Prevalence of dementia in African–Caribbean compared with UK-born White older people: two-stage cross-sectional study
Open accessAbstract
Background: Preliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African–Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures. Aims: To determine the prevalence of dementia in older people of African–Caribbean country of birth compared with their White UK-born counterparts. Method: A total of 218 people of African–Caribbean country of birth and 218 White UK-born people aged ⩾60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria. Results: African–Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African–Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3–7.3, P = 0.012). Conclusions: There is an increased prevalence of dementia in older people of African–Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.
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Underserved ethnic groups, such as the Māori group in New Zealand, First Nation groups in Australia, Black individuals in the US and UK, and Hispanic individuals in the US, have higher prevalence of potentially modifiable risk factors.
“Underserved ethnic groups, such as the Māori group in New Zealand, First Nation groups in Australia, Black individuals in the US and UK, and Hispanic individuals in the US, have higher prevalence of potentially modifiable risk factors.(38-45)”
From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [38]
The Background links possible excess dementia in UK African-Caribbean people to vascular risk factors that may be amenable to prevention, and Clinical and policy implications discusses treating hypertension. But the paper does not establish that modifiable risk factors are more prevalent in that group than in White people, and it does not address the other populations listed. (LLM, conf=0.76)
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References 35 · Cited by 87
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- Authors
- Adelman, S., Blanchard, M., Rait, G., Leavey, G., & Livingston, G.
- Affiliations
- University College London (GB)
- University of Ulster (GB)
- Corresponding author
- Adelman, Simon
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2011-08
- Volume
- 199
- Issue
- 2
- Pages
- 119-125
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W1978424189
- Cited by
- 87
- References
- 35
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 10 · 2021: 9 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 9 · 2012: 3
- FWCI
- 3.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- University College London
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- dementia prevalence, ethnic minority health, vascular risk factors, social adversity, cognitive screening, dementia prevention, socioeconomic status
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Dementia, Epidemiologic Methods, Family Practice, Female, United Kingdom, Guyana, Health Services Accessibility, Humans, Interview, Psychological, Male, Mental Status Schedule, Middle Aged, Minority Groups, Socioeconomic Factors, Urban Population, Caribbean Region, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Black People, White People, Emigrants and Immigrants, Healthcare Disparities
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