Ethnic Groups Vary In Susceptibility To Alzheimer’s
Autopsy Confirmation Of Ad Pathology
Neuropathological confirmation of the presence and severity of AD pathology among patients diagnosed with AD is the only way to confirm ethnic discrepancies in AD prevalence and incidence. However, African Americans and other ethnic minorities are less likely to consent to autopsy . Therefore, there are few published studies comparing the rates of neuropathologically defined AD among different ethnic groups in the United States most published neuropathological studies of AD have examined whites almost exclusively. The few studies with ethnically diverse samples have found, among those autopsied, no racial differences in frequency of AD pathology , or that AD lesions are more prevalent among whites than among blacks . Small sample size is a problem for each of these studies, and because there is a much lower rate of consent for autopsy among African Americans, there may be a selection bias.
How Is Alzheimers Disease Diagnosed
Doctors use several methods and tools to help determine whether a person who is having memory problems has Alzheimers disease.
To diagnose Alzheimers, doctors may:
- Ask the person and a family member or friend questions about overall health, use of prescription and over-the-counter medicines, diet, past medical problems, ability to carry out daily activities, and changes in behavior and personality.
- Conduct tests of memory, problem solving, attention, counting, and language.
- Carry out standard medical tests, such as blood and urine tests, to identify other possible causes of the problem.
- Perform brain scans, such as computed tomography , magnetic resonance imaging , or positron emission tomography , to support an Alzheimers diagnosis or to rule out other possible causes for symptoms.
These tests may be repeated to give doctors information about how the persons memory and other cognitive functions are changing over time.
People with memory and thinking concerns should talk to their doctor to find out whether their symptoms are due to Alzheimers or another cause, such as stroke, tumor, Parkinsons disease, sleep disturbances, side effects of medication, an infection, or another type of dementia. Some of these conditions may be treatable and possibly reversible.
In addition, an early diagnosis provides people with more opportunities to participate in clinical trials or other research studies testing possible new treatments for Alzheimers.
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Outreach To Minority Communities
Another approach to addressing disparities involves targeting programs and outreach to minority populations. For example, the Alzheimer’s Disease Demonstration Grants to States program provided demonstration grants to Florida, Kentucky, and the District of Columbia, that focused on African Americans . For example, in the District of Columbia, the intervention focused on educational efforts conducted within church communities. They also held awareness events and developed caregiver respite programs. More recently, several of the current Alzheimer’s Disease Supportive Services Program grantees, including South Carolina, California, Florida, North Carolina and Puerto Rico, are targeting ethnic or racial groups.
Another intervention aimed at reaching minority populations is the Alzheimer’s Disease Research Center Satellite Diagnostic and Treatment Clinics program . Begun in 1990, the program established satellite clinics linked with one of the 30 existing Alzheimer’s Disease Centers. In recent years, satellite clinics have been established on the Choctaw nation reservation, in Harlem, at Grady Hospital in Atlanta, and in St. Louis. The Alzheimer’s Disease Centers are actively involved in formulating strategies and plans to recruit diverse populations to their clinics. Strategies that have met success include improved patient coordination, increasing the personal attention patients receive, home visits, and support groups .
Use And Costs Of Long
An estimated 70% of older adults with Alzheimer’s or other dementias live in the community, compared with 98% of older adults without Alzheimer’s or other dementias. Of those with dementia who live in the community, 74% live with someone and the remaining 26% live alone. As their disease progresses, people with Alzheimer’s or other dementias generally receive more care from family members and other unpaid caregivers. Many people with dementia also receive paid services at home in adult day centers, assisted living facilities or nursing homes or in more than one of these settings at different times during the often long course of the disease. Medicaid is the only public program that covers the long nursing home stays that most people with dementia require in the late stages of their illnesses.
6.3.1 Use of long-term care services by setting
Long-term care services provided at home and in the community
Transitions between care settings
6.3.2 Costs of long-term care services
Affordability of long-term care services
Long-term care insurance
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Studies In The United States
A series of case-control studies comparing ethnic groups in the Washington Heights-Inwood Columbia Aging Project’s community-based random sample found different degrees of association between AD risk and presence of the APOE 4 allele. Among African Americans the association of the APOE 4 allele to AD was weak or absent, but it was significant among white study participants. The 4-associated risk among Hispanics in this project was intermediate to that of African Americans and whites.
The relationship between APOE genotype and ethnicity was investigated among elders with late-onset AD in Florida . Participants were classified into four ethnic groups: Ashkenazi Jewish , Hispanic , non-Hispanic white , and African American . Diagnosis of probable or possible AD was made using NINCDS-ADRDA criteria. The investigators found that age of onset was later in Ashkenazi Jewish elders than among African-American, Hispanic, and non-Hispanic non-Jewish whites. The 4 allele frequency was 29 percent for the entire sample, which is significantly different from the 13.7 percent frequency reported among normal subjects aged 45 and over. These investigators found no ethnic differences in frequency of the 4 allele or the 2 allele. A later case-control study by the same group found that although the 4 allele is a risk factor for AD among white non-Hispanics and white Hispanics , other risk factors such as low education and hypertension appear to be important only for white non-Hispanics.
