What is Alzheimer’s?

Alzheimer's disease is a neurodegenerative disorder, primarily affecting those over 65 and the most common cause of dementia worldwide, accounting for 60-80% of cases, in numbers about 50 million people are affected.

Symptoms include memory loss, language difficulties such as finding words, difficulty with mobility, impaired decision-making, confusion, trouble recognising familiar faces, obsessive or repetitive behaviours, and mood swings.

These symptoms can vary depending on how far the disease has progressed and greatly affect personal relationships and work performance. This makes early intervention crucial to slowing cognitive decline and improving the quality of life for both individuals and their caregivers.

Currently, Alzheimer’s is characterised by the build-up of harmful proteins, known as beta-amyloid plaques and tau tangles, which cause brain cells to die and the brain to shrink. However, recent research is showing other causes either in conjunction with or opposing these classical traits.

Studies now show the role of neuroinflammation, vascular dysfunction, and glial cell activity in Alzheimer’s progression. For example, elevated levels of proteins such as glial fibrillary acidic protein and neurofilament light chain (NfL) are being explored as blood-based biomarkers that reflect broader neurodegenerative processes beyond amyloid and tau pathology. Additionally, oxidative stress, mitochondrial dysfunction, and impaired lipid metabolism are showing potential as contributing factors that may interact with or exacerbate protein aggregation.

Causes are linked to genetics, environment, and lifestyle, with a gene called APOE E4 increasing risk, age, inflammation, oxidative stress, cardiovascular health, and lifestyle choices including diet, exercise and cognitive engagement.

The Impact on Black Communities

Black communities face disproportionate challenges related to Alzheimer’s disease and dementia. In the U.S., Black Americans are approximately twice as likely to develop Alzheimer’s compared to White Americans, yet they are 35% less likely to receive a diagnosis. In the UK, dementia rates among Black adults are 22% higher than the national average, and they are diagnosed at younger ages with more severe symptoms.

This shows an urgent need for targeted interventions. Not only are Black individuals at a higher risk, but they also tend to experience symptoms earlier which also progress more rapidly. Risk factors are more pronounced in Black adults, with those diagnosed often showing greater cognitive impairment, more severe memory and thinking problems, requiring help with daily activities, and worse mental health symptoms.

Black adults often encounter significant challenges when trying to access help and support for Alzheimer's disease. Research shows they are less likely to receive timely care for Alzheimer's, facing obstacles like limited access to specialised memory clinics, lower rates of early diagnosis, and systemic issues within the healthcare system. Making access to healthcare crucial for Black individuals, as disparities in diagnosis and treatment can result in delayed intervention and more severe disease progression.

Socioeconomic factors, financial constraints and neighbourhood disadvantages affecting healthcare access. Additionally, cultural and institutional biases contribute to disparities, as Black individuals are less likely to be included in dementia research and may encounter healthcare providers in the US who lack cultural competency. Misinformation, historical mistrust of medical institutions, and stigma surrounding Alzheimer's within Black community’s further delay diagnosis and treatment.

Cultural and language barriers, along with a lack of culturally tailored diagnostic tools, also hinder effective treatment. Addressing these disparities through improved healthcare access, education, and equitable treatment options is essential for achieving better outcomes.

What Changes are Needed?

To address the disparities in Alzheimer’s care affecting Black communities, we must prioritise:

1. Improving Healthcare Access – Expanding memory clinics in underserved areas and ensuring equitable access to culturally appropriate diagnostic tools could help Black individuals receive timely care.

2. Culturally Tailored Outreach - Dementia services must be designed with cultural sensitivity, incorporating trusted community leaders and healthcare professionals to build awareness and trust.

3. Reducing Stigma - Launch public health campaigns to challenge misconceptions, promote early interventions, and normalise help-seeking.

4. Increasing Research Representation - Encourage Black participation in clinical trials to develop treatments that reflect diverse needs and experiences.

5. Policy and Advocacy - Strengthen policies that address healthcare disparities, invest in community-based programs and fund initiatives that support Black communities.

6. Culturally Competent Care - Train healthcare providers to understand cultural contexts and deliver respectful, inclusive care.

7. Faith-Based and Community Support - Leverage faith networks and grassroots organizations to offer support for individuals and caregivers.

To address the deep-rooted disparities in Alzheimer’s care for Black communities, we must drive systemic change. Currently, barriers like limited healthcare access, economic inequality, and cultural bias delay diagnoses and restrict treatment options.

Expanding memory clinics in underserved areas, integrating culturally responsive outreach, and ensuring diverse representation in research are vital steps. Smart use of technology can also improve early detection and care coordination. Equipping healthcare providers with cultural competency training and investing in community-led programs will encourage trust and improve outcomes.

Public awareness campaigns can challenge stigma, while faith-based and grassroots networks offer essential support to individuals and caregivers. With coordinated advocacy, inclusive policies, and community-driven solutions, we can build a healthcare system that truly serves Black individuals, ensuring timely, equitable, and compassionate Alzheimer’s care.