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Reproduced with the permission of the Alzheimer's
Association.
Copyright 2004 Alzheimer’s Association,
www.alz.org,
800.272.3900
Prevalence, Incidence, and Cumulative Risk of
Alzheimer's Disease Reported Higher in African-American Community
Washington, D.C. — Alzheimer’s disease appears to be
more prevalent among African-Americans—with estimates ranging from
14 percent to almost 100 percent higher than the disease’s
prevalence among whites—according to a
new
report prepared by the Alzheimer’s Association and
released today by the Congressional Black Caucus.
The report brings together for the first time an accumulating
body of evidence about the scope and nature of Alzheimer’s disease
in African-Americans. “Each scientific study is important research
on its own, but when put together with other studies the magnitude
of the crisis becomes clear,” said Orien Reid, chair of the
Alzheimer’s Association Board of Directors.
“Alzheimer’s disease is a ‘silent epidemic’ that has
slowly invaded the African-American community before most of us were
even aware of its symptoms and its impact. These studies are sending
us a clear wake-up call,” said Reid. “Now, the epidemic has
reached crisis proportions. We must mobilize all of the resources we
can find to get it under control before it overwhelms us.”
The Alzheimer’s Association calls on the federal government to:
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Appropriate an additional $200 million in fiscal year 2003
for Alzheimer research across the National Institutes of Health,
and $1 billion in total funding by fiscal year 2004.
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Establish and fund a program through the
Centers for Disease
Control to expand community outreach efforts, translate research
results to public health practice, and develop a system to
accurately report the incidence and prevalence of Alzheimer’s
disease.
-
Reauthorize the Alzheimer state matching grant program at the
Administration on Aging and convert it from a demonstration
project to a 50-state program designed to expand and reach
underserved communities dealing with Alzheimer’s disease.
Research highlighted in the report suggests that:
The prevalence, incidence, and cumulative risk of Alzheimer’s
disease appears to be much higher in African-Americans.
-
Age-specific prevalence of dementia has been found to be 14
percent to 100 percent higher in African-Americans. (While the
rates vary among studies, three out of four report these higher
prevalence rates.)
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Among African-Americans, the cumulative risk of dementia
among first-degree relatives of persons with Alzheimer’s
disease is 43.7 percent.
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For spouses (who share environmental but not genetic
backgrounds), the cumulative risk is 18.4 percent. These
findings, reported in January 2002, are based on family
histories of the largest number of African-American families
ever studied for Alzheimer’s disease.
The number of African-Americans entering age of risk (65 and
older) is growing rapidly.
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Age is a key risk factor for Alzheimer’s disease in all
racial and ethnic groups. Over 10 percent of all persons over
65, and nearly half of those over 85 have Alzheimer’s disease.
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The number of African-Americans age 65 and over will more
than double by 2030, from 2.7 million in 1995 to 6.9 million by
2030.
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The number of African-Americans age 85 and over is growing
almost as rapidly, from 277,000 in 1995 to 638,000 in 2030, and
will increase more than fivefold between 1995 and 2050 when it
will reach 1.6 million.
Genetic and environmental risk factors for Alzheimer’s disease
seem different in African-Americans but have not been well studied.
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Genetic risk factors seem different in African-Americans and
white Americans. APOE genotype alone does not explain the
increased frequency of Alzheimer’s disease in older
African-Americans.
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Vascular disease may be a particularly powerful factor in the
prevalence of Alzheimer’s among African-Americans.
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Data from a large-scale longitudinal study indicate that
persons with a history of either high blood pressure or high
cholesterol levels have been found twice as likely to get
Alzheimer’s disease. Those with both risk factors are four
times as likely to become demented.
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Sixty-five percent of African-American Medicare
beneficiaries have hypertension, compared to 51 percent of
white beneficiaries. They are also at higher risk of stroke.
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African-Americans have a 60 percent higher risk of type 2
diabetes—a condition that contributes directly to vascular
disease.
-
African-Americans have a higher rate of vascular dementia
than white Americans.
Screening and assessment tools and clinical trials are not
designed to address the unique presentation of Alzheimer’s disease
in African-Americans.
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Ethnic and cultural bias in current screening and assessment
tools is well documented; as a result, African-Americans who are
evaluated have a much higher rate of false-positive results. At
the same time, there is substantial evidence of underreporting
of dementia among African-Americans.
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African-Americans tend to be diagnosed at a later stage of
Alzheimer’s disease—limiting the effectiveness of treatments
that depend upon early intervention.
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African-Americans are seriously underrepresented in current
clinical trials of potential treatments for Alzheimer’s
disease—particularly in trials conducted by drug companies
—even though evidence of genetic differences and response to
drugs varies significantly by race and ethnicity
Alzheimer's
Association Study indicates Black Americans are at Greater Risk
Physical and mental activity
wards off Alzheimer's
Promising
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