Our caregiver's group brought up this subject at our last meeting. Wondering if there is a study re: race and Alzheimer's Disease. We've been going to our Neurologist's Clinic for years and when asked, I had to admit, I don't believe I have ever seen an oriental, middle Easterner or black patient in the waiting room. This clinic operates on three floors, and share a large waiting area. Houston is a large international city, and many doctors in the Medical Center are from India and the Orient, as well as other places around the world.
Has anyone ever seen a study about Alzheimer's and how frequently it affects the black, Hispanic or oriental races.
We this discussion before. Blacks and Orientals tend to keep their elders at home. Don't seek treatment and don't put them in institutions. As I remember dementia hits all races. Marsh even mentioned that "in lily white Maine" he did treat a black dementia patient.
That is interesting. We have so many oriental doctors in the medical center, you'd think they'd bring their LO's in for treatment. We should all be elders in oriental families. They sooooooo honor and respect their elders. It's beautiful!
I cannot say I have ever seen a black dementia patient in a care facility or a doctor's office. I have seen women who are obviously Indian, Pakastani, or similar. I've not seen an Oriental in any of the nursing homes, and I am certain it has nothing to do with money! They are highly educated and almost always pay cash for their homes and/or cars.
We have to be careful not to stereotype here, but there is AD in most every race. (Someone can look it up - there is at least one culture that has little or no AD, but I don't remember which it is.) The difference is in culture, as has been mentioned. In the Hispanic and Asian cultures, they do tend to take care of the ill and demented at home. Today, there are many well educated professionals in the black community, but there has always been, and still is a lot of poor education and poverty in the American black community = no health care = why you may not see them in the neurologist's office.
BTW - Sid's psychiatrist is a specialist in Alzheimer's Disease, and she is Indian ( from India).
If I remember right there are several Mediterranean cultures who have less dementia. Hopefully someone will have the answer to your question as far as which ethnic background.
There is absolutely NO INTENT of racial stereotyping on my part here! NONE whatsoever. !!!! It's a simple question that is often addressed in regard to many different diseases. I am a heart patient at the Texas Heart Institute at St. Lukes Hospital and have been told, for example, that there is a relative low incidence of heart disease among Oriental people, and it's attributed to their low fat diet and low obesity rates. On the other hand, my Caucasian doctor's Black Nurse Assistant (!!!) has told me that heart disease and stroke is extremely prevalent among (her) black race. Hispanics have low incidence of ulcers and common stomach/intestinal problems according to my personal gastroenterologist. I am interested in learning how various diets have impacted long term health conditions among people from different countries. That being said, I had never read a report or comment on the incidence of Alzheimer's among the various cultures of our world.
Again, I pray I did not offend anyone on this site by asking that question. It was certainly not my intention. If I did, I offer my most sincere apology.
Frequency of Dementia Etiologies in Four Ethnic Groups Craig E. Houa, Kristine Yaffea-c, Eliseo J. Pérez-Stabled, Bruce L. Millera
Departments of aNeurology, bPsychiatry and cEpidemiology and Biostatistics, and dCenter for Aging in Diverse Communities, Division of General Internal Medicine, Department of Medicine, and Medical Effectiveness Research Center for Diverse Populations, University of California at San Francisco; San Francisco, Calif., USA
Background/Aims: Research on dementia among ethnically diverse populations in the USA has focused primarily on Alzheimer disease and vascular dementia, but there are limited data on other neurodegenerative causes of dementia. Methods: To determine the frequency of neurodegenerative disorders in four ethnic groups, data collected at Alzheimer's Disease Research Centers of California for assessments between 1992 and 2002 were analyzed retrospectively. Cases of Alzheimer disease, vascular dementia, dementia with Lewy bodies, frontotemporal lobar degeneration, Parkinson disease and progressive supranuclear palsy were identified for 452 Asian and Pacific Islander, 472 Black, 675 Latino and 4,926 White patients. Results: The percentage of non-Whites diagnosed as having dementia with Lewy bodies was lower than that of Whites. Frontotemporal lobar degeneration was as common in Asians and Pacific Islanders compared to Whites, but less common in Blacks and Latinos. Progressive supranuclear palsy was more frequent in Asians and Pacific Islanders compared to Whites, but equally common in Blacks and Latinos. Conclusion: Additional study is needed on the social and biological factors that influence the diagnosis and prevalence of non-Alzheimer and nonvascular dementias among diverse ethnic groups.
You did not offend at all. I'm just always extra vigilant in being careful that the discussions such as these stay on an intellectual level, and don't become inappropriate. See Bluedaze's research above. The conclusion is inconclusive because there are so many biological and social factors involved. It is fascinating as to which group of people in the world are more prone to get which disease.
