Article by: Emeobong “Eme” Martin, MPH, Regional Director, Health Systems, Region 14 (DC/MD/VA) Alzheimer’s Association
During the last eight months, have you found it difficult to remember recent events, felt confused, anxious, depressed or noticed other behavioral changes? Indeed, the present pandemic has created challenging times where many of us may have felt one or more of the above noted differences. However, these signs and several others are also key indicators for dementia. Defined by a group of specific symptoms, including difficulty completing familiar tasks, new problems with speaking and/or writing clearly, dementia is an umbrella term for “memory loss and other cognitive abilities serious enough to interfere with daily life.” ( www.alz.org).
Alzheimer’s disease is the most prevalent form of dementia, accounting for nearly 80% of all dementias. In the United States, more than 5 million people are living with Alzheimer’s disease and all other dementia. Closer to home in Virginia, there are 150, 000 people living with Alzheimer’s disease and all other dementia; during 2018 (the most recent year for which data is available) nearly 2,600 people died from complications due to dementia, making it the sixth leading cause of death in the state and nationwide.
The challenges of living with a dementia expand beyond the individual, as there are an estimated 467,000 caregivers for persons living with dementia in Virginia alone, many of who are uncompensated family members delivering literally millions of hours (an estimated 532 million hours) of care. And while there is significant time donated to caring for people living with Alzheimer’s and all other dementia, there are many hours billed to medical care, including Medicaid billings which recently totaled $1 billion dollars in the state of Virginia.
Another significant and costly aspect of dementia is the disproportionate impact that Alzheimer’s disease and all other dementia has on communities of color, specifically the African American community. African Americans are twice as likely to develop dementia, when compared to their non-Hispanic White counterparts. While the full details of this stark disparity are unknown, there are key contributing factors for consideration.
Several research studies suggest a link between diet and disease toward the development of dementia. More specifically, cardiovascular conditions such as diabetes, heart disease, and hypertension (i.e., high blood pressure), illnesses which are disproportionately prevalent among African Americans, are connected to the onset of dementia. In addition to health considerations, socioeconomics factors, such as less and lower quality education, increased rates of poverty and stress related to systemic discrimination may contribute to the disparate diagnosis rates of dementia between African Americans and non-Hispanic Whites.
The racial disparity in dementia diagnosis is a sobering statistic, further exacerbated by the observation of some research that suggests misdiagnosis of dementia is more common among African American patients than non-Hispanic Whites, creating a strong imperative to educate the African American community and their providers about Alzheimer's disease and all other dementia.
In an effort to improve dementia outcomes for African Americans, the Alzheimer’s Association provides targeted training and education for the community as well as healthcare providers. For example, over the summer, the Alzheimer’s Association’s Greater Richmond Chapter hosted a community conversation, “Caregiving through the Lens of African Americans in 2020” to address health equity considerations in dementia care for African Americans. Last October, the Alzheimer’s Association National Capital Area Chapter hosted a one-hour continuing medical education webinar on culturally appropriate dementia care for African-American patients and their caregivers. Every year during November, National Alzheimer’s Disease Awareness Month, the Alzheimer’s Association Greater Maryland Chapter hosts the Pythias A. and Virginia I. Jones African American Community Forum on Memory Loss to educate and update attendees on research, signs, symptoms, and support services for dementia care, attracting more than 400 participants throughout the state of Maryland.
“The Alzheimer’s Association is committed to health equity in its vision of a world without Alzheimer’s and all other dementia for all communities, with special emphasis on those who are disproportionately affected”, says Dr. Carl V. Hill, Interim Chief for Diversity and Inclusion for the Alzheimer’s Association. “It is important that we continue to seek better understanding of the factors that put Black/African Americans at increased risk, and that we provide culturally appropriate and accountable care and support to Black/African Americans families who are enduring this devastating disease.”
This year, the Pythias A. and Virginia I. Jones African American Community Forum on Memory Loss is taking place virtually over four 90-minute Saturday morning sessions. The final session taking place on Saturday, December 5th. To register, please email Kristi Mroz at [email protected].
Reference: Alzheimer’s Association. 2020 Alzheimer’s Disease Facts and Figures. Alzheimer’s Dement 2020;16(3):391+