Monday, 20 February 2023

Diagnosing Alzheimer's Disease: Black vs White Patients

In the U.S., Black Americans are about 1.5 to 2 times more likely to develop Alzheimer's or related dementias than whites are. Nevertheless, fewer Black than white Americans are diagnosed with Alzheimer's or related dementias. In a study carried out by Lennon et al. (2022), 15 years (ranging from 2005 to 2020) of data on 5.700 Black and 31.225 white participants were tracked. While 36.1% of white participants were diagnosed with Alzheimer's, only 26.8% of Black participants received the diagnosis. Relative to white participants, Black participants had 35% lower odds of having the diagnosis at the initial visit (via).

Black study participants showed higher rates concerning cognitive impairment (particularly processing speed, language, executive function) than white participants, higher rates of hypertension and diabetes - in other words, more potential risk factors for Alzheimer's. In addition, they were twice as likely to experience delusions and hallucinations and generally more likely to show symptoms such as abnormal sleep, appetite or eating changes, irritability, agitation or aggression.

According to the research team, the results are further evidence that - compared to white patients - Black patients usually need more severe clinical presentations to receive a diagnosis of dementia from physicians. The results are backed by the tendency found in numerous studies showing that Black individuals are only diagnosed with Alzheimer's or related dementias when the disease process is more advanced.

Apart from the differences in diagnostic thresholds applied by providers, the scientists believe that these trends are partly due to social attitudes within Black communities in which memory problems are viewed as a normal part of ageing and medical treatment is only sought when neuropsychiatric symptoms (hallucinations, delusions, personality changes) are encountered. 

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- Lennon, J. C., Aita, S. L., Del Bene, V. A., Rhoads, T., Resch, Z. J., Eloi, J. M. Walker, K. A. (2022). Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation. Alzheimer's & Dementia, The Journal of the Alzheimer's Association, 18(8), 1461-1471.
- photograph by Gordon Parks via