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February 25, 2014

Dr. Darrell Gaskin
Dr. Darrell Gaskin

Alzheimer's Disease Is Growing Rapidly in the African-American Community, and the Cost of Treatment Is Soaring

by Frederick H. Lowe
Alzheimer's Disease and other forms of dementia are growing rapidly in the African-American community and no one is sure why or what medicines are effective in stopping the debilitating disease because blacks so far have been reluctant to participate in clinical trials to find an effective treatment.

African Americans are 13 percent of the U.S. population, but they account for 33 percent or $71 billion of the $210 billion annually spent on medical treatment for Alzheimer's disease and other forms of dementia, Dr. Darrell Gaskin, a Ph.D. health economist and deputy director for the Center for Health Disparities Solutions at Johns Hopkins Bloomberg School of Public Health in Baltimore. Dr. Gaskin is author of  “The Costs of Alzheimer’s Disease and Other Forms of Dementia for African Americans.”

Dr. Gaskin made his comments during a nationwide conference call on Monday hosted by the African American Network Against Alzheimer's.

He added that nearly 61 percent of the cost or $43.6 billion is for informal-care giving; nursing home-care costs $14.6 billion; $6.1 billion is a result of lost productivity and wages for those 40 to 64 years old with Alzheimer's and other forms of dementia and medical costs are $5.5 billion.

By 2050, the total cost, including medical care for Alzheimer's Disease and other forms of dementia in the African-American community, is predicted to balloon to $146 billion, Dr. Gaskin said.

He explained that the majority of African-American Alzheimer's patients live in the South because of the region's large black population. Care for blacks suffering from Alzheimer’s and other forms of dementia currently represent 49 percent of medical costs.

Many older African Americans retire to the South, and Alzheimer's is a disease that affects older adults. Alzheimer's, the most-common form of dementia, is characterized by a marked loss of global cognitive ability.

Alzheimer's is the fourth-leading cause of death among blacks and the sixth-leading cause of death among whites.

Dr. Gaskin said it is not known why African-Americans suffer from such a high rate of Alzheimer's Disease and other dementias, but he speculated that a cause might be poverty and the lack of early childhood education, which starts the mind on the road to being active.

"We don't really know the reason for the disparity, but African Americans are concentrated in poverty and live in high-poverty communities," he said.

Alzheimer’s and other dementia could be caused by low-literacy levels
Dr. Jennifer Manly, Ph.D. noted that memory decline occurs more rapidly among low-literacy elders. “This does not suggest that high literacy skills do not provide complete preservation of memory skills, but rather a slowing of age-related decline,” wrote Dr. Manly an associate professor of Neuropsychology in Neurology, the Sergievsky Center  and the Taub Institute at Columbia University. “In future years, we will determine if literacy is a significant predictor of who will develop Alzheimer’s disease and other dementias.”

The African American Network Against Alzheimer's is supporting clinical trials at 65 locations nationwide to determine what medicines may be effective treating African Americans with Alzheimer's Disease and other forms of dementia, said Stephanie Monroe, the network's director.

Individuals participating in the conference noted that medicines that are effective in the treatment of Alzheimer's in white males, a heavily studied group, may not be effective in treating African Americans because of differences in physical makeup. There is not a cure for Alzheimer's.

The African American Network Against Alzheimer's wants 1,000 African Americans interviewed for the clinical trials. One hundred blacks will be selected to participate at 65-study locations. The trials are scheduled to begin in the spring, and the participants must be between 65 and 85 years old, Monroe said.

African Americans have shown little interest in participating in clinical trials because of the medical community's history of inadequate and disrespectful treatment of blacks.
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