Background.Hispanics/Latinos (H/Ls) are one of the fastest-growing cultural groups in the United States. They are also disproportionately affected by various health conditions. These health-related disparities have significant implications as the population ages.
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The Largest and Fastest-Growing Cultural GroupRoughly 18% of the United States population -- nearly 1 in 5 US residents -- identifies as Hispanic/Latino (US Census Bureau). It is expected this number will grow to 28% -- or 111 million people -- by 2060.
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A Rapidly Growing Age GroupAs the population ages, the number of Hispanic/Latino older adults quickly grows. By some estimates, this number is doubling every 15 years (Pew Research Center).
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Increased Alzheimer's RiskAlzheimer's disease is a condition linked to cell death in the brain. In the early stages, it can cause problems with memory and thinking abilities, impacting our ability to carry out daily activities, like cooking and driving. Together, these problems are called a dementia. Compared to non-Hispanic White individuals, Hispanics/Latinos have a 50% greater risk for Alzheimer's disease and related dementia (ADRD).
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Rising Rates of ADRD Diagnosis
Age is the biggest risk factor for Alzheimer's disease related dementia (ADRD). The older we get, the greater the risk for ADRD. Hispanics/Latinos tend to live longer compared to other cultural groups. With the growing population of older adults as well as the increased risk for ADRD, the number of Hispanics/Latinos diagnosed with ADRD is expected to grow 9-fold by 2060.
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ADRD: A Leading Cause of Death
As Alzheimer's disease progresses, causing more severe stages of the dementia, brain areas crucial for keeping our bodies alive are affected, leading to death. Alzheimer's disease and its related dementia is one of the top causes of death for Hispanics/Latinos in the United States. Currently, there is no cure for Alzheimer's disease, but some available treatments can help with symptoms. Scientists are currently working on finding a cure.
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Different Disease Course
While there are similarities in the Alzheimer's disease related dementia (ADRD) symptoms both groups experience -- like problems with memory -- Hispanics/Latinos may start experiencing symptoms as much as 7 years earlier than non-Hispanic White individuals. However, Hispanics/Latinos often wait longer to seek help for their symptoms. By this time, their symptoms tend to be more severe and harder to treat. The presentation of the dementia might also look different and Hispanics/Latinos live longer with the disease. The reasons for these differences in the course of the disease remain largely unknown.
Less Likely to Receive Treatment
In addition to seeking help later than other groups, Hispanics/Latino individuals are less likely to take medications available for Alzheimer's disease symptoms. How likely H/Ls are to receive treatments varies, but can be as much as 40% less than non-Hispanic White individuals. Issues of trust and access to medical care as well as perceptions of what is "normal" aging likely contribute.
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Different Disease Risk Factors
We still do not know what causes Alzheimer's disease and its related dementia. However, several factors seem to increase our risk or chances of getting the disease. One of these, a genetic factor known as apolipoprotein E4 (apoE4), has consistently been linked to a greater risk for Alzheimer's Disease in non-Hispanic White individuals, but not in Hispanic/Latino individuals. Instead, other health factors -- like hypertension and diabetes -- and social determinants of health seem to help explain some of the increased risk for Alzheimer's Disease related dementia in Hispanics/Latinos.
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Little Representation in Research
Despite these differences in disease risk, rates, and course, little is known why these differences exist. Knowing more about the causes of these differences can help us better understand Alzheimer's disease, which can lead to better ways of treating -- or even curing -- the disease. However, Hispanics/Latinos are not represented well in Alzheimer's research. The National Alzheimer's Coordinating Center (NACC) has one of the largest sets of Alzheimer's research data. While Hispanics/Latinos represent 18% of the United States population, less than 9% of the research participants in the NACC data set are Hispanic/Latino. Participating in research may open doors to improving both our own health and that of our communities
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The ParadoxIn summary, compared to non-Hispanic White communities, the growing Hispanic/Latino communities entering older ages are (1) at increased risk for Alzheimer's disease and related dementias (ADRD), (2) showing symptoms earlier and more severely, (3) not getting diagnosed until much later, (4) not receiving treatment, but (5) may live longer with the disease.
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The ProblemThe reasons for this pattern in communities of Hispanic/Latino older adults remain unclear. Genetic factors do not seem to help explain this, suggesting other factors may be responsible. What factors may help explain these differences? Finding an answer to this question may help scientists find better treatments -- or even a cure -- for Alzheimer's disease. However, most research programs do not include enough Hispanic/ Latino individuals to find an answer.
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The Path to a SolutionWhy are Hispanic/Latino individuals not well represented in aging research? Several barriers may exist, such as: lack of trust in scientists/doctors; access issues (e.g., taking time off work to participate); understanding of normal aging vs dementia. Solutions to these barriers are critical -- the problem is too big to ignore. To find a solution, it will be vital to engage communities, build trust, and improve communication.
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