Estimating prevalence of early Alzheimer's disease in the United States, accounting for racial and ethnic diversity

Abstract

Introduction Updated estimates of the US Alzheimer's disease (AD) population, including under‐represented populations, are needed to improve clinical trial diversity. Methods A step‐wise approach calculating prevalent numbers from clinical syndrome to biomarker‐positive mild cognitive impairment (MCI) due to AD and mild AD was developed, using age‐and‐race/ethnicity‐stratified data where available. Results The estimated percentage of Americans aged ≥ 65 years with MCI due to AD was 9.2% of non‐Hispanic Whites, 13.6% of non‐Hispanic Blacks, 11.1% Hispanics, and 9.7% other race/ethnicities. The estimated percentage of Americans aged ≥ 65 years with mild dementia due to AD among non‐Hispanic Whites was 3.7%, non‐Hispanic Blacks 7.0%, Hispanics 5.3%, and 3.9% other race/ethnicities. Of these early‐stage AD cases, few are likely diagnosed, ranging from 13% of prevalent non‐Hispanic Black cases to 27% of non‐Hispanic White cases. Discussion Under‐representation in clinical trials may be improved by setting recruitment goals reflecting the diversity of the AD patient population and supporting efforts toward timely diagnosis.

Estimating prevalence of early symptomatic Alzheimer's disease in the United States

“… 26 In their study, among those aged ≥ 65 years in the United States, ≈ 9.2% and 3.7% of non‐Hispanic Whites, 13.6% and 7.0% of non‐Hispanic Blacks, 11.1% and 5.3% of Hispanics, and 9.7% and 3.9% of those of other races or ethnicities were living with MCI due to AD and mild dementia due to AD, respectively. 26 Our current analysis provided updated estimates by age but did not evaluate data for specific racial or ethnic groups. Compared to those reported by Gillis et al., our base case estimates for individuals aged ≥ 65 years with mild dementia or MCI due to AD are lower, with the differences primarily driven by the source of dementia prevalence data; the estimates used in our calculation 30 used data from meta‐analyses and were smaller than those used by Gillis et al., 26 , 31 which used data from a single study and may not be generalizable to the entire United States.…”

“…performed a literature review to obtain population estimates of MCI or mild dementia due to AD based on age and race or ethnicity 26 . In their study, among those aged ≥ 65 years in the United States, ≈ 9.2% and 3.7% of non‐Hispanic Whites, 13.6% and 7.0% of non‐Hispanic Blacks, 11.1% and 5.3% of Hispanics, and 9.7% and 3.9% of those of other races or ethnicities were living with MCI due to AD and mild dementia due to AD, respectively 26 . Our current analysis provided updated estimates by age but did not evaluate data for specific racial or ethnic groups.…”

“…This study provides an updated estimate of the prevalence of clinical diagnosis of MCI and mild dementia due to AD among US older adults aged ≥ 60 years who may be eligible for amyloid‐targeting therapies. 18 , 26 , 27 Although studies of AD prevalence, incidence, and mortality face challenges related to variations in diagnosis and disease stage classifications, epidemiologic data suggest that the medical community will face significant and increasing numbers of patients presenting with potential AD risk factors in the near future. Therefore, there will be a need to identify patients most likely to benefit from treatment early in the disease process.…”

The importance of the dyad: Participant perspectives on sharing biomarker results in Alzheimer's disease research

“…Research in real‐world populations will also be necessary to leverage biomarker testing and disclosure to address disparities in AD research 36 . Diagnosis is often delayed in underrepresented and minoritized populations, at the same time as cognitive impairment is expected to increase as this growing population ages 37 . The National Institute of Health's Minority Health and Health Disparities (NIHMD) research framework describes disparities as health differences that adversely affect the health outcomes among disadvantaged populations, and specifies domains that interact to shape health outcomes by influencing individual, interpersonal, community, and societal strata through biological, behavioral, environmental, social‐cultural, and health system effects 38 .…”

Photobiomodulation in experimental models of Alzheimer’s disease: state-of-the-art and translational perspectives

“…Alzheimer’s disease (AD) is a progressive neurodegenerative disorder affecting millions of people across the world [ 1 ]. With the continued aging of the population, the prevalence of AD is expected to further rise in the coming decades [ 2 ]. AD is characterized by the extracellular accumulation of amyloid-beta (Aβ) plaques and the presence of intracellular neurofibrillary tangles (NFTs).…”