Alzheimer and Dementia Projected to Especially Affect Black and Hispanic Americans

Investigators stressed the importance of culturally competent care for patients with dementia and support for their caregivers.

Kevin Matthews, PhD

A new study by CDC investigators estimates that the prevalence of Alzheimer disease and related dementias in Black and Hispanic Americans will increase more than in any other ethnic group between now and 2060.

The study, which is the first ever to break such predictions down by race and ethnicity, suggests that it will be crucial to consider the increasing number of minority dementia patients when developing and implementing state- and nation-wide plans to prevent and treat the disease.

Lead author, Kevin Matthews, PhD, health geographer and lead author of the study with the CDC’s Division of Population Health, was inspired to conduct the study by his own experience with dementia.

“I became interested in Alzheimer and dementia when my father died from the disease in 2015, which was around that time that I started my career at the CDC. I was able to channel my loss into a scientific study that I am proud to say will have major impact in the field of aging,” he told MD Magazine®. “When I started researching the topic, I noticed several other forecasts were available, but none accounted for differences in prevalence by race and ethnicity.”

To develop their estimates, the researchers used Medicaid Fee-for-Service data from 2014 combined with population prediction data from the US Census Bureau. The Medicaid data included 28,027,071 beneficiaries 65 or older in 2014, representing about 60% of adults in the US who are 65 or older. More than 3.2 million of these beneficiaries had been diagnosed with Alzheimer disease and related dementias in 2014.

In 2014, 1.6% of the US population was diagnosed with Alzheimer disease and related dementias, but by 2060 this percentage will double to 3.3% with 13.9 million Americans affected. This estimate is in line with previous estimates about the prevalence of dementia in the entire US population.

However, this was the first study to break those estimates down by race and ethnicity, providing unique insights. The populations with the highest prevalence of Alzheimer disease and related dementias are also those whose populations are expected to increase the most by 2060. While non-Hispanic whites will still have the largest total number of Alzheimer disease and related dementia cases, the number of cases among Blacks and Hispanics, who currently have the highest prevalence (14.7% and 12.9%, respectively) is expected to increase the most due to population growth.

“Given the expected growth in the burden of disease, particularly among minority populations, culturally competent care for these groups will be of paramount importance. Thus, our findings highlight the need to monitor and evaluate minority populations to ensure materials and evaluations are culturally sensitive and to define the needs of a diverse group of caregivers and persons with dementia,” the authors wrote.

It is also important to take these new predictions into account when developing state- and community-level plans. In many places, races will clump together geographically. In areas where prevalence is likely to be the highest, it is especially important that states work to revise and implement individual Alzheimer disease and related dementia plans.

Lastly, Matthews pointed out that “these findings support efforts to develop a culturally competent workforce of health care providers of all types, from direct care workers to clinicians. Such training would help to improve the recognition of early signs of dementia despite cultural differences and to identify ways health care workers can assist people with dementia in navigating the health care system across all settings of care.”

The study, “Racial and ethnic estimates of Alzheimer's disease and related dementias in the United States (2015—2060) in adults aged ≥65 years,” was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.