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February 12, 2002
Prevalence, Incidence, and Cumulative
Risk of Alzheimer's Disease Reported Higher in
African-American Community
Washington,
D.C. Alzheimers disease appears to be more prevalent
among African-Americanswith estimates ranging from 14 percent
to almost 100 percent higher than the diseases prevalence
among whitesaccording to a new report* prepared by the Alzheimers Association> and released today by the Congressional Black Caucus.
The
report brings together for the first time an accumulating body of
evidence about the scope and nature of Alzheimers disease
in African-Americans. Each scientific study is important research
on its own, but when put together with other studies the magnitude
of the crisis becomes clear, said Orien Reid, chair of the Alzheimers
Association Board of Directors.
Alzheimers
disease is a silent epidemic that has slowly invaded
the African-American community before most of us were even aware
of its symptoms and its impact. These studies are sending us a clear
wake-up call, said Reid. Now, the epidemic has reached
crisis proportions. We
must mobilize all of the resources we can find to get it under control
before it overwhelms us.
The Alzheimers
Association calls on the federal government to:
-
Appropriate
an additional $200 million in fiscal year 2003 for Alzheimer
research across the National Institutes of Health, and $1 billion
in total funding by fiscal year 2004.
-
Establish
and fund a program through the Centers for Disease Control to
expand community outreach efforts, translate research results
to public health practice, and develop a system to accurately
report the incidence and prevalence of Alzheimers disease.
-
Reauthorize
the Alzheimer state matching grant program at the Administration
on Aging and convert it from a demonstration project to a 50-state
program designed to expand and reach underserved communities
dealing with Alzheimers disease.
Research highlighted in the report suggests that:
The prevalence,
incidence, and cumulative risk of Alzheimers disease appears
to be much higher in
African-Americans.
-
Age-specific
prevalence of dementia has been found to be 14 percent to 100
percent higher in
African-Americans. (While the rates vary among studies, three
out of four report these higher prevalence rates.)
-
Among African-Americans,
the cumulative risk of dementia among first-degree relatives
of persons with Alzheimers disease is 43.7 percent.
-
For spouses
(who share environmental but not genetic backgrounds), the cumulative
risk is 18.4 percent. These findings, reported in January 2002,
are based on family histories of the largest number of African-American
families ever studied for Alzheimers disease.
The number of
African-Americans entering age of risk (65 and older) is growing
rapidly.
-
Age is a
key risk factor for Alzheimers disease in all racial and
ethnic groups. Over 10 percent of all persons over 65, and nearly
half of those over 85 have Alzheimers disease.
-
The number
of African-Americans age 65 and over will more than double by
2030, from 2.7 million in 1995 to 6.9 million by 2030.
-
The number
of African-Americans age 85 and over is growing almost as rapidly,
from 277,000 in 1995 to 638,000 in 2030, and will increase more
than fivefold between 1995 and 2050 when it will reach 1.6 million.
Genetic and environmental
risk factors for Alzheimers disease seem different in African-Americans
but have not been well studied.
-
Genetic risk
factors seem different in
African-Americans and white Americans. APOE genotype alone does
not explain the increased frequency of Alzheimers disease
in older
African-Americans.
-
Vascular disease
may be a particularly powerful factor in the prevalence of Alzheimers
among African-Americans.
-
Data
from a large-scale longitudinal study indicate that persons
with a history of either high blood pressure or high cholesterol
levels have been found twice as likely to get Alzheimers
disease. Those with both risk factors are four times as
likely to become demented.
-
Sixty-five
percent of African-American Medicare beneficiaries have
hypertension, compared to 51 percent of white beneficiaries.
They are also at higher risk of stroke.
-
African-Americans
have a 60 percent higher risk of type 2 diabetesa
condition that contributes directly to vascular disease.
-
African-Americans
have a higher rate of vascular dementia than white Americans.
Screening and
assessment tools and clinical trials are not designed to address
the unique presentation of Alzheimers disease in African-Americans.
-
Ethnic and
cultural bias in current screening and assessment tools is well
documented; as a result, African-Americans who are evaluated
have a much higher rate of false-positive results. At the same
time, there is substantial evidence of underreporting of dementia
among African-Americans.
-
African-Americans
tend to be diagnosed at a later stage of Alzheimers diseaselimiting
the effectiveness of treatments that depend upon early intervention.
-
African-Americans
are seriously underrepresented in current clinical trials of
potential treatments for Alzheimers diseaseparticularly
in trials conducted by drug companies even though evidence
of genetic differences and response to drugs varies significantly
by race and ethnicity.
Report:
African-Americans and Alzheimer's Disease: The Silent Epidemic
*To view the report
you must have Adobe Acrobat Reader® . To download Adobe Acrobat
Reader® click here.
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