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Does Race Play a Role in Alzheimer’s Disease?

Published July 27, 2015 10:27 AM by Brian Garavaglia

In a recent study in the journal of the American Academy of Neurology, some interesting findings as it relates to Alzheimer’s disease and race were found that may have implications for further research and treatment. There have been some assumptions that the brain changes found in Alzheimer’s disease among different racial groups are not uniform. In the recent study Lisa Barnes, PhD, of Rush University Medical Center decided to put this hypothesis to a test. She decided to examine the underlying neuropathological changes found in the brain of those that have Alzheimer’s disease based on the race of the subject.

The study examined 41 African Americans with a diagnosis of Alzheimer’s disease. They were compared with 81 individuals who were categorized as European American and also had Alzheimer’s disease. Both groups were matched on level of disease, age, sex and education. All individuals from both groups had autopsies on their brains completed at the time of their death. The researchers examined the brains of both groups for the typical brain changes often found among Alzheimer’s disease patients, such as plaques and tangles. However, in addition, they looked for vascular changes that may have occurred due to strokes, Lewy bodies, Parkinson-type brain pathologies as well as other pathological changes in the brain.                   

The results of the study showed that virtually all subjects that were autopsied had evidence of Alzheimer’s disease. However, they also demonstrated that when comparing the two groups approximately half of the 81 European-Americans had “pure Alzheimer’s disease,” which they defined as brain pathology that was exclusively dominated by Alzheimer’s disease and no other histopathology. Conversely, when the African American group was examined, they found that less than 25% of the subject’s brains showed pure Alzheimer’s pathology. The African American subjects had a greater likelihood of their dementia having a mixed pathology. Approximately 71%, as compared to approximately 50% for the European American group, demonstrated more than a single underlying pathology that contributed to their dementia. Quite frequently, the African American group’s co-morbid feature that accompanied their traditional Alzheimer’s pathology was cerebral blood vessel disease. Given that African Americans often have a greater likelihood of having blood pressure issues and diabetes, the discovery of the mixed pathology of African Americans, especially the findings of Alzheimer’s with cerebral vascular pathology, appears to make sense. 

Although these findings are quite important, it is also quite early to draw definitive conclusions about differences between different racial groups and dementia. More work has to be done to examine a larger number of individuals to determine whether the results that were found in this study continue to stand. Furthermore, it would be interesting to also broaden the examination to other groups such as those of Asian descent to see if different forms of underlying histopathology are found in their brains as well. Furthermore, do racial groups found in our society with specific underlying brain pathology continue to demonstrate the same pathology in other countries, for instance, African Americans or Asian American in the United States with those who suffer from dementia and are African and Asian and live in these parts of the world? 

Nevertheless, if the results of the study continue to be demonstrated by future studies, it has important implications for treatment of different racial groups and individuals who suffer from symptoms of Alzheimer’s disease and other forms of dementia. As the author of the study states, current treatments for Alzheimer’s disease are quite specific, with the drugs targeting anticipated underlying Alzheimer’s pathology. With the current study’s findings that many African Americans have a greater likelihood of mixed etiology for their dementia, the arsenal of Alzheimer’s specific medications currently used as treatments may be far less helpful for many African Americans that have signs and symptoms of dementia. Therefore, targeting new forms of therapeutic intervention, as well as even prevention, may be quite important for future clinical success in the treatment of dementia, especially in considering how different racial groups may have different contributing etiological factors to the makeup of their disease.   

References:
1. Science News (July 15, 2015).  Alzheimer's may affect the brain differently in African-Americans than         European-Americans: http://www.sciencedaily.com/releases/2015/07/150715170654.htm
posted by Brian Garavaglia

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About this Blog


    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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