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For those either experiencing a form of dementia or caring for a loved one who suffers from the disease, the day-to-day challenges can be daunting to adjust to and make peace with. It’s important to stay well-informed about Alzheimer’s, even well before the potential diagnosis.
Dr. Sheria G. Robinson-Lane is a gerontologist with expertise in palliative care, long-term care and nursing administration. She is a researcher at the University of Michigan at the Michigan Center for Contextual Factors in Alzheimer’s Disease (MCCFAD) and the Michigan Alzheimer’s Disease Resource Center.
“One of the large effects is that we know Alzheimer’s disease affects Black older adults at more significant rates. We’re seeing twice as much prevalence in Black adults,” said Robinson-Lane.
While research is still trying to identify the cause of this disparity between Black and white Americans, higher rates of vascular-related diseases, such as blood pressure and cholesterol, may play a contributing factor.
“Most Black folks don’t necessarily have Alzheimer’s disease, as it’s only a cognitive health condition,” said Robinson-Lane. “They tend to have a blend of a combination of vascular dementia which comes from having long-term hypertension issues or high blood pressure combined with Alzheimer’s.”
Also, untreated depression can add complications to dementia-related diseases, as it impacts a person’s cognition.
Although it is important to know, other compounded illnesses may not necessarily increase the likelihood of developing dementia but they might worsen the symptoms such as memory loss and ability to think clearly.
What are Alzheimer’s and related dementia diseases?
Dementia is the general term for a group of diseases or conditions that cause impairment to a person’s thinking, memories or decision-making. Alzheimer’s disease is the most common type of dementia, affecting 60 to 80 percent of people living with dementia.
According to the Centers for Disease Control and Prevention (CDC), by the year 2060, there may be 14 million Americans with a form of dementia, with four times as many Black Americans, as there are today.
“One of the biggest myths is that Alzheimer’s is a normal part of aging, but it’s not,” said Treena Horton, program coordinator and head of Black outreach at the Alzheimer’s Association, Greater Michigan chapter. “There are plenty of statistics that show otherwise. Not everyone that gets past a certain age develops cognitive impairment.”
The Greater Michigan chapter of the Alzheimer’s Association reported that a total of 190,000 people aged 65 and older have Alzheimer’s and estimated a 15.8 percent increase by the year 2025. Since 2000, there has been a 171.4 percent increase in Alzheimer’s deaths, with the mortality count at 4,467 as of 2019.
In the city of Detroit, the Association estimates there are 8,918 residents currently living with Alzheimer’s.
Alzheimer’s typically develops in adults over the age of 70 and is a terminal disease that slowly develops over a 6- to 10-year life span from the initial diagnosis. Early onset dementia may impact adults in their 50’s and is a more aggressive progression with a shorter life trajectory. Women are more likely to develop dementia, since they tend to live longer than men.
“In the earlier stages, individuals tend to have more forgetfulness, losing things more commonly like keys, glasses and wallets, and then it slowly affects in other areas of cognition, like their short-term memory,” said Robinson-Lane.
“Being able to figure out what to do in otherwise habitual situations, like using the bathroom, what’s called executive function, becomes challenging. This means being able to plan and take care of things. It progresses to not being able to remember names and becomes even more challenging to take care of yourself, culminating in a loss of physical function until you develop complications of immobility and become bedridden. Ultimately, they tend to die of an infection of some type, like pneumonia, that gets worse and you see repeat hospitalization.”
Research has shown that Black people frequently encounter obstacles in receiving dementia treatment, including delays in diagnosis.
Robinson-Lane also said Black Americans are less likely to get differential diagnosis, since dementia is more of an umbrella term for different types of cognitive impairment. A less precise diagnosis can negatively impact some of the treatment options and long-term care for older adults.
“Unfortunately, this community is less likely to get diagnosed early in the disease process, which means that some of the available medication that can help with function early on may be less accessible,” said Robinson-Lane.
According to the Alzheimer’s Association, half of African Americans say they have experienced discrimination while seeking care for a person living with Alzheimer’s. Further, only forty-eight percent of Black people report being confident they can access culturally competent care.
“There are a percentage of those that don’t trust the health care system or they feel they are being discriminated against,” said Horton. “It’s really going to be about educating our medical professionals, our clinics, our hospitals on the needs of the African American people. We also need to talk to those conducting studies as Black Americans are underrepresented in the research too. Those in the medical field won’t know what the barriers are, to know about our culture, and to understand the reasons for our hesitancy to seek care.”
At the same time, Horton said, addressing the issue is two-pronged, that the efforts of outreach and community education are important to empower people to know how to speak to health care personnel if there are concerns and where to find resources for the best possible treatment, as early as possible.
For anyone interested in learning more on dementia-related issues or seeking help, contact a local Detroit Area Agency on Aging at detroitseniorsolution.org. To request an educational session at your organization or community group, contact Treena Horton at Greater Michigan Chapter of the Alzheimer’s Association at (248) 996-1058 or email thorton@alz.org .
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