Racial And Ethnic Discrimination
Although discrimination by providers against racial and ethnic minorities in the United States is commonly asserted as the cause of racial and ethnic disparities, we were unable to find any empirical studies on this topic that focused on people with Alzheimer’s disease. Indeed, there appear to be few empirical studies on this topic in health care.
A rare study of discrimination in health care used the implicit association test to assess the degree to which implicit racial bias affected physicians’ decisions on thrombosis . A total of 287 internal and emergency medicine residents from four hospitals in Boston and Atlanta participated in an online study. Half of the physicians received information about a White patient, and the other half received the same information but were told that the patient was African American. Although physicians self-reported that they did not prefer treating one group or the other and did not see either group as more cooperative, the test found a preference for treating Whites and the perception that African Americans were less cooperative. Similarly, Blanchard and Lurie found that minorities were more likely to report being looked down upon or treated with disrespect than Whites. Specifically, adjusting for sex, language, income, insurance coverage, and education, 20% of Asians, 19% of Hispanics, and 14% of Blacks reporting being treated disrespectfully or looked down upon by their provider compared to 9% of Whites.
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Disability In Activities Of Daily Living
Disability rates are relatively high among adults over age 85. Rates of disability in activities like dressing and bathing, and disability in instrumental activities of daily living such as cooking, all rise with age over 80. Difficulty with bathing typically precedes difficulty with dressing or difficulty with using the toilet. In one study, 75% of people aged 85 had difficulty or disability with bathing and 25% had difficulty or disability with using the toilet . People with disabilities often also struggle with chronic pain, depression, and complex medication regimens . The percentage of older adults with disabilities has modestly decreased in recent decades.
How Is Alzheimers Disease Treated
Alzheimers is complex, and it is therefore unlikely that any one drug or other intervention will successfully treat it in all people living with the disease.
Scientists are exploring many avenues to delay or prevent the disease as well as to treat its symptoms. In ongoing clinical trials, scientists are developing and testing several possible interventions. Under study are drug therapies aimed at a variety of disease interventions, as well as nondrug approaches such as physical activity, diet, cognitive training, and combinations of these. Just as we have many treatments for heart disease and cancer, we will likely need many options for treating Alzheimers. Precision medicine getting the right treatment to the right person at the right time will likely play a major role.
Current approaches to treating Alzheimers focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms.
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Racial And Ethnic Disparities In Alzheimer’s Disease: A
Latinos, too, are disproportionately affected by diabetes, though the disease affects people of all races and ethnicities, and is becoming alarmingly common even among young people as well. A number of studies have tied obesity, and in particular having lots of belly fat, with an increased risk of Alzheimer’s and other forms of dementia Among people ages 65 and older, African Americans have the highest prevalence of Alzheimer’s disease and related dementias , followed by Hispanics , and non-Hispanic whites , American Indian and Alaska Natives , and Asian and Pacific Islanders
Loading your audio article Women are statistically more likely than men to develop Alzheimer’s disease and other forms of dementia. While 16 percent of women over 71 years old develop the.. Alzheimer’sis not only a social burden, but an economic one as well. The financial cost of caring for someone with Alzheimer’s disease can be overwhelming. It is estimated that in 2010, Alzheimer’s will cost more than $172 billion in health care, long-term care, and hospice services. More than 10.9 million people are providing unpaid. Please fill out the form to get Alzheimer’s and dementia care information: * Locatio
Why Has Dementia Been So Predominantly White In Its Presentation In The Mainstream Dialogue
Mainstream services have grown out of what currently exists and because of the nature of dementia, which tends to affect people as they grow older, and the result of migration patterns from the 1960s on, there have historically been fewer older people from minority ethnicities in the UK.
There is a projected eight-fold increase in the number of people from black and minority communities developing dementia between now and 2051, though, with only a two-fold increase generally in people with dementia from all backgrounds. This obviously has implications for policy and the way services are delivered, and its an issue thats going to become more and more relevant as the next generations age.
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Total Cost Of Health Care And Long
Table reports the average annual per-person payments for health care and long-term care services for Medicare beneficiaries age 65 and older with and without Alzheimer’s or other dementias. Total per-person health care and long-term care payments in 2019 from all sources for Medicare beneficiaries with Alzheimer’s or other dementias were over three times as great as payments for other Medicare beneficiaries in the same age group .,
|TOTAL* Payments from sources do not equal total payments exactly due to the effects of population weighting. Payments for all beneficiaries with Alzheimer’s or other dementias include payments for community-dwelling and facility-dwelling beneficiaries.
