Racial and Ethnic Disparities in Alzheimer's Disease: A Literature Review. Possible Reasons for Racial and Ethnic Disparities

02/01/2014

Possible reasons for racial and ethnic disparities include factors related to measurement of Alzheimer's disease, genetics, cardiovascular and cerebrovascular disease, socioeconomic factors, cultural differences, and racial and ethnic discrimination. A range of pathways have been suggested that link race and ethnicity with cognitive impairment, some of which have implications for disparities (Figure 3) (Glymour & Manley, 2008). In this section, we describe the evidence underlying selected factors, mediators, and pathways associated with disparities in this population.

FIGURE 3. Pathways Linking Race/Ethnicity and Cognitive Impairment

FIGURE 3, Direction Chart: Three Mediators--Distal, Socially Patterned; Individual; Proximal. Race/Ethnicity leads to (1) Geographic exposures, Immigration, Socioeconomic status, Discrimination, Group resources/ties/identify. (1) leads to (2) Material conditions, Psychological stressors; (3) Cognitive engagement; (4) Test-taking skills. (2) leads to (5) Physical health, Health behaviors. (3) leads to (5) and (6) Cognition function/impairment/change. (4) leads to (7) Diagnosis of cognitive impairment. (5) leads to (6). (6) leads to (7). (8) Access to medical care leads to (6) and (7).

SOURCE: Adapted from Glymour and Manly, 2008.

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