Why Do Racial Disparities Exist in Alzheimer's Disease and Dementia Care?

Alzheimer's disease and dementia diagnoses are on the rise across the country, especially in communities of color.

Fact checked by Nick Blackmer

As a child, I watched my grandmother care for and then lose three of her sisters to Alzheimer’s disease all within the span of 10 years. Back then, I thought that the memory loss my aunts experienced was a normal part of aging—an unfortunate assumption that many of us make before our loved ones receive their diagnosis.

Almost 7 million people in the United States live with Alzheimer’s disease, but the burden of that diagnosis is not carried equally among the racial groups that make up this country. Black people carry the highest risk of developing dementia followed by Indigenous Americans, and people of Hispanic and Latino descent. Despite this increased risk, these groups are often underrepresented in research and clinical trials and are more likely to face barriers to accessing quality care and basic resources like healthy foods and clean air.

The underlying risk factors of dementia—hypertension, diabetes, air pollution, poor nutrition, and lack of physical activity—all have a connection to the inequalities experienced by communities of color and people with lower incomes.

As our country becomes more diverse, we need to build a more equitable system that allows for better health outcomes for communities. In this series, Health explores the dementia risk factors within our control, why people of color receive their Alzheimer's disease diagnoses later and the symptoms to watch out for, and the barriers marginalized communities face when they do try to access memory care.

Dementia and Alzheimer’s disease are conditions that typically manifest as we grow old, but prevention starts with the resources we have early on in our lives. Something as simple as proximity to fresh air and clean food could improve your health outcomes and the health of future generations.

— Destine Manson, Health’s assistant editor

Why Some People Don’t Seek a Dementia Diagnosis Sooner

Communities of color, despite having higher risks of dementia, tend to seek care from a provider much later than white communities. But why?

Evidence suggests that racial bias has led to stark healthcare inequalities for people of color. Some examples in the research show that healthcare providers are more likely to ignore symptoms in people of color, and Black and Latino people are less likely to receive appropriate and advanced treatment options for health conditions.

When it comes to getting a dementia diagnosis, research found it can take four months longer, on average, for Black people to receive a diagnosis, and over a year longer for Hispanic people. When people from these communities finally get a diagnosis, they’re more likely to have significant cognitive and functional difficulties as a result of this diagnostic delay.

For the best outcomes, it’s important to address dementia symptoms as soon as they appear. Below, Health editor Sukhman Rekhi explains the early warning signs of dementia to keep watch for in yourself or a loved one.

Implicit Bias

Implicit bias is a term for negative and unconscious beliefs and attitudes about certain racial identities, genders, sexual orientations, and other identifying factors. These biases can influence you to make judgments about or discriminate against certain groups of people.

Barriers to Dementia Care and How to Bridge the Gap

Dementia is a leading cause of death in Black Americans and continues to be a significant risk factor for Latino, Indigenous, and Asian communities in the United States.

Current statistics show that approximately 40% of primary care providers—who are considered frontline resources in dementia care—come from diverse racial and ethnic backgrounds. Because communities of color often experience racial discrimination in healthcare systems, they prefer working with providers who understand their cultural background or speak their language.

Additionally, drug trials that test new medical treatments have excluded people of color due to discriminatory practices in research. But now, Black people are left out of dementia clinical trials for a different reason.

Health reporter Julia Landwehr explores the barriers Black Americans and people in less affluent neighborhoods face when it comes to accessing dementia care, including the latest drugs for Alzheimer's disease, and what can be done to address these inequities.

The High Cost of Treatment

Caring for a loved one with dementia can be financially challenging. A 2015 study found that the cost of care for a person with Alzheimer’s disease can be up to $287,000. This cost is especially difficult for uninsured families and those who live in areas with limited resources.

In addition, people of color are more likely to be uninsured than their white counterparts. 2021 U.S. Census Bureau data outlined the differences in healthcare coverage by race. They found that 18.8% of AIAN communities, 17.7% of Latinos, 10.1% of Pacific Islanders, and 9.6% of Black people are uninsured—as compared to 5.7% of white people.

The cost of dementia treatment through Medicaid is expected to continue to grow exponentially by 2050. As the prevalence of the disease increases, affordable healthcare programs will be necessary to care for a growing population of people with dementia.

Given the cost of caring for someone with dementia, many people cannot afford outside help and in turn care for their loved ones themselves. If you're a caregiver to someone with dementia, read on for some simple ways to support a loved one with dementia.

Frequently Asked Questions

Can dementia be cured?

There is currently no cure for dementia, but having access to treatment can help slow disease progression.

Is Alzheimer's disease hereditary?

While you don’t need to have a family history of Alzheimer’s disease for you to get Alzheimer’s, some research suggests that those with a first-degree relative with Alzheimer’s are more likely to develop the disease, and the risk increases with each affected relative.

Your direct environment plays a significant role in your Alzheimer’s risk.

How can I prevent dementia?

While there aren’t any proven ways to prevent dementia, you can reduce your risk by lowering your chances of developing diseases that are linked to dementia, like high blood pressure and heart disease.

Methods for managing your risk include eating a heart-healthy diet, exercising regularly, getting enough sleep, not smoking, and limiting alcohol consumption.

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