WASHINGTON, DC— According to the Alzheimer’s Association’s 2010 Alzheimer’s Disease Facts and Figures, African-Americans are two times more likely than their white counterparts to have Alzheimer’s and other dementias. Hispanics are one and one-half times more likely than whites to have Alzheimer’s and other dementias. Although whites make up the great majority of the more than five million people with Alzheimer’s and other dementias, African-Americans and Hispanics are at higher risk for developing the disease.
There are no known genetic factors that can explain the greater
prevalence of Alzheimer’s and other dementias in African-Americans and Hispanics than in whites. On the other hand, conditions, such as high blood pressure and diabetes, which are known risk factors for
Alzheimer’s and other dementias in all groups, are more common in
African-Americans and Hispanics than in whites. Socioeconomic factors, such as having a low level of education and low income are also
associated with greater risk for Alzheimer’s and other dementias in
all groups. Data from a federal survey of older Americans shows that
African-Americans and Hispanics are disproportionately represented
among socioeconomically disadvantaged people in this country. The
Association’s new report points out that these health and
socioeconomic factors probably contribute to the greater prevalence of
Alzheimer’s and dementia in African-Americans and Hispanics.
“Alzheimer’s disease is the single largest, looming unaddressed public
health threat facing the nation, but we now know the threat is even
more substantial in the African-American and Hispanic communities,”
said Harry Johns, Alzheimer’s Association President and CEO. “These
groups are more likely to have Alzheimer’s, less likely to know it
and, as a result, less likely to receive available treatments and
supportive services that can help them cope with the disease.”
High blood pressure and diabetes are potentially modifiable
conditions. Better management of these conditions could help to reduce
the prevalence of Alzheimer’s and other dementias, especially if
treatment were begun in people who have these conditions in midlife.
Since high blood pressure and diabetes are more common in
African-Americans than whites and diabetes is more common in Hispanics
than in whites, effective treatment for these potentially modifiable
conditions could be especially beneficial for these groups.
Socioeconomic disparities, such as lower income, translate into
reduced access to health care and therefore, reduced opportunities to
avoid or better manage high blood pressure and diabetes that, in turn,
increase Alzheimer risk.
Under diagnosis of Alzheimer’s and Dementia in African-Americans and Hispanics
Although African-Americans and Hispanics are more likely than whites
to have Alzheimer’s and other dementias, the report reveals that
African-Americans and Hispanics are less likely than whites to have a
formal diagnosis of their condition. National data show that
African-Americans and Hispanics with Alzheimer’s disease and other
dementias are less likely than whites to report that a doctor has told
them they have a “memory related disease” (45 percent of whites with
Alzheimer’s or other dementias compared with 33 percent of
African-Americans and 34 percent of Hispanics).
Research shows that many African-American family members recognize the
value of having a diagnosis; but long delays often occur between
family members’ recognition of symptoms of cognitive impairment and
the scheduling of a medical evaluation. The same is true for
Hispanics. Delays in diagnosis mean that African-Americans and
Hispanics are not getting treatment in the earlier stages of the
disease, when the available treatments are more likely to be effective
and do not have an opportunity to make legal, financial and care plans
while they are still capable.
“The Association is committed to increasing awareness about risk
factors for Alzheimer’s and other dementias among all Americans,” said
Johns. “Greater understanding about the importance of proper
management of diseases like high blood pressure and diabetes will
allow individuals to make more informed health care decisions and
adopt healthy life style behaviors that can also help to reduce
Alzheimer and dementia risk.”
Growing Impact of Alzheimer’s Disease and Dementia
According to the report, there are 5.3 million Americans living with
the disease and every 70 seconds someone in America develops
Alzheimer’s disease. By mid-century someone will develop Alzheimer’s
every 33 seconds. In 2010, there will be a half million new cases of
Alzheimer’s, and there will be more new cases in each subsequent year.
In 2050, there will be nearly a million new cases.
Alzheimer’s was the seventh leading cause of death in the country in
2006, the latest year for which final death statistics are available.
