Ethnicity and dementia

Harwood, Dylan G.; Ownby, Raymond L.

doi:10.1007/s11920-000-0040-4

Cited by 28 publications

(32 citation statements)

References 69 publications

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“…Researchers focusing on ethnicity and dementia have attempted to disentangle differences that reflect socioeconomic status from those that are more closely linked to ethnicity or race 14 . The current study included African‐American caregiving units presenting at inner city and suburban memory assessment clinics.…”

Section: Discussionmentioning

confidence: 99%

Impediments to Timely Diagnosis of Alzheimer's Disease in African Americans

Clark

Kutner

Goldstein

et al. 2005

J American Geriatrics Society

101

108

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The purpose of this study was to identify early patterns of care for Alzheimer's disease (AD) in a cohort of African-American patients and their caregivers presenting at an inner city clinic and a suburban memory assessment clinic. Caregivers (N=79) of patients diagnosed with probable AD were interviewed. Data were collected about the delay from noticing first AD signs until recognition that a problem existed and delay from problem recognition until first physician consultation. Patients and caregivers had lower educational status, and patients had been diagnosed more recently at the inner city clinic than at the suburban clinic, although MMSE scores of patients at the two clinics did not differ; median delays in caregivers' recognizing a problem and in consulting a physician were also similar across clinics. Delay was as long as 7 years between noticing symptoms and problem recognition and between problem recognition and physician consultation. Although patients attending the suburban clinic were more likely to have previously seen a physician than those attending the inner city clinic, they were no more likely to have received a prior diagnosis of AD. Lack of physician contact is likely to be widespread in families caring for African Americans with AD. Physician consultation is more characteristic of more highly educated families but may not yield a correct diagnosis for the patient. Intensive efforts are needed to connect African-American families with physicians and to achieve more timely diagnosis of AD to enable families to understand the illness, plan for patient safety, and make long-term plans.

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Section: Discussionmentioning

confidence: 99%

Impediments to Timely Diagnosis of Alzheimer's Disease in African Americans

Clark

Kutner

Goldstein

et al. 2005

J American Geriatrics Society

101

108

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“…Prevalence studies in New Haven, Connecticut; Copiah County, Mississippi; Houston, Texas; New York, New York; Dade County, Florida; and East Baltimore, Maryland, have all found higher rates of dementia among elderly ethnic minority peoplespecifically African Americans and Hispanics-than among whites and Asians (Demirovic et al, 2003;Harwood & Ownby, 2000;Perkins et al, 1997). Among African Americans, prevalence estimates have been as high as 56 percent, although rates of diagnosed disease have been more in the 5 to 16 percent range (Teresi, Holmes, Ramirez, Gurland, & Lantigua, 2002).…”

Section: Prevalence Incidence Diagnosis and Phenotypesmentioning

confidence: 99%

“…Asian-American caregivers were more likely to be highly educated. Compared with non-Hispanic whites, MexicanAmerican caregivers of persons with dementia report greater distress, poorer self-rated health, more somatic complaints, and increased levels of sensitivity to patient problem behaviors (Harwood & Ownby, 2000). Similarly, depression is more common in Hispanic family caregivers than in whites (Janevic & Connell, 2001).…”

Section: Caregivingmentioning

confidence: 99%

“…Culture has been defined as a group's values, beliefs, traditions, symbols, language, and social organization (Harwood & Ownby, 2000). The US model of health care, which values autonomy in medical decision making, contrasts with preferences for more familybased, physician-based, or shared physician-and family-based decision making in other cultures.…”

Section: Cultural Differencesmentioning

confidence: 99%

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Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Lines¹,

Sherif²,

Wiener³

2014

115

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This study reviews the published literature on racial and ethnic disparities among people with Alzheimer’s disease (AD) and related dementias in the United States. To identify relevant studies, we searched electronic sources for peer-reviewed journal articles and unpublished research reports that were published through July 2014; related to the AD population and their caregivers; and provided evidence of racial and ethnic disparities, discussed reasons for disparities, or described interventions to address disparities. The literature shows consistent and adverse disparities among blacks and Hispanics compared with non-Hispanic whites concerning AD, including the disease’s prevalence and incidence, mortality, participation in clinical trials, use of medications and other interventions, use of long-term services and supports, health care expenditures, quality of care, and caregiving. The literature suggests numerous underlying causes, including factors related to measurement of the disease, genetics, socioeconomic factors, cultural differences, lack of culturally competent clinicians, and discrimination. Although these disparities are well known, little is known about the effectiveness of various strategies, such as cultural competence training, to address these differences, and very few studies evaluate possible interventions.

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“…Indeed, AAs have twice the risk of incident stroke than Whites. AA-White disparities extend to multiple additional neurological endpoints including post-stroke dementia, vascular dementia, and Alzheimer's disease (2–4). Self-identified AA race further confers greater risk for cognitive decline, decreased physical function, disability, frailty, and magnetic resonance imaging (MRI)-assessed subclinical brain pathology (5–12).…”

Section: Introductionmentioning

confidence: 99%

Differential Associations of Socioeconomic Status With Global Brain Volumes and White Matter Lesions in African American and White Adults: the HANDLS SCAN Study

et al. 2017

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Objective Examine interactive relations of race and socioeconomic status (SES) to magnetic resonance imaging (MRI) - assessed global brain outcomes with previously demonstrated prognostic significance for stroke, dementia, and mortality Methods Participants were 147 African Americans (AAs) and Whites (ages 33 to 71 years; 43% AA; 56% female; 26 % below poverty) in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN sub-study. Cranial MRI was conducted using a 3.0 Tesla unit. White matter (WM) lesion volumes and total brain, gray matter (GM) and WM volumes were computed. An SES composite was derived from education and poverty status. Results Significant interactions of race and SES were observed for WM lesion volume (b = 1.38; η2 = 0.036; p = .028), total brain (b = 86.72; η2 = 0.042; p = <.001), GM (b = 40.16; η2 = 0.032; p = .003), and WM (b = 46.56; η2 = 0.050; p < .001). AA participants with low SES exhibited significantly greater WM lesion volumes than white participants with low SES. White participants with higher SES had greater brain volumes than all other groups (albeit within normal range). Conclusions Low SES was associated with greater WM pathology – a marker for increased stroke risk – in AAs. Higher SES was associated with greater total brain volume – a putative global indicator of brain health and predictor of mortality - in Whites. Findings may reflect environmental and interpersonal stressors encountered by AAs and those of lower SES and could relate to disproportionate rates of stroke, dementia, and mortality.

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Ethnicity and dementia

Cited by 28 publications

References 69 publications

Impediments to Timely Diagnosis of Alzheimer's Disease in African Americans

Impediments to Timely Diagnosis of Alzheimer's Disease in African Americans

Racial and Ethnic Disparities Among Individuals with Alzheimer’s Disease in the United States: A Literature Review

Differential Associations of Socioeconomic Status With Global Brain Volumes and White Matter Lesions in African American and White Adults: the HANDLS SCAN Study

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