The Stark Reality of Racial Disparities in Alzheimer’s Care
Alzheimer’s disease affects millions of Americans each year, yet not all communities benefit equally from advances in diagnosis, care, and treatment. In the United States, Black individuals are significantly more likely to develop Alzheimer’s and related dementias than White individuals, but they are far less likely to receive timely diagnosis, adequate care, and access to the latest treatments — resulting in a growing health equity crisis.
According to the Centers for Disease Control and Prevention (CDC), about 14 % of Black Americans over age 65 have Alzheimer’s, compared with approximately 10 % of white Americans — and this disparity may be even higher due to underdiagnosis.
Despite this elevated risk, research shows that Black patients are less likely to receive specialized dementia care, and often present at more advanced stages of the disease.
Why Early Diagnosis Matters
The latest approved therapies for Alzheimer’s — such as lecanemab (Leqembi) and aducanumab (Aduhelm) — are most effective when administered in the early stages of cognitive decline. However, studies show that Black patients are more likely to receive a diagnosis later in the disease’s progression and are underrepresented in specialty memory clinics — key points of access for new treatments.
One study found that Black patients were underrepresented in memory care settings relative to their presence in the community and tended to have more advanced dementia at first clinic visit compared to white patients.
This delayed care means that many Black patients may not be eligible for certain therapies because their disease has progressed beyond the early stage at which these drugs are most effective.
Barriers to Alzheimer’s Care for Black Americans
Several intersecting factors contribute to the disparity in Alzheimer’s care for Black Americans:
1. Mistrust in Medical Systems
Historical abuses — including unethical research practices like the Tuskegee syphilis study — have contributed to mistrust among Black communities. As a result, Black individuals may be less likely to seek care early or participate in clinical research.
2. Perceived and Experienced Discrimination
Black Americans are more likely than other racial and ethnic groups to believe that race or ethnicity makes it harder to receive excellent care for Alzheimer’s. Many also report having experienced discrimination when seeking care for themselves or a loved one.
3. Lack of Culturally Competent Providers
Only about half of Black Americans feel confident that they have access to healthcare professionals who understand their cultural and racial backgrounds. This lack of culturally sensitive care can discourage patients from seeking help or adhering to care plans.
4. Socioeconomic and Systemic Barriers
Socioeconomic factors — like lower average income, less access to specialized neurologists, and fewer resources for memory care — further limit equitable care and treatment opportunities. Research confirms that patients from less affluent neighborhoods, including many Black communities, are less likely to be seen in clinics where innovative treatments are offered.
The Impact on Treatment and Clinical Trials
The under‑representation of Black patients in Alzheimer’s clinical trials remains a significant concern. Without diverse participation, researchers cannot fully understand how new treatments work across different populations — or ensure that these medications are effective and safe for everyone.
The Alzheimer’s Association has emphasized that clinical trials must include diverse participants to accurately assess effects and benefits across racial and ethnic groups.
What Can Be Done to Improve Equity?
Addressing racial disparities in Alzheimer’s care will require action at multiple levels:
✔ Community Education and Outreach
Raising awareness about Alzheimer’s symptoms and the importance of early detection can empower families to seek care earlier.
✔ Increase Cultural Competence in Healthcare
Training healthcare providers in culturally aware best practices builds trust and improves patient experiences.
✔ Targeted Clinical Trial Recruitment
Research institutions and pharmaceutical companies should expand efforts to recruit diverse participants in clinical trials, helping ensure that novel therapies benefit all populations.
✔ Policy and Health Equity Initiatives
Public health policies that address social determinants of health and improve access to specialized care — such as incentives for clinics serving underserved communities — can help reduce disparities over time.
For more information on disparities and efforts toward equitable Alzheimer’s care, visit the Alzheimer’s Association Health Equity page 👉 https://www.alz.org/professionals/public-health/public-health-topics/health-equity.
Conclusion
Black patients in the United States face a complex web of barriers to Alzheimer’s care, from societal discrimination and mistrust to delayed diagnosis and limited access to new treatments. As Alzheimer’s innovations emerge, it is essential to ensure that access is equitable — so that these breakthroughs do not disproportionally benefit only those already privileged with early access to care.
By recognizing these disparities and actively working to dismantle them, healthcare providers, policymakers, and communities can help ensure that every patient — regardless of race — has the opportunity to benefit from advances in Alzheimer’s treatment and care.
