Alzheimer’s disease rates are projected to triple by 2060, according to the latest data from the CDC. But while everyone is at risk to develop this devastating condition as they age, Hispanics and Latinos – defined as people of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin – are predicted to have the largest increase. By 2060, it’s estimated that there will be 3.2 million Hispanics and Latinos living with Alzheimer’s disease and related dementias.
Are Hispanics and Latinos at a Higher Risk to Develop Alzheimer’s Disease?
Hispanics and Latinos are 1.5 times more likely than whites to have dementia, although it’s not clear why. Hispanics and Latinos are more likely to have risk factors for Alzheimer’s, which include:
- Low socioeconomic status
- Cardiovascular disease
- High blood pressure
- Obesity
- Depression
- Diabetes
They also develop symptoms almost 7 years earlier than whites.
One theory is that while Alzheimer’s disease in white people is more likely to be tied to genetics, Alzheimer’s in Hispanics and Latinos is driven by the underlying health conditions mentioned above. For example, a well-known genetic risk factor for Alzheimer’s – a mutation in the APOE-e4 gene – is not as common among Hispanics and Latinos. But they’re more likely to have gene mutations related to insulin metabolism, which supports the idea that these groups may be more likely to develop Alzheimer’s from vascular or metabolic problems.
As a result, Hispanics and Latinos who already have preexisting medical conditions such as high blood pressure or type 2 diabetes may be more vulnerable.
Can Lack of Health Care Access Raise the Risk of Alzheimer’s for Hispanics and Latinos?
One third of Hispanics and Latinos say that they’ve faced discrimination when it comes to health care. As a result, they may be more reluctant to seek medical help if they begin to show signs of cognitive impairment and to let conditions that may raise the risk of developing Alzheimer’s, such as high blood pressure or type 2 diabetes, go untreated. One report found that only 44% of Hispanics and Latinos who noticed signs of cognitive decline said that they’d talk to their doctor about their symptoms. In addition, almost 40% of Hispanics and Latinos who’ve noticed signs of memory loss and cognitive problems said that they’d found it hard to access health care services because of:
- Lack of health insurance
- Worries about cost
- No transportation
- Long wait times for appointments
Over half of Hispanics and Latinos surveyed also reported that they believe that a loss of memory or cognitive abilities is just another inevitable part of aging.
Unfortunately, as a result, many Hispanics and Latinos are reluctant to be part of clinical trials for Alzheimer’s. While Latinos make up 18% of the U.S. population, they are less than a percent of the people in National Institutes of Health-funded clinical trials.
More than half of Hispanic and Latino adults surveyed by the Alzheimer's Association say they wouldn’t want to participate in a clinical trial because they don’t want to be guinea pigs. But clinical trials are one of the only ways people with Alzheimer’s can get potentially game-changing medical care.
What’s the Impact on Caregivers in the Hispanic and Latino Community?
There are almost 2 million Hispanic or Latino caregivers – about a fifth of the overall population – who take care of a loved one with Alzheimer’s disease or another form of dementia. They face numerous challenges, which includes:
- Financial stress. Many Hispanic and Latino older adults already live month-to-month on low incomes, which makes them more vulnerable to the economic impact of Alzheimer’s disease. Families who have a loved one with dementia can already expect to pay anywhere from $41,000 to $56,000 a year in health-care related costs. But many Hispanic and Latino families make less than that amount.
- High-intensity care. It is very hard for anyone to be a caregiver for a person with Alzheimer’s. But almost two-thirds of Hispanic and Latino family caregivers report that they are in very intense caregiving situations, compared to only about half of non-Latino caregivers. The typical Hispanic or Latino family caregiver is a woman in her 40s, caring for an older adult, and more than half also have a child or teen who still lives at home.
- Reluctance to ask for help. Sometimes, Hispanic and Latino caregivers are reluctant to ask for health care or community assistance and instead rely on family support. But more formal caregiving options, like respite care or financial assistance, may actually be more beneficial, for both them and their loved one.
- Lack of Hispanic and Latino medical professionals. Less than 5% of practicing doctors are Hispanic or Latino. This can make it harder to find a doctor who families feel share their cultural values, as well as their language. As a result, it may be harder for them to access care.
How Can You Help a Friend or Loved One Who Has Alzheimer’s Disease?
You can encourage them to be part of a clinical trial. This is important because people who are Hispanic or Latino may not respond in the same way to a specific diagnostic tool or treatment as someone who is white. Researchers need to understand how different therapies or approaches to Alzheimer’s work on a diverse group of people to make sure that they work for everyone. Research shows that Hispanic and Latino people are more likely to volunteer for a clinical trial if they are asked by someone who is the same race, as long as it doesn’t disrupt their time at work or with family and they have transportation and childcare. The Alzheimer’s Association has organized two major trials that focus on diversity and Alzheimer’s:
The New Ideas Study. This is a clinical trial that plans to recruit 2,000 Latinos and 2,000 African Americans to see if brain PET scans impact diagnosis and treatment.
The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk, or the U.S. Pointer study. This is a 2-year trial that studies the effects of several lifestyle interventions on the risk of cognitive decline among a diverse population, including Hispanics and Latinos.
The National Institute on Aging has also created a new online tool, Outreach Pro, to help increase participation in clinical trials for Alzheimer’s disease and other dementias among underrepresented communities such as Hispanics and Latinos.
There’s still a lot of work to do to make sure Hispanics and Latinos with Alzheimer’s disease get equal access to health care and that their caregivers get needed support. This way, an already devastating disease won’t be made worse by doctor discrimination and health care inequalities.
