The Alzheimerâs Epidemic No One Is Talking About
Black Americans are twice as likely to develop Alzheimerâs disease as white Americans. Hereâs what we know right nowâand how to make a difference. BY MEGHAN RABBITT
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SIX YEARS AGO, Veronica Shanklin showed up at her childhood home in DeSoto, Texas, expecting a typical visit. Shanklinâs grandmother, whoâd been diagnosed with Alzheimerâs disease at age 82, had moved in with Shanklinâs mom a few years earlier. Shanklin, a marketing executive in Chicago, wanted to spend some time with them and was also eager to help with caretaking for a few days; she was sure her mom, then 66, could use a break. Yet mere minutes after walking in the door, Shanklinâs heart sank. Both her grandmother and mother had lost weight. The usually tidy home was a mess, with dirty laundry piling up and overdue bills scattered across a bed.
âMy mom was the manager of the credit union at her church,â Shanklin says. âIf she couldnât pay her own bills or keep up with cooking and cleaning, I knew something was wrong.â Then Shanklin noticed that her mother kept forgetting what day it was. Sheâd seen her grandmotherâand grandfather, who also had Alzheimerâsâdeal with similar issues. Worried, Shanklin took her mom to the doctor. The diagnosis confirmed her fear: Alzheimerâs disease. Shanklin quit her job and moved to Texas. She took over caregiving for her mother and grandmotherâpreparing meals, keeping house, helping them get to doctorâs visitsâ all while making sure they didnât wander out of the house or otherwise endanger themselves. âThis disease has turned my life upside down,â Shanklin says. âAnd the fact that itâs touched two of my grandparents and my mom almost seems unfair.â Unfair, yes, but unfortunately not unusual. Shanklinâs family history is in line with some staggering statistics: Older African Americans are about twice as likely as older non-Hispanic white people to develop Alzheimerâs or other dementias, according to the Alzheimerâs Association. On top of that, less than 5 percent of participants in U.S. health studies are black, making it difficult to identify factors driving the disparity and find ways to address them. Scientists have tried to ascertain whether African Americans naturally make more betaamyloid and tau proteins, two of the signature causes of Alzheimerâs. Beta-amyloid forms clumps in the brain that interfere with cell-to-cell communication, and tau creates so-called tangles inside brain cells. Both result in forgetfulness, confusion, difficulty concentrating, delusions, and other telltale symptoms of the disease. So far, thereâs no evidence that African Americans have higher levels of beta-amyloid or tau, says Reisa A. Sperling, MD, a Harvard Medical School neurology professor and director of the Center for Alzheimer Research and Treatment at Brigham and Womenâs Hospital. âWe have other theories, though,â says Lisa L. Barnes, PhD, a professor of gerontology and geriatric medicine at the Rush Alzheimerâs Disease Center at Rush University Medical Center and a trailblazer in researching the Alzheimerâs racial imbalance. Barnes and other experts point to the fact that black Americans have higher rates of diabetes, hypertension, stroke, elevated cholesterol, and heart diseaseâall of which are correlated with Alzheimerâs dementia. These conditions also affect blood vessels and can impair blood flow, which can then damage the brain and may also contribute to beta-amyloid and tau protein buildup, thereby raising Alzheimerâs risk, explains Barnes.
I L L U S T R A T I O N S B Y Dan Bejar
