During Black History Month, we celebrate the many accomplishments and successes of Black Americans. It is somewhat ironic that one of these individuals was a world-renowned physician and researcher who worked closely with Dr. Alois Alzheimer to identify the disease we have come to know as Alzheimer’s – the same disease that affects Black Americans at twice the rate as Whites.
The African-born grandson of slaves, Dr. Solomon Carter Fuller was the first African-American psychiatrist. His work focused on degenerative brain diseases and, while in Germany, he worked closely with Dr. Alzheimer to study the disorientation and hallucinations experienced by patient Auguste Deter, the first person diagnosed with Alzheimer’s disease.
Black Americans and Alzheimer’s
Alzheimer’s is arguably the leading global healthcare challenge. Roughly 50 million people around the world, including 6 million in the United States and 76,000 Coloradans, are living with this incurable disease. But Black Americans have a much higher likelihood of developing Alzheimer’s or other forms of dementia.
“There are a number of factors that scientists believe help explain the elevated risk of Alzheimer’s disease in Black Americans,” said Amelia Schafer, executive director of the Alzheimer’s Association of Colorado. “For instance, older Black Americans have higher rates of cardiovascular risk factors including high blood pressure and diabetes, which are also risk factors for Alzheimer’s disease.”
Over time, high blood pressure may damage the blood vessels in the brain, which can starve the brain of oxygen and vital nutrients needed for the brain to function properly. Diabetes also affects how well the brain uses glucose, its main fuel source.
One of the challenges in reducing the Alzheimer’s rate among Blacks is the fact that they – and all minority populations – are underrepresented in Alzheimer’s disease studies.
For instance, one assessment of Alzheimer’s research reported that in 18 observational studies and clinical trials, only 7% of the Alzheimer’s participants were Black. Thus, knowledge about diagnosis, mechanisms, management, and treatment of the disease is based almost exclusively on studies of non-Hispanic whites.
“Increasing minority enrollment in research will help us gain a better understanding of how Alzheimer’s affects minority populations and which interventions are most effective for each population,” said Schafer. “It is also important to enroll more minorities in clinical trials as different ethnicities may respond to drugs in different ways.”
For example, several studies on anti-hypertensives found that White participants responded better to one class of drugs (i.e., β-blockers) while Blacks responded better to another class (i.e., diuretics).
Social determinants of health
The Alzheimer’s Association is actively assessing these and other health factors that affect various population groups differently in order to better understand the impacts they have and how they can be addressed.
“These ‘social determinants of health’ cover a range of personal, social, economic and environmental factors that research has shown can have significant effects on people’s cognitive health,” said Schafer. “As an association, we feel it is essential to better understand these risk factors and provide health education so, when possible, the public can make decisions that will support their long-term health.”
The growing challenge
In 2010 the U.S. Census Bureau indicated that 20% of the U.S. population ages 65 and older was a racial or ethnic minority. Current projections suggest that by 2050, 42% of the nation’s older adults will be members of minority groups. Among those ages 85 and older, 33% are projected to be a minority.
“The challenge moving forward is to increase the representation of Blacks and other ethnic minorities in Alzheimer’s research,” said Schafer. “The Alzheimer’s Association’s TrialMatch program is an important way that we can match people from all ethnic groups with ongoing Alzheimer’s research. It’s a free service, and we encourage all older adults, whether or not you have a family history of Alzheimer’s or other form of dementia, to sign up.”
To learn more about TrialMatch, call the free 24/7 Alzheimer’s Association Helpline at 800-272-3900, or go to alz.org
The Alzheimer's Association leads the way to end Alzheimer's and all other dementia — by accelerating global research, driving risk reduction and early detection, and maximizing quality care and support. Our vision is a world without Alzheimer's and all other dementia.™ For more information, visit www.alz.org or call the 24/7 Helpline at 800.272.3900.