Sometime when I am more awake, I will tell you the interesting theory our neurologist has on which group of caregivers do best. (Believe me, the group I fall into is not high on the list.)
This is an excerpt from some research I did on this subject for one of my columns:
"These defective genes are found throughout the human race, but the subsequent appearance of Alzheimer’s differs among whites, blacks and other groups, even between Europeans, occurring at 30% in Lapps, Swedes and Finns to 10% to 12% with Greeks, for example. Because of cultural differences, extended families who may share caregiving, reluctance to see a doctor, misdiagnosis, finances, and social taboos, it can be difficult to achieve accurate statistics, but all races appear to get Alzheimer’s, one way or another."
I have a doctor from India and she told me her FIL had AD in India. She also told me that the family begged her to put a feeding tube in, and that, she confessed, was the worst medical decision she'd ever made. AD is vastly underreported in India, but it does exist. Lots of stigma, of course, and I wonder about the caste system and intermarriage and how that may affect different groups. Many cultures still have extended families with several relatives around to care for someone w/AD, but in many Western countries, America, i.e., we have the nuclear family, lots of moving around, children going off to other places and care too often falls on one person. I think we show great care and love by putting our LO's in care facilities, it is not a matter of abandonment or neglect, quite the opposite, but one person--like many on this list--simply cannot do it alone. Placement is often a profound emotional and financial sacrifice done out of love and self-preservation, it is not an easy decision blightly made to get someone off our hands so we can be free to go party. There are just too many variables amoung different countries, groups & sub-groups at this time to be able to make a definitive conclusion. Well, anyway, that's my opinion.
California is among the most ethnically and culturally diverse states in the U.S., and the question of which ethnics/cultures tend to exhibit dementias, and how quickly the trends will change, is a very serious question for our state government. If you would like information on this, go to:
http://www.alz.org/cadata/
and pull the full report for 2009. It's not terribly long, and is well-written. Information on this particular subject begins at Sec2:6.
Although there is some evidence of genetic differences and environmental risk factors for AD among ethnically diverse groups, more studies are needed to confirm these variations. Also, cultural biases in cognitive testing (remember the MMSE is designed for those who speak English as their native language) and inadequate translation of diagnostic tools may influence the identification of dementia in ethnically diverse populations. There are also not enough bilingual professionals in this field. Ergo, underreporting and obtaining a diagnosis at a later stage of AD often occurs among these populations.
The report discusses in detail Latino/Hispanic, Asian/Pacific Islander, African-American, and Native American populations.
Studies on this subject are quite recent. The report says that research to date suggests that Latinos/Hispanics may be at greater risk of developing dementias than other ethnic or cultural groups, due to a number of factors. Genetic risk factors are apparently different in African-Americans versus Caucasian/non-Latino Americans, and environmental factors may work differently to cause AD in this population. They have a higher risk of stroke, vascular dementia, and type 2 diabetes, for example.
Asian/Pacific Islanders encompass immigrants and their descendants from a large number of countries with widely varying histories, cultures, traditions, and languages. It is therefore much more difficult to study this population and evaluate genetic and environmental risk factors.
However, what we do know is that between 2000 and 2004, African-Americans and Asian/Pacific Islanders in California showed the greatest increase in reported deaths due to AD. Between 2008 and 2030, AD in Asian/Pacific Islanders is predicted to almost triple, from ~72,075 to 194,266 AD patients in California.
Sunshyne I am really surprised with the summation and prediction. Would have thought Pacific Islanders would not be so afflicted in such large numbers (see-I really do read your tomes)
It is interesting to see the comments about India. Several months ago I was in contact with a doctor in California about the use of curcumin. He got interested in this because, he said, AD was uncommon in India, where they use a lot of curry (from curcumin) in their diet. I tried the curcumin on my wife, with no benefit, so stopped.
marsh-I asked one of our Indian doctors why so many cardiologists were Indian. His response: they are prone to DM. have very small coronary arteries, and their diet is very high in fat-even those who shun meat.
Joan--Please do your next blog on your doctor's theory about which caregivers do best! The only thing I have been told is that the lower people are economically, the more hands-on support they get from their community, and vice versa.
From the readings I would say there are indications that it is something in our diets or environment that is behind it. The exception would be the type caused from the gene. I was watching Oprah briefly yesterday while talking with Michael J Fox. He was talking about how his symptoms of Parkinsons was reduced when he went to this country. He was at a higher altitude and taking medication to prevent altitude sickness. Dr. Oz thought that was interesting and someone needs to look at why.