- * Payments from sources do not equal total payments exactly due to the effects of population weighting. Payments for all beneficiaries with Alzheimer’s or other dementias include payments for community-dwelling and facility-dwelling beneficiaries.
- Created from unpublished data from the Medicare Current Beneficiary Survey for 2011.
Estimates Of The Number Of People With Alzheimer’s Dementia By State
Table lists the estimated number of people age 65 and older with Alzheimer’s dementia by state for 2020, the projected number for 2025, and the projected percentage change in the number of people with Alzheimer’s between 2020 and 2025.,
|Projected Number with Alzheimer’s
- Created from data provided to the Alzheimer’s Association by Weuve et al.,
As shown in Figure , between 2020 and 2025 every state across the country is expected to experience an increase of at least 6.7% in the number of people with Alzheimer’s. These projected increases in the number of people with Alzheimer’s are due solely to projected increases in the population age 65 and older in these states. Because risk factors for dementia such as midlife obesity and diabetes can vary dramatically by region and state, the regional patterns of future burden may be different than reported here. Based on these projections, the West and Southeast are expected to experience the largest percentage increases in people with Alzheimer’s dementia between 2020 and 2025. These increases will have a marked impact on statesâ health care systems, as well as the Medicaid program, which covers the costs of long-term care and support for many older residents with dementia, including more than a quarter of Medicare beneficiaries with Alzheimer’s or other dementias.
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Q: Does The Research Team Keep My Identity Private
A: Researchers must keep health and personal information private, as outlined by federal laws. Most studies only share results that are de-identified, or not linked to specific individuals. Some studies may share de-identified data with other qualified researchers to use in their investigations. Talk with the study coordinator to find out what information may be shared and how.
Racial And Ethnic Differences In The Prevalence Of Alzheimer’s And Other Dementias
Although there are more non-Hispanic whites living with Alzheimer’s and other dementias than any other racial or ethnic group in the United States , older black/African Americans and Hispanics/Latinos are disproportionately more likely than older whites to have Alzheimer’s or other dementias., , – Most studies indicate that older black/African Americans are about twice as likely to have Alzheimer’s or other dementias as older whites., , Some studies indicate older Hispanics/Latinos are about one and one-half times as likely to have Alzheimer’s or other dementias as older whites.,, , However, Hispanics/Latinos comprise a very diverse group in terms of cultural history, genetic ancestry and health profiles, and there is evidence that prevalence may differ from one specific Hispanic/Latino ethnic group to another .,
There is evidence that missed diagnoses of Alzheimer’s and other dementias are more common among older black/African Americans and Hispanics/Latinos than among older whites., Based on data for Medicare beneficiaries age 65 and older, it has been estimated that Alzheimer’s or another dementia had been diagnosed in 10.3% of whites, 12.2% of Hispanics/Latinos and 13.8% of black/African Americans. Although rates of diagnosis were higher among black/African Americans than among whites, according to prevalence studies that detect all people who have dementia irrespective of their use of the health care system, the rates should be even higher for black/African Americans.
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Q: If I Join A Study Will I Get The Investigational Treatment
A: In many studies, not all participants will receive the new treatment. Often, some participants will receive a placebo. A placebo is an inactive substance that looks like the drug or treatment being tested. Participants will not know whether they receive the new treatment or the placebo. This is done so researchers can judge whether or not the new treatment has an effect. In some cases, the researchers and study personnel are also unaware of who is in which treatment group. In a study that includes placebos, all participants receive the same standard of medical care and are important in helping to test the treatment.
Differences Between Women And Men In The Prevalence And Risk Of Alzheimer’s And Other Dementias
More women than men have Alzheimer’s or other dementias. Almost two-thirds of Americans with Alzheimer’s are women., Of the 5.8 million people age 65 and older with Alzheimer’s in the United States, 3.6 million are women and 2.2 million are men., Based on estimates from ADAMS, among people age 71 and older, 16% of women have Alzheimer’s or other dementias compared with 11% of men.
The prevailing reason that has been stated for the higher prevalence of Alzheimer’s and other dementias in women is that women live longer than men on average, and older age is the greatest risk factor for Alzheimer’s.- But when it comes to differences in the actual risk of developing Alzheimer’s or other dementias for men and women of the same age, findings have been mixed. Most studies of incidence in the United States have found no significant difference between men and women in the proportion who develop Alzheimer’s or other dementias at any given age., , – However, some European studies have reported a higher incidence among women at older ages,, and one study from the United Kingdom reported higher incidence for men. Differences in the risk of dementia between men and women may therefore depend on age and/or geographic region.,
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