Posted 1/18/21
I pray that the eyes of your heart may be enlightened in order that you may know the hope to which he has called you, the riches of his glorious inheritance in his holy people… Ephesians 1:18
Hi all! Happy Martin Luther King Day! I am off for said holiday and thought I might offer a quick statement on the stats regarding African American’s harmed by this terrible disease. Here are the sober numbers (each is linked):
- Age is a key risk factor for Alzheimer’s disease in all racial and ethnic groups. Over 10% of all persons over 65, and nearly half of those over 85 have Alzheimer’s disease. 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 five-fold between 1995 and 2050, when it will reach 1.6 million.
• Sixty-five percent of African-American Medicare beneficiaries have hypertension, compared to 51% of white beneficiaries. They are also at higher risk of stroke. (Data from the Current Medicare Beneficiary
Survey. As we know, what is good/bad for the heart is good/bad for the brain.
- 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 Alzheimer’s disease — limiting the effectiveness of treatments that depend upon early intervention.
- African-Americans are seriously underrepresented in current clinical trials of potential treatments for Alzheimer’s disease, particularly in trials conducted by drug companies. This has occurred even though evidence of genetic differences and response to drugs varies significantly by race and ethnicity.
- Link for this data/quote: “Scientists have tried to ascertain whether African Americans naturally make more beta-amyloid and tau proteins, two of the signature causes of Alzheimer’s. Beta-amyloid forms clumps in the brain that interfere with cell-to-cell communication, and tau creates so-called tangles inside brain cells. Both result in forgetfulness, confusion, difficulty concentrating, delusions, and other telltale symptoms of the disease. So far, there’s no evidence that African Americans have higher levels of beta-amyloid or tau, says Reisa A. Sperling, MD, a Harvard Medical School neurology professor and director of the Center for Alzheimer Research and Treatment at Brigham and Women’s Hospital.—“We have other theories, though,” says Lisa L. Barnes, PhD, a professor of gerontology and geriatric medicine at the Rush Alzheimer’s Disease Center at Rush University Medical Center and a trailblazer in researching the Alzheimer’s racial imbalance. Barnes and other experts point to the fact that Black Americans have higher rates of diabetes, hypertension, stroke, elevated cholesterol, and heart disease—all of which are correlated with Alzheimer’s dementia. These conditions also affect blood vessels and can impair blood flow, which can then damage the brain and may also contribute to beta-amyloid and tau protein buildup, thereby raising Alzheimer’s risk, explains Barnes.”
- Link for this data “The prevalence of the e4 allele is consistently found to be higher in African Americans than non-Hispanic whites,22 but it is inconsistently related to Alzheimer’s disease or cognition in this population.12 However, a recent genome-wide association study (GWAS) using several African American cohorts confirmed that the APOE e4 allele, along with a new gene, ABCA7, is related to an increased risk of Alzheimer’s disease among African Americans.23 The study is noteworthy for two reasons. First, it represents the largest genomewide association study to date involving African Americans—almost all such studies for late-onset Alzheimer’s disease have been done with non-Hispanic whites. Second, both genes that were found to be related to an increased risk of Alzheimer’s disease are involved in cholesterol transport, and given that cholesterol metabolism has been implicated in Alzheimer’s disease,24 this presents a potential target for future intervention studies.”-
Summary: The standard Beta Amyloid/Tau combo can be at play in the high numbers of African American cases, but the more likely causes are environmental and genetic. This may prove to be a “good” thing as genetic treatments are becoming more and more effective and environmental factors are not beyond change. To me, this is encouraging and another reason to peacefully and lovingly advocate for this population because what you do CAN make a difference in these numbers.
On March 25, 1966 in Chicago at a press conference before his speech at the second convention of the Medical Committee for Human Rights (MCHR), King said (in part):
“We are concerned about the constant use of federal funds to support this most notorious expression of segregation. Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death….I see no alternative to direct action and creative nonviolence to raise the conscience of the nation.”
Race relations is a complex and charged topic, well beyond the scope of this blog, but suffice it to say that African-Americans (as are Hispanics) are doing much worse in this dementia battle, and we need to address the preventable factors quickly as they seem to be disproportionately harming these wonderful men and women. Do you want to honor Dr. King’s legacy? This is one very good way. After all, as Dr. King himself said, “Injustice anywhere is a threat to justice everywhere.“
#EndALZ
Update: Nothing new with mom. I will be talking with her via Zoom this week. It is what it is. 🙁 Missouri is doing better than most states on vaccinations and in many areas the cases are slowly coming down, so we can hope that we will resume at least outdoor visits quite soon. We are coming up on a year now…it is about time.
Image by Clker-Free-Vector-Images from Pixabay
Last thought: Listen to this full speech. We quote a few of our favorite lines, but hop on this link and listen to it in context. It was truly remarkable:
https://www.npr.org/2010/01/18/122701268/i-have-a-dream-speech-in-its-entirety
Also, these aren’t political concerns. If your politics (of any stripe) gets in the way of your love and empathy for those suffering, you need to rethink your way of thinking…it is clearly broken. If your politics or social group or religion or (Insert any social construct here) causes you to wish harm, and worse, to wish dementia on someone else, you need to repent of this sin. There will never be a cure until we work together…
Our Alzheimer’s Caregiver’s Support Group is tomorrow night at 6pm CST. Call or text me at 417-955-2513 or email me at mark.applegate@senioragemo.org for the Zoom link. 🙂
