Trends in Relative Incidence and Prevalence of Dementia Across Non-Hispanic Black and White Individuals in the United States, 2000-2016

Abstract

In the US, dementia risk is higher in non-Hispanic Black individuals than in non-Hispanic White individuals. To evaluate progress toward reducing such disparities, tracking secular trends in racial disparities in dementia prevalence is essential. OBJECTIVE To examine whether relative racial disparities in dementia prevalence or incidence have changed in the US from 2000 to 2016. DESIGN, SETTINGS, AND PARTICIPANTSThe Health and Retirement Study (HRS) is a nationally representative study of adults 50 years or older. New participants are recruited every 6 years, and study visits occur biennially. Approximately 17 000 to 22 000 respondents have been surveyed at each wave since 2000, achieving response rates of 81% to 89%. Data for this cohort study were obtained from non-Hispanic White and non-Hispanic Black participants aged 70 years and older from the 2000 to 2016 waves. For analyses of secular trends in racial disparities in dementia prevalence, each HRS wave was considered separately (range of participants meeting eligibility criteria in each wave, 6322-7579). For analyses of secular trends in racial disparities in dementia incidence, 7 subcohorts were created (range of participants meeting eligibility criteria in each subcohort, 5322-5961) following up people without dementia for 4 years from subcohort baseline visits

2021 Alzheimer's disease facts and figures

“…Although there are more Whites living with Alzheimer's and other dementias than any other racial or ethnic group in the United States (because Whites are the largest racial/ethnic group in the country), older Black and Hispanic Americans are disproportionately more likely than older White Americans to have Alzheimer's or other dementias 271–277 . Data from the CHAP study indicates 18.6% of Blacks and 14% of Hispanics age 65 and older have Alzheimer's dementia compared with 10% of White older adults 216 .…”

“…It is unclear whether these encouraging trends will continue into the future given worldwide trends showing increases in diabetes and obesity — potential risk factors for Alzheimer's dementia — which may lead to a rebound in dementia risk in coming years, 107,301,303,321–323 or if these positive trends pertain to all racial and ethnic groups 241,273,300,319,320,324 . Thus, while recent findings are promising, the social and economic burden of Alzheimer's and other dementias will continue to grow.…”

“…As discussed in the Prevalence section, health and socioeconomic disparities and systemic racism contribute to increased Alzheimer's and dementia risk in communities of color 85,140,217,284,287–289,292,293 . Older Black and Hispanic Americans are also disproportionately more likely to have Alzheimer's and other dementias, as well as more likely to have missed diagnoses, than older White Americans 271–277,294–296 …”

“…As described in the Prevalence Section, older Black and Hispanic Americans are more likely to have Alzheimer's or other dementias than Whites, and this is likely due in part to health and health care disparities 85,87,271–277,284,285,287,288 . Coinciding with increasing diversity in the general population, the number of older Americans, particularly the oldest‐old (those age 85 or older), is also expected to grow — with more than twice as many cases of Alzheimer's and other dementias anticipated by 2050 216 .…”

2022 Alzheimer's disease facts and figures

“…Racial and ethnic differences in the prevalence of Alzheimer's and other dementias Older non-Hispanic Blacks and Hispanic Americans are disproportionately more likely than older Whites to have Alzheimer's or other dementias. [290][291][292][293][294][295][296] Data from the CHAP study indicates 19% of Black and 14% of Hispanic adults age 65 and older have Alzheimer's dementia compared with 10% of White older adults. 224 Most other prevalence studies also indicate that older Blacks are about twice as likely to have Alzheimer's or other dementias as older Whites.…”