Written by Being Patient

Experts estimate that, by 2030, more than 8 million Americans will be living with Alzheimer’s disease or another form of dementia. Black Americans will make up a disproportionate amount of these cases: They are twice as likely to develop these diseases than their white counterparts. Despite ongoing research, scientists still can’t definitively say why that’s the case. 

Here are a few factors that experts believe contribute to the disproportionate dementia risk in Black Americans:

1. Race-specific genetics and other biological factors 

Scientists are also looking at the underlying biology of Alzheimer’s and dementia for more clues that are specific to genetic risk. 

Black individuals are more likely to carry the Alzheimer’s gene APOE4. While there is a strong association between the APOE4 gene and cognitive decline in whites, it does not appear to be as strong a driver of decline in Black Americans. Another gene called ABCA7 is linked to a higher risk of developing the disease, specifically in Black Americans, where it might even have more of an influence than APOE4. 

Many questions related to genetics and Alzheimer’s risk in Black Americans have gone unanswered due to lack of Black Americans participating in clinical trials, medical research, and doctors for hundreds of years of mistreatment from the medical community. Researchers are now playing catch-up to understand risk and treatment of Alzheimer’s and other neurodegenerative diseases in Black Americans. Increasing the inclusion of Black Americans and diverse populations in clinical trials and research studies will help scientists begin to answer these questions.

2. Increased health conditions and less access to healthcare

Due to the previously mentioned factors, as well as race-specific genetics and historically experiencing higher levels of food insecurity, Black Americans are also more likely to have other chronic health conditions. High cholesterol, high blood pressure, diabetes, and stroke health conditions can bump up the dementia risk of Black Americans when these conditions go untreated.

Black Americans have less access to quality medical care, and also report higher levels of experiencing medical injustices and overall being treated poorly by healthcare workers. According to a survey by Pew Research, more than half of Black Americans have had negative experiences with healthcare providers in the past year — including having to advocate to ensure they got proper care.

3. Systemic racism and individual racism

Experts say that the long-lasting effects of systemically racist policies throughout history have led to an elevated risk for older Black Americans. Residential segregation and redlining in the 1960s geographically isolated Black communities in areas that were exposed to higher levels of air pollution and fewer educational opportunities than white children. Increased exposure to pollution and toxic chemicals and receiving lower levels of education are factors that lead to an increased risk of developing dementia.On an individual level, enduring racism and discrimination sets the brain into overdrive to help people cope, and it might lead to faster brain aging as a result.