Alzheimer's Diagnosis

Research Shows A Link Between Racism And Alzheimer’s Disease

According to a Columbia University study, exposure to racism is tied to a lower memory score during a person's midlife.

In the spring 2023 edition of the ALZ Magazine, the Alzheimer’s Association cited two studies that linked racism with the development of Alzheimer’s disease. They coupled those studies with a call to address health disparities and inequities faced by Black people. 

Those studies, the magazine stated, declared that racism must be addressed to create justice and health equity across all racial and ethnic groups. According to a study conducted by a team of researchers at Columbia University’s Irving Medical Center, exposure to racism is tied to a lower memory score during a person’s midlife. 

As Jennifer Manly, Ph.D, a professor of neuropsychology at the Columbia University Irving Medical Center, told ALZ, “Overall, our findings indicate that racism impacts brain health and contributes to the unfair burden of Alzheimer’s disease in marginalized groups.”

Manly added, “Black adults are about twice as likely and Hispanic adults are about one-and-a-half times as likely to have Alzheimer’s or other dementias than white adults.”

Scientists have known that discrimination is a cause of health disparities and inequities for some time, but they did not know if discrimination had any effect on memory or thinking in older adults. To test this theory, Kristen George, Ph.D, an assistant professor of epidemiology at the University of California’s Department of Public Health Sciences, set up experiments that examined the relationship between discrimination and cognitive function in Black, white, Asian, Latinx, and multiracial people who had an average age of 93. 

George discovered that those who experienced discrimination had a lower long-term memory of ideas, facts, and concepts than those who had not. George told the outlet, “These findings highlight that despite the incredible longevity of this group, discrimination has an indelible impact on cognitive health.”

In 2022, the Department of Health and Human Services added a section on addressing systemic racism to that year’s update of the National Plan to Address Alzheimer’s Disease, something that Carl V. Hill, Ph.D., MPH, the chief diversity, equity, and inclusion officer at the Alzheimer’s Association, believes is vital.

“In order to achieve health equity — as a step toward complete inclusion and representation — individuals and society must identify and reduce racism and other forms of discrimination,” Hill said. “We must create a society in which the underserved, disproportionately affected and underrepresented are safe, cared for and valued.”

In January 2024, the HHS commissioned a study on the literature concerning racial and ethnic disparities in Alzheimer’s disease, the clearest indication that the federal government sees it as a public health issue. Its study discovered that in addition to the experience of racism by Black people, Alzheimer’s disease may also be attributed to various other factors that disproportionately affect Black people. Those factors include but are not limited to high blood pressure, heart failure, high cholesterol, and diabetes. Racial bias in the healthcare industry, although not specifically tied to Alzheimer’s disease, is another reason Black people experience a difference in medical treatment when compared to other ethnic groups. 

In its conclusion, the study notes that there are consistent and adverse disparities between Black and non-white Latinx people compared to white people regarding Alzheimer’s disease rates, participation in clinical trials, and other markers that indicate quality care. The study does not explain why these disparities exist but notes that additional factors, such as education and poverty, may be at play.

“The reasons for these disparities are not well understood but include possible genetic differences, prevalence of other diseases that may increase the risk of Alzheimer’s disease, higher rates of poverty, and lower levels of education. In addition, differences in the use of services and expenditures may be related to cultural differences and racial and ethnic discrimination. Although these disparities are well known, little is known about the effectiveness of various strategies, such as cultural competence training, to address these differences within the context of Alzheimer’s disease, with almost no studies available that evaluate possible interventions.”

The study does provide a glimmer of hope regarding the treatment of Alzheimer’s disease. Rather than simply providing equal access to services, a better resolution involves determining the proper level of care and making sure the patient is able to receive that care at the right time in the appropriate setting. 

“In seeking to alleviate these disparities, one of the important points made in the IOM’s Unequal Treatment report is that matching needs to services is a more important goal than trying to provide equal amounts of services to different groups,” The conclusion states. “Both undertreatment and overtreatment can be a problem, and it would be undesirable to insist on all patients being equally overtreated. Instead, the goal should be the right care, delivered to the right patient, at the right time, in the right setting.”

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