Studies show discrimination may cause cognitive decline
Racism is known to negatively impact a person's life in a wide variety of ways — such as education, housing, nutrition, employment and health. Now research shows racism may also directly impact memory and cognition.
Two studies released at the Alzheimer's Association International Conference® 2022 (AAIC®) revealed
new evidence linking racism and cognitive decline across the course of a person's lifetime — underscoring the need to address health disparities and inequities to build a better future for generations to come.
Racism and lower memory scores
"Overall, our findings indicate that racism impacts brain health and contributes to the unfair burden of Alzheimer's disease in marginalized groups."
Jennifer Manly, Ph.D., professor of neuropsychology at Columbia University Irving Medical Center
A team of researchers at the Columbia University Irving Medical Center assessed experiences of racism among nearly 1,000 middle-aged White, Hispanic and Black adults. The study found that Black participants faced the most exposure to racism, and that these experiences were associated with lower memory scores at midlife.
Examining these results, researchers theorize that exposure to racism leads to stress that affects the body and likely contributes to cognitive decline.
"Overall, our findings indicate that racism impacts brain health and contributes to the unfair burden of Alzheimer's disease in marginalized groups," says Jennifer Manly, Ph.D., professor of neuropsychology at Columbia University Irving Medical Center. 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.
These results offer further evidence that racism is a systemic issue that must be addressed in order to achieve both societal justice and health equity for all groups.
"The problem is most people do not recognize that racism impacts all areas of our life such as the extended trauma seen in this study," says Rev. Miriam J. Burnett, M.D., MDiv, MPH, medical director of the African Methodist Episcopal Church International Health Commission, a national partner of the Alzheimer's Association. "This includes lack of access to quality care for our physical and mental health."
Discrimination and increased cognitive decline
Discrimination is a fundamental cause of health disparities and inequities. But scientists wondered whether discrimination contributed specifically to changes in memory and thinking among older adults. To answer this question, Kristen George, Ph.D., assistant professor of epidemiology in the Department of Public Health Sciences at University of California, Davis, and colleagues examined the relationship between experiences of discrimination and cognitive function among Asian, Black, White, Latino and multiracial participants with an average age of 93.
Older Black Americans are twice as likely as older White Americans to be living with Alzheimer's or another dementia. Researchers continue to try to find out why.
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The participants who experienced wide-ranging discrimination throughout life had lower semantic memory (long-term memory of ideas, facts and concepts) in late life as compared to those who experienced little to no discrimination. "These findings highlight that despite the incredible longevity of this group, discrimination has an indelible impact on cognitive health," says George.
Ending health disparities for future generations
To eliminate the additional burden racism creates around cognition and memory, it is critical to build health equity at the community level. Recognizing this need, the U.S. Department of Health and Human Services included addressing systemic racism in its 2022 update to the National Plan to Address Alzheimer's Disease.
Addressing these issues is also a key focus of the Alzheimer's Association and its partners in underserved communities, such as the African Methodist Episcopal Church.
"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," says Carl V. Hill, Ph.D., MPH, chief diversity, equity and inclusion officer at the Alzheimer's Association. "We must create a society in which the underserved, disproportionately affected and underrepresented are safe, cared for and valued."
The Alzheimer's Association is working to increase health equity through a multilayered effort that includes targeted outreach to underserved populations, education and information that reflect a community's chosen language, and relationships that are built on trust and respect.
Investing in education, health care, nutrition and other social determinants of health will also improve health equity — and in turn, have a long-term impact on cognition and related health concerns, such as diabetes and heart disease. For example, the African Methodist Episcopal Church has taken action by establishing farms and gardens in underserved communities across the world, helping to eliminate food deserts and providing healthy food for people in need.
"Our goal should be to reduce the burden of cognitive decline for everyone. There is a lot we can do, especially for future generations," says Burnett. "We can impact dementia in a real way."