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January 7, 2019

Biomarkers for Alzheimer Dementia in Diverse Racial and Ethnic Minorities—A Public Health Priority

Author Affiliations
  • 1Rush Alzheimer’s Disease Center, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
JAMA Neurol. Published online January 7, 2019. doi:10.1001/jamaneurol.2018.3444

Research on racial differences in Alzheimer dementia (AD) has increased dramatically in recent years. Older African American individuals, a rapidly growing segment of the US population, bear a disproportionate burden of AD and cognitive impairment compared with non-Hispanic white individuals, with some estimates suggesting that they may have more than a 2-fold increased risk than their white counterparts.1 Our understanding of AD has steadily advanced owing to increasing knowledge about the underlying pathologic substrates leading to disease.2,3 Ultimately, this knowledge has translated into clinical knowledge via biofluid and neuroimaging biomarkers of underlying pathologic characteristics, and into clinical trials of disease-modifying pharmacotherapies.4 However, because of challenges in the recruitment of African American individuals into AD research studies in general,5 the field has struggled to include this population in studies that involve invasive procedures such as lumbar punctures and autopsy.6,7 As a consequence, there is an unfortunate lack of biological data on this population, causing knowledge of the drivers of the disparities to lag far behind.