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November 2005

Earlier Alzheimer Onset in Latino Persons: Ethnic Difference vs Selection Bias

Arch Neurol. 2005;62(11):1786-1787. doi:10.1001/archneur.62.11.1786-c

We found the observation of an earlier onset of Alzheimer disease symptoms in persons of Latino descent described by Clark et al1 a step forward in the characterization of the burden of dementia in this growing segment of the US population. However, we also feel that the group studied may have idiosyncrasies that limit the generalizability of this finding to the wider US Latino population. It is possible that older persons of Latino descent with memory loss are less likely to be brought to tertiary centers because their problems may be considered an inevitable consequence of aging. Although we don’t know of any studies that directly address differences in this form of “ageism” between Latino people and white people, it is known that Latino people use nursing facilities less frequently.2 A study of Mexican American individuals in Texas suggested that such persons tend to view the caregiving experience as an expression of family values; they may have a distrust for “culturally alien institutions”3 and therefore avoid bringing older persons with memory problems to a tertiary center for assessment. There might then be a bias in such a population for younger persons with memory problems, who are still the family breadwinners, to be preferentially brought to medical attention.