In These 10 U.S. Counties, 1 in 6 People Over 65 Have Alzheimer’s Disease

By | July 17th, 2023

Researchers pinpointed the U.S. counties with the highest prevalence of Alzheimer’s disease. Among the most afflicted places: Miami, Baltimore, and the Bronx.

There are at least 6 million Americans living with Alzheimer’s disease. But some counties have much higher rates of Alzheimer’s than others. Today at the Alzheimer’s Association International Conference, researchers shared data on the nation’s most dire brain health hotspots.

Counties in New York, California, Maryland, Florida, Georgia, South Carolina, Louisiana, Mississippi and Texas comprised the top 10 list of the nation’s most afflicted counties. In these places — which include Miami, Baltimore, the Bronx, New Orleans and El Paso — at least one in six people 65 or older are living with Alzheimer’s.

Where in the U.S. has the highest rates of Alzheimer’s?

They found that the following counties (with a population of 10,000 or more individuals age 65 or older) had the highest prevalence of Alzheimer’s. Tied for most prevalent:

  • Miami-Dade County, Fla. (16.6% of the population has Alzheimer’s)
  • Baltimore City, Md. (16.6%)
  • Bronx County, N.Y. (16.6%)

Followed closely by:

  • Prince George’s County, Md. (16.1%)
  • Hinds County, Miss. (15.5%)
  • Orleans Parish, La. (15.4%)
  • Dougherty County, Ga. (15.3%)
  • Orangeburg County, South Carolina (15.2%)
  • Imperial County, Calif. (15.0%)
  • El Paso County, Texas (15.0%)

The results shared at AAIC were also published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Mapping Alzheimer’s risk

“These new estimates add more granular data to our understanding of Alzheimer’s prevalence across the country,” Rajan said. “This information, in addition to raising awareness of the Alzheimer’s crisis in specific communities, may help public health programs better allocate funding, staffing and other resources for caring for people with Alzheimer’s and all other dementia.”

The countries with the highest prevalence — like Bronx County, New York — had a higher percentage of older Black and Latino residents than other counties with a lower prevalence of the disease. Older Black Americans are twice as likely to have Alzheimer’s or other dementias, while older Latino individuals are one and one-half times as likely compared to white individuals. 

“The estimates are based on cognitive and demographic characteristics,” Rajan added. “Alzheimer’s dementia is a multifactorial disease involving several risk characteristics that interact with demographic risk factors and ultimately contribute to the prevalence.”

A call for brain health equity

According to Matthew Baumgart, Alzheimer’s Association vice president of health policy, these estimates should help public health officials deliver resources to the areas in with the greatest need.

“County-level estimates help us better understand and pinpoint areas of high risk and high need — where, for example, culturally-sensitive health support and caregiver training services are needed,” Baumgart said. 

In Latino communities for example, gender-role expectations mean that women often take on the majority of family caregiving responsibilities, according to David X. Marquez who has studied the reasons for Latinos’ higher Alzheimer’s risk in his work  at the University of Illinois at Chicago. Being aware of these sociocultural norms should help public health services better dole out resources to support the people who need it most, he said.

Baumgart called for more training of doctors and support staff for diagnosing, treating, and caring for people living with dementia. The Alzheimer’s Association is committed to advancing public policies at the state and federal level to address the needs of people living with Alzheimer’s and their caregivers,” he said. 

Some researchers are already working on solutions in their local counties. 

University of Texas Rio Grande Valley’s Dr. Gladys Maestre, MD, PhD is working to address these issues in the Rio Grande Valley which has one of the highest rates of Alzheimer’s across the country.  Maestre and her colleagues deployed and trained local community health workers, known as promotores in Spanish, to do just that — go into the communities and help neighbors with health issues, advocacy, awareness and other needs around healthcare. 

In Maestre’s program, these promotores have started making home visits, calling on people whom they know may be impacted by Alzheimer’s and asking if those folks have any interest in learning about Maestre’s research. This also helps build trust within the community and may attract more researchers in the near future. 

“By working together, we are building infrastructure and a system for data collection that will attract and support diverse expert multidisciplinary researchers,” Maestre said, “so we can expand this important research aimed at reducing the impacts of Alzheimer’s disease on families in South Texas and beyond.”

UPDATE 19 July 1:36 P.M. ET: Orangeburg County is in South Carolina, not California as AAIC’s press release originally stated. This article has been updated accordingly.

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