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Alzheimer's and Dementia: Exploring Disparities in Impact

If you have a loved one with Alzheimer’s disease or dementia, you know it can be devastating. People with these conditions slowly lose their memory and their ability to think clearly. Over time, they can’t manage daily tasks like remembering to eat, bathing or getting dressed. 

Alzheimer’s disease is the most common form of dementia — 60% to 70% of people with dementia have Alzheimer’s disease, and it’s the sixth leading cause of death in the United States. Other types include vascular dementia, Lewy body dementia and frontotemporal dementia (FTD).

These conditions don’t affect all groups of people equally. Here, with the help of Angela Allen, clinical research program director of nursing research with Banner Health, we’ll dive into some of the groups that are hit hardest by Alzheimer’s and dementia. And we’ll explore what can be done to reduce risk.

Age and gender impact your risk

“The percentage of people with Alzheimer’s dementia increases dramatically with age,” Dr. Allen said. It affects:

  • 5% of people aged 65 to 74
  • 13% of people aged 75 to 84
  • 33% of people aged 85 or older

While most people who develop Alzheimer’s or dementia are older, younger people aren’t immune. With early-onset dementia, symptoms can start before age 65. These cases aren’t as common, but they can be especially challenging since people may still be working or raising children while their symptoms are getting worse.

Women are more likely than men to get Alzheimer’s disease. “Almost two-thirds of people with Alzheimer’s are women,” Dr. Allen said. That’s partially because women live longer on average. But genetics, hormones and lifestyle may also play a role. 

Factors that can make Alzheimer's and dementia worse for some people

People who are the same age and gender could have different risks for Alzheimer’s and dementia. That’s because other factors come into play that can make it more likely that people have dementia, don’t get diagnosed quickly and can’t access care easily.

Ethnic or racial background 

People from certain backgrounds are more likely to get Alzheimer’s or other related dementias than others. 

“On average, Blacks have a higher cost of health care than whites or Hispanics because they are more likely to have other health conditions and need care in the hospital more often,” Dr. Allen said. “These differences can mean they have delays in getting care, get diagnosed later and have more disability.” 

Blacks are twice as likely as whites to have Alzheimer’s, and Hispanics are 1.5 times as likely as whites to develop the disease. Social isolation among Hispanic immigrants might increase their risk.

Income and education

People with lower income or education levels may be less likely to get medical care when they see signs of a problem. They may not be able to pay for tests, medicine and services they need. They may not know what resources are available or why early diagnoses are important. That can mean they get diagnosed and treated when their disease is more advanced. 

They may also struggle to follow healthy lifestyle habits. It can be harder for people in some communities to access healthy food, so they can be more likely to have obesity or heart issues that are linked to dementia. It might be hard for people with limited resources to find time for physical activity or to have access to a place where they can exercise. 

Addressing lifestyle factors like these could prevent or delay up to 40% of cases of dementia.

People with low incomes or little education may also have trouble accessing care, especially if they live in a rural area. They may face challenges getting care for themselves because they may have to care for others.

Cultural factors

Symptoms of Alzheimer’s and related dementias can be different for people in different cultures, and that can change how people with symptoms and their families perceive and report them. 

Plus, some cultures consider problems with thinking to be a natural part of aging while others view them with stigma. People who are afraid of judgment from others because of signs of dementia might not get medical care as quickly as they could.

People in some cultures may face language barriers that make it harder for them to understand and follow the process of diagnosis and treatment. 

And people in some cultures don’t trust the health care system because of issues in the past. So providers need to work to help them feel comfortable getting care. They need to understand cultural norms, beliefs and practices around health, illness and caregiving.

Why prevention and early detection are important

When people understand Alzheimer’s disease and dementia, they can make lifestyle changes to reduce their risk. Education is the first step. 

And people who get earlier care for Alzheimer’s and related dementia may have better outcomes and quality of life. They can access support, interventions and resources. They can also take medications that work better when they are started early.

Additionally, early detection can help lower the burden on caregivers. So regular checkups that include cognitive screenings are important, especially for people at higher risk.

How communities and providers can help everyone get the care they need  

While you may be able to take steps to lower your risk for Alzheimer’s disease or related dementias and to get yourself screened, there are additional opportunities for local communities, government and providers to support and promote early detection and care.

Here are a few things that can help bridge the gap and make sure that everyone who’s at risk for Alzheimer’s or related dementias gets the information and access they need: 

  • Community-based education programs. These programs can promote nutrition and brain health and raise awareness about Alzheimer's and dementia. That way, people understand the importance of early detection and can connect with available resources. This outreach should be sensitive to different cultures and should reach people in diverse communities. 
  • Diversity in communications. By using images of families, people who look natural and people in a range of ages, skin tones and genders in mailers and online sites, providers can relate to a diverse group of people.
  • Physical activity initiatives. Community fitness programs and public space for exercise and activity can help promote physical activity and maintaining a healthy weight.
  • Public awareness campaigns. These campaigns can help promote early detection and the importance of cognitive screenings to people in at-risk groups.
  • Telehealth (care by phone or video). Offering virtual health care visits can help people in rural or underserved areas connect with specialists more easily without having to travel long distances.
  • Cultural competency training for health care professionals. This training can help providers understand cultural norms, language preferences and possible stigmas related to Alzheimer's and dementia. 
  • Financial assistance. Offering financial assistance and low-cost options for diagnostic procedures, medications and other aspects of care can promote early detection and make treatment more accessible.
  • Policies that address health care disparities. Initiate or support policies such as legislation that promotes fair access to health care services.

Connecting with support

People with Alzheimer’s or related dementias and their families don’t have to face their challenges alone. They can reach out to:

  • National and local Alzheimer's and dementia associations
  • Caregiver support groups
  • Online communities and forums
  • Educational programs at local nonprofit or health care organizations
  • Memory cafés and social programs
  • Organizations that offer legal and financial help

If you or a loved one has Alzheimer’s or dementia, talk to your provider about ways to connect with resources in your area. 

The bottom line

Alzheimer’s disease and related dementias can be devastating for people with these conditions and their families. And some groups are hit harder than others. People in these groups may not have the access they need to take steps to reduce their risk, and they don’t always get diagnosed early when treatments can be more effective.

Connecting with people in at-risk groups and creating opportunities for education and communication can help them get the care they need.

If you would like to learn more about lowering your risk for Alzheimer’s disease and related dementias, talk to your health care provider or reach out to an expert at Banner Health.

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