Disparities in Alzheimer’s Disease and Related Dementias

Impact Brief May 2022

More than 6 million Americans are living with Alzheimer’s Disease.  By 2060, the number of Alzheimer’s disease cases is predicted to rise to an estimated 14 million people, with minority populations being affected the most.[i]

The greatest increase in Alzheimer’s disease and related dementias (ADRD) between 2015-2060 is expected in the US Hispanic and Black populations:

  • Cases among Hispanic Americans will increase seven times over today‚Äôs estimates.
  • Cases among Black Americans will increase four times over today‚Äôs estimates.
  • Cases among American Indians/Alaska Natives is estimated to increase five-fold.

While age is the greatest risk factor for ADRD, other health-related risk factors, such as heart disease and diabetes may contribute to these differences.  Among persons with intellectual and developmental disabilities (IDD), about half of those with Down syndrome have Alzheimer‚Äôs disease in their 60s[ii]. Lower levels of education, higher rates of poverty, and greater exposure to adversity and discrimination may also increase risk of Alzheimer‚Äôs disease.

A 2021 report from the Alzheimer‚Äôs Association documented barriers when accessing health care.  While only 9% of Non-Hispanic White Americans reported facing discrimination, higher rates of discrimination noted by Black Americans (50%); Native Americans (42%); Asian Americans (34%) and Hispanic Americans (33%).

The report found additional barriers and stigma associated with accessing dementia care:   

  • Two-thirds of Black Americans (66%) believe it is harder for them to get excellent care for Alzheimer‚Äôs disease or other dementias. Likewise, 2 in 5 Native Americans (40%) and Hispanic Americans (39%) believe their own race or ethnicity makes it harder to get care, as do one-third of Asian Americans (34%).
  • Nearly two-thirds of Black Americans (62%) believe that medical research is biased against people of color ‚ÄĒ a view shared by substantial numbers of Asian Americans (45%), Native Americans (40%) and Hispanic Americans (36%) as well. Only half of Black Americans (53%) trust a future cure for Alzheimer‚Äôs will be shared equally regardless of race, color, or ethnicity.
  • Fewer than half of Black Americans (48%) and Native Americans (47%) feel confident they have access to providers who understand their ethnic or racial background and experiences, and only about 3 in 5 Asian Americans (63%) and Hispanic Americans (59%) likewise feel confident.    
  • The percentage of Black Americans, Hispanic Americans and American Indian persons who would not see a provider about problems with thinking or memory is twice as high compared to whites. Additionally, approximately 20% of Black and Hispanic Americans would be insulted if a cognitive assessment was suggested by a provider.

The health care practitioner workforce needs were also documented. There is a shortage of geriatric specialists, while primary care physicians do not have adequate knowledge, training, or time to perform cognitive assessments.  One recommendation of the 2021 report for the Alzheimer’s Association calls for a team-based, interdisciplinary approach to dementia care to include physician assistants, nurse practitioners, and non-clinical office staff to improve coordination of services with families, caregivers, and community resources.

To address these disparities, the National Healthy Brain Initiative is funding grantees to reach populations with a demonstrated disproportionate burden of ADRD:

  • UsAgainstAlzheimer‚Äôs has established a Center for Brain Healthy Equity, to leverage the expertise of Black and Hispanic providers and community leaders to design community outreach and educational strategies to address disparities experienced in those communities.¬† usagainstalzheimers.org/center-brain-health-equity
  • The International Association for Indigenous Aging (IA2) is addressing ADRD in tribal communities by implementing recommendations in the Road Map for Indian Country, including building capacity among tribes and tribal member-serving organizations, promoting brain health strategies across the lifespan, and fostering dementia-capable tribal communities. iasquared.org/initiatives/current-initiatives/#AIANRCBH
  • The University of Illinois at Chicago‚Äôs (UIC) Healthy Brain Community of Practice promotes brain health and well-being among people with IDD and to achieve health equity for people with IDD and to support health and wellness of their caregivers. healthmattersprogram.org

[i] Alzheimer‚Äôs Disease: Fact and Figures.  Special Report More than Normal Aging: Understanding Mild Cognitive Impairment.  Alzheimer‚Äôs Association, 2022

[ii] Alzheimer‚Äôs Disease Fact and Figures.  Alzheimer‚Äôs Association, 2021.

The Integrating Alzheimer‚Äôs Messages into Chronic Disease Programs project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

A 2021 report from the Alzheimer‚Äôs Association documented barriers when accessing health care. To address these disparities, the National Healthy Brain Initiative is funding grantees to reach populations with a demonstrated disproportionate burden of Alzheimer’s Disease and Related Dementias.

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