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Black and Hispanic families suffered the most from dementia




It can start with the occasional overlooked invoice payment. I can’t remember the name. Repeat the same story. There may be personality changes and mood swings. confusion. Over time, it’s like someone who once slowly disappeared.

dementia. As the population ages, more and more families face this debilitating condition. It is emotionally and financially exhausted and requires nearly constant supervision from a spouse or an adult child. It can be a daunting task for any family, but in the United States, the black and Hispanic communities have been hit hardest.

“I don’t know exactly why,” said Jason Resendez, secretary-general of Us Against Alzheimer’s Center for Brain Health Disparities in Washington, DC. “More and more evidence is diabetes and heart disease, but there are also social and economic factors such as education, social isolation, smoking, low income and other inequality.”

According to a study published last year in JAMA Neurology, the risk of dementia in the United States has been relatively stable for the past two decades, but racial inequality remains high. According to other data, black adults after the age of 50 are 2-3 times more likely to be diagnosed with dementia than white adults. Latin Americans are 1.5 times more at risk.

Studies show that many of the risk factors can be reduced. In fact, efforts to do so have been somewhat successful, but less successful for people of color. For example, a 2017 study by JAMA Neurology found that cholesterol-lowering drugs could reduce the risk of dementia by 23%, but were less effective in blacks and Latin adults than in whites.

The Lancet Committee reports that up to 40% of all cases of dementia can be reduced by lowering 12 risk factors. These include high blood pressure, obesity, smoking, diabetes, physical inactivity, depression, deafness, poor education, air pollution, social isolation, excessive alcohol intake, and traumatic brain injury.

Almost all of these factors are “intertwined with social inequality,” Resendez said. “Not all of us are born with the same opportunity for brain health.”

For example, black and Hispanic adults are more likely to have less controlled blood pressure levels than white adults, said Dr. Deborah Levine, an associate professor of internal medicine and director of the University of Michigan’s Cognitive Health Services Research Program. Stated. Black adults also suffer from more severe hypertension than white adults and are more likely to develop it at an earlier age.

Levine led a 2020 study showing that cumulative hypertension in black adults may explain faster cognitive decline compared to white adults.

High blood pressure also significantly increases the risk of stroke. This is a higher risk for blacks and Hispanic adults than for whites. And stroke doubles the risk of dementia. Levine led another study that showed that post-stroke cognitive decline was faster than in non-stroke individuals.

Troublesome statistics on these health inequalities are not explained by genetics, said Chandra Jackson, a researcher at the National Institutes of Environmental Health Sciences, which is part of the National Institutes of Health. “These disparities are a manifestation of historical and contemporary forms of structural racism.”

Long-standing discrimination in housing, education, employment, income, benefits, credit, media and criminal justice all contribute to making colored races more vulnerable to situations that contribute to poor health. She said.

“The place where people live, learn, work and play affects the risk of dementia,” said Jackson, an assistant researcher at the National Institutes of Health at NIH. Researchers call these “social determinants of health.”

Last year’s report by the Urban Institute and Us Against Alzheimer highlights the role of social inequality. We compared the counties with the highest incidence of Alzheimer’s disease, the most common form of dementia, with the counties with the lowest incidence among black and Latin adults. In the counties with the highest incidence of Alzheimer’s disease, the proportion of families in poverty was highest, there were less opportunities for exercise, and some had less education and health insurance.

Lynn Rosenberg, a professor of epidemiology at Boston University and an epidemiologist at the lonely epidemiological center, said the stress of living with racism is likely to have an impact. She is a senior researcher in the Health Survey of Black Women. Her team found that women who reported experiencing the highest levels of racism in their daily lives had lower measurements on cognitive function tests than women with less racism.

Other studies have shown that daily stress increases the risk of dementia.

To close the gap in dementia and other health risks, structural racism needs to be addressed at the social level, Jackson said. It also means creating a community that promotes a healthier life through financial stability, healthy food, physical activity opportunities, and greater access to better social support for families and caregivers. To do.

However, studies show that there are also steps that individuals can take to improve their brain health. Stop smoking, eat a healthier diet, stay active, lose weight, and maintain good blood pressure, cholesterol, and blood sugar levels.

These are steps that people should take long before they reach their elders, Resendez said. “We need to target people in their 30s and 40s. Their behavior today will affect their brain health 20 years from now.”

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