February 14, 2001

Intercontinental Epidemiology of Alzheimer DiseaseA Global Approach to Bad Gene Hunting

Author Affiliations

Author Affiliations: Departments of Medicine and Neurology, School of Medicine, and Department of Epidemiology and Biostatistics, School of Public Health, Boston University, Boston, Mass.

JAMA. 2001;285(6):796-798. doi:10.1001/jama.285.6.796

The population of African Americans older than 65 years and therefore at risk for Alzheimer disease (AD) and other dementias is increasing even faster than the white population in this age group.1,2 In general, studies have found rates of dementia in African Americans to be comparable with or higher than in whites.35 However, this issue is far from clear. Vascular dementia (VaD), which is more prevalent among African Americans than whites,6 is usually attributed to the higher prevalence of cardiovascular risk factors. For example, according to data from the Third National Health and Nutrition Examination Survey from 1988-1991, 24% of the US population has hypertension.7 The age-adjusted national prevalence is higher in non-Hispanic African Americans (32.4%) overall, and even higher for African Americans in the southeast region of the country: 35% for African American men, 37.7% for African American women.8 The definitive diagnosis of VaD is more imprecise than that of AD, and the prevalence of mixed dementias (AD and VaD) is more elusive,9 even with the advent of more precise clinical criteria.911

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