At the University of California, Los Angeles, the Equity for Latinx-Hispanic Health Aging Lab (EHLA) for Alzheimer’s Research and Care Department of Neurology recently went through the process of evaluating the role that structural and social determinants play in dementia care.
“Alzheimer’s disease and other dementias represent critical cognitive decline conditions,” according to EHLA and