Diversity and Dementia

Alzheimer’s disease is twice as likely to affect Black people as white people, and the risk for the Hispanic population is one and a half times higher than that of the white population. The elevated risk is driven by a combination of factors — not biology alone. UCSF neurologist Dr. Charles Windon explains that Black Americans may have greater exposure to structural racism, the historical practices of redlining, and other social determinants of health that can both increase the risk of disease and affect its course. Compounding this, Black and Latinx communities have higher rates of cardiovascular disease and diabetes — both known dementia risk factors — and face higher rates of discrimination in healthcare settings that lead to delayed or missed diagnoses, with over half of Native American, Black, and Latinx caregivers reporting racial prejudice when navigating health care.

As we age, it’s normal for the brain to experience natural cognitive decline in various areas. University of Washington’s Dr. Barak Gaster identifies three condensed warning signs beyond normal aging: losing short-term memory, such as asking the same question repeatedly within a short timeframe; having difficulty completing complex tasks, like following a recipe; and becoming disoriented in familiar places, such as getting lost on a well-known route. Some conditions that mimic dementia are actually reversible — blood tests can rule out reversible causes of memory issues, like vitamin B12 deficiency, thyroid problems, infections, or liver/kidney issues.

Neurologist Dr. Marwan Sabbagh offers the following guidance: if a patient complains about their memory, a doctor should evaluate them or refer them to a neurologist — and patients should keep pushing and if a doctor dismisses or downplays their concerns, another doctor should be consulted. For instance, Don Kent was misdiagnosed by six different neurologists before he finally received an accurate diagnosis on Lewy body dementia.