Debate exists regarding differences in the prevalence of Alzheimer disease (AD) in African Americans and Hispanics in the United States, with some evidence suggesting that the prevalence of AD may be considerably higher in these groups than in non-Hispanic whites. Despite this possible disparity, patients of minority ethnoracial groups often receive delayed diagnosis or inadequate treatment for dementia. This review investigates these disparities by conceptualizing the dementia disease process as a product of both biological and cultural factors. Ethnoracial differences in biological risk factors, such as genetics and cardiovascular disease, may help to explain disparities in the incidence and prevalence of AD, whereas race-specific cultural factors may impact diagnosis and treatment. Cultural factors include differences in perceptions about what is normal aging and what is not, lack of adequate access to medical care, and issues of trust between minority groups and the medical establishment. The diagnosis of AD in diverse populations may also be complicated by racial biases inherent in cognitive screening tools widely used by clinicians, but controlling for literacy level or using savings scores in psychometric analyses has the potential to mitigate these biases. We also suggest that emerging biomarker-based diagnostic tools may be useful in further characterizing diverse populations with AD. Recognizing the gap in communication that exists between minority communities and the medical research community, we propose that education and outreach are a critical next step in the effort to understand AD as it relates to diverse populations.
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Race does not have a genetic basis, and genetic factors do not account for the large differences in prevalence and incidence among racial groups.
“Race does not have a genetic basis, and genetic factors do not account for the large differences in prevalence and incidence among racial groups.”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [306]
In “Biological Basis of AD: Risk Factors in Diverse Populations” (page unavailable), the review says factors other than genetics may account for a large proportion of increased AD risk in non-white populations. But “Epidemiologic Differences and AD” describes the biological basis of race as poorly understood, not nonexistent, and the review does not rule out genetic contributions to differences in prevalence and incidence. (LLM, conf=0.86)
Experimental — accuracy not yet measuredRace is a social construct with little to no genetic or biological basis.
“Race is a social construct with little to no genetic or biological basis.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [332]
The Epidemiologic Differences and AD section describes substantial diversity within ethnoracial groups and says race may serve as a surrogate for other dementia risk factors, including educational attainment. It does not state that race is a social construct with little to no genetic or biological basis; instead, it says the biological basis of race is poorly understood. The Introduction also discusses possible ethnoracial differences in genetic risk factors for Alzheimer’s disease. (LLM, conf=0.82)
Experimental — accuracy not yet measuredGenetic factors do not account for the large differences in prevalence and incidence among racial groups.
“Instead, race is an idea created and used throughout history by groups in power to justify their control and dominance over other groups, and genetic factors do not account for the large differences in prevalence and incidence among racial groups.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [332]
The Biological Basis of AD section says genetic risk may be similar across groups and that factors other than genetics may account for a large proportion of increased AD risk. But the Introduction says genetic differences may help explain some differences in AD incidence and prevalence, so the categorical exclusion of genetic factors overstates the paper. Page numbers are not available in the supplied passages. (LLM, conf=0.88)
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STIGMATIZATION IN ALZHEIMER'S DISEASE RESEARCH ON AFRICAN AMERICAN ELDERS
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Cholinesterase Inhibitors for Alzheimer Disease: Do They Provide More Than Symptomatic Benefits?
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Flagged first, then by citations
Research works printed but not linked: 3
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- Authors
- Chin, A. L., Negash, S., & Hamilton, R.
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- Chin, Alexander L.
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2011-07
- Volume
- 25
- Issue
- 3
- Pages
- 187-195
- ISSN
- 0893-0341 (ISSN-L)
- PMC
- PMC3396146
- OpenAlex
- W2000808937
- Cited by
- 416
- References
- 88
- Citations by year
- 2026: 23 · 2025: 52 · 2024: 44 · 2023: 50 · 2022: 42 · 2021: 51 · 2020: 38 · 2019: 17 · 2018: 24 · 2017: 13 · 2016: 18 · 2015: 12 · 2014: 12 · 2013: 12 · 2012: 7
- FWCI
- 7.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Research Resources (KL2RR024151, K12RR24151)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- Alzheimer's disease, dementia, racial disparities, African Americans, Hispanic Americans, minority health, cultural factors, biological risk factors, cardiovascular disease, genetic risk, health care access, literacy, biomarker-based diagnosis
- MeSH terms
- Alzheimer Disease, Black or African American, Hispanic or Latino, Humans, United States, Prevalence, White People, Health Status Disparities, Healthcare Disparities
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