Geographies in Depth

Why your dementia risk doubles if you're African American

A man beats a sheet of metal cut from an oil barrel to use as recycling material in Kamukunji, Nairobi on February 16, 2015. Saudi Arabia's oil exports have risen in February in response to stronger demand from customers. As OPEC's top producer battles for market share Reuters photographers around the globe have been photographing oil barrels to document how they are utilised once the fuel has been used. REUTERS/Siegfried Modola (KENYA - Tags: BUSINESS SOCIETY ENERGY TPX IMAGES OF THE DAY)

A man working with a United States flag on his cap. Image: REUTERS/Siegfried Modola

Andy Henion
Postdoctoral Researcher, Michigan State University

African Americans face a much higher risk—2.52 times greater—than Caucasian Americans of developing cognitive impairment, including dementia, later in life. A new study uncovers several reasons why.

Much of that racial disparity can be explained by childhood disadvantages, such as growing up poor and in the segregated South, and lower socioeconomic status in adulthood, particularly educational attainment, researchers say.

Surprisingly, health problems, such as heart disease and diabetes, and health behaviors, such as smoking and drinking, don’t account for much of the racial gap, says Zhenmei Zhang, associate professor of sociology at Michigan State University.

While the findings don’t fully explain blacks’ higher risk of cognitive impairment, they point to a strong need for policymakers to focus more on reducing racial gaps in socioeconomic resources over a lifespan, Zhang says. The study is published in the Journal of Health and Social Behavior.

“Social policies such as increasing educational resources in low-income communities, providing economic support to poor students and their families, improving graduation rates in high schools and colleges, and eliminating discrimination against blacks in the job market may significantly reduce racial disparities in cognitive impairment in later life.”

Researchers analyzed survey data from 8,946 participants in the Health and Retirement Study. They collected the information in multiple waves over a 12-year period (1998-2010); participants were aged 65 or older at the start of the study.

Once the researchers took into account the various socioeconomic factors, which include childhood disadvantages, the odds ratio of cognitive impairment between blacks and whites—or the racial gap—was reduced considerably, from 2.52 to 1.45. That means socioeconomic factors explained a lot.

Cognitive impairment among the elderly is a growing problem—spending on dementia care alone exceeds $100 billion a year in the United States—but it hits blacks particularly hard. The Alzheimer’s Association has identified Alzheimer’s disease among blacks as an emerging public health crisis.

“As people live longer and longer, it becomes an even bigger issue,” Zhang says.

Other researchers from Michigan State and from the University of Texas are couauthors of the study, which was supported by the National Institutes of Health.

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