It was the fifth leading cause of death among individuals 65 and
older. From 2000-2006 death rates have declined for most major
diseases – heart disease (-11.1 percent), breast cancer (-2.6
percent), prostate cancer (-8.7 percent), stroke (-18.2 percent) and
HIV/AIDS (-16.3) while Alzheimer’s disease deaths rose 46.1 percent.
“Strategic investments in research for diseases such as heart disease,
breast cancer, prostate cancer, stroke and HIV/AIDS have all resulted
in declines in deaths. We have not seen the same type of significant
strategic investment in Alzheimer’s and because of that, deaths from
Alzheimer’s disease continue to soar,” said Johns. “Discovering
effective treatments that prevent onset or delay disease progression
takes on an all encompassing urgency as the nation braces for an
onslaught of aging baby boomers. This disease, unlike any other, has
the power to undermine all of our best efforts to control health care
People with Alzheimer’s and other dementias are high users of
hospital, nursing home and other health and long term care services,
translating into high costs for all payers. The Alzheimer’s
Association estimates that total payments for health and long-term
care services for people with these conditions will amount to $172
billion from all sources in 2010. Medicare costs are almost three
times higher for people with Alzheimer’s and other dementias than for
other older people, and Medicaid costs are almost nine times higher.
Most people with Alzheimer’s also have one or more additional serious
medical conditions, such as diabetes or coronary heart disease. Their
Alzheimer’s greatly complicates medical management for these other
conditions, resulting in more hospitalizations and higher costs.
Impact of Alzheimer’s and Dementia on Caregivers
According to the new report, in 2009, nearly 11 million family members
and other unpaid caregivers provided 12.5 billion hours of care for
people with Alzheimer’s and other dementias, an amount of unpaid care
valued at $144 billion. In fact, Alzheimer’s and dementia caregivers
provided care valued at more than $1 billion in each of 36 states, and
nine states saw an Alzheimer and dementia caregiver contribution
valued at $5 billion or more per state.
“Alzheimer’s disease often progresses in a slow, unrelenting pace
exacting a tremendous emotional, physical and financial toll on
caregivers. Every day these caregivers rise to meet the challenges of
Alzheimer’s,” said Robert J. Egge, Alzheimer’s Association Vice
President of Public Policy. “The uncompensated care they provide is
valued at $144 billion, which is more than the Federal government
spends on Medicare and Medicaid combined for people with Alzheimer’s
and other dementias.”
More than 40 percent of family and other unpaid Alzheimer and dementia
caregivers rate the emotional stress of caregiving as high or very
high, compared with 28 percent of caregivers of other older people.
Caregivers often report a decline in their own health as they try to
balance the demands of caregiving with their own work
responsibilities. In 2009, 60 percent of Alzheimer and dementia
caregivers were employed full-time or part-time and among those
employed, two-thirds said they had to go in late, leave early or take
time off because of caregiving; 14 percent had to take a leave of
absence and 10 percent had to reduce their hours or take a less
demanding job. Juggling the demands of caregiving, particularly in
these financially difficult times, has placed additional stress on
caregivers as their caregiving duties threaten their own job security.
Ultimately solving the Alzheimer crisis – with its far-reaching impact
on families, Medicare, Medicaid and the health care system – will mean
addressing the chronic underinvestment in research. A rapidly aging
population and dramatic increases in the number of Alzheimer cases in
coming years should catapult the government into action. “We know what
the future will bring if we do nothing – more lives lost, overloaded
nursing homes, overworked caregivers and an overwhelmed health care
system,” said Egge. “Our country must increase its investment in
research and scientific innovation if we hope to soon live in a world
together with Alzheimer survivors.”
The full text of the Alzheimer’s Association’s 2010 Alzheimer’s
Disease Facts and Figures can be viewed at www.alz.org after the
embargo lifts. The full report will also appear in the March 2010
issue of Alzheimer’s & Dementia: The Journal of the Alzheimer’s
Association (volume 6, issue 2).