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Minority groups in the US experience cognitive issues earlier in life

Minority groups in the US are more vulnerable to memory loss, confusion and their consequences earlier in life, according to a study published in the open access journal BMC Public Health.

A researcher at Delaware State University, USA, investigated levels of subjective cognitive decline in US adults, who were over 45 years old. Subjective cognitive decline is the experience of frequent confusion and memory loss, which has been identified as a potential early sign of Alzheimer’s disease. The author used data on 179,852 US adults aged 45 and over, collected as part of the Behavioral Risk Factor Surveillance System survey from 2015 to 2018 during which respondents answered six questions designed to self-assess memory loss and cognitive ability.

Overall, 10.8% (19,276) of adults aged 45 or over self-reported subjective cognitive decline. 10.7% of those who were white experienced subjective cognitive decline compared to 12.3% of those who were Black and 9.9% of those who were Hispanic.

Black and Hispanic individuals with subjective cognitive decline were more likely to be younger (45-54 years) compared to white individuals with subjective cognitive decline (most of whom were 65 or over). In the Black and Hispanic groups, those with subjective cognitive decline were more likely to be less educated, to have a lower income and to have functioning difficulties (struggling to complete household chores).

Less than half of those who were Black (46.8%) or Hispanic (44.5%) with subjective cognitive decline had discussed their issues with a healthcare provider, but this did not significantly differ from those who were white.

However, the author found a significantly higher burden of chronic conditions such as diabetes and high blood pressure among the Black and Hispanic groups with subjective cognitive decline. Nearly 80% of people who identified themselves as Black and reported subjective cognitive decline symptoms, reported at least one chronic condition, compared to around 64% in white and Hispanic groups. The author suggests there may be a higher burden of chronic conditions as Black and Hispanic groups were found to be more likely in the lower income category and experience more functioning difficulties.

The author emphasises that by 2060, the percentage increase in total population in the US is estimated to be 172% for African Americans, and 391% for Hispanics compared to 75% non-Hispanic whites. They suggest it may mean higher numbers in Black and Hispanic groups experiencing cognitive difficulties. 

Sangeeta Gupta, the author said: “It is concerning that we found Black and Hispanic groups self-report cognitive symptoms at an earlier age especially considering the projected rise in minority populations in the U.S by 2060. Looking to the future, as we see more younger Black and Hispanic individuals developing cognitive decline symptoms, this may mean we have higher numbers in those groups not only struggling to be independent but also possibly progressing towards Alzheimer’s disease and related dementia.”

The author cautions that the survey may not have captured individuals with more severe cognitive issues, as these individuals are likely to live in residential care homes which were not included in the study. Additionally, comprehending questions and answering accurately requires some level of memory, and those who are more affected may not have been able to answer.


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Notes to editor:

1.    Research article:
Racial and ethnic disparities in subjective cognitive decline: a closer look, United States, 2015–2018
BMC Public Health 2021
DOI: 10.1186/s12889-021-11068-1

The article is available at the journal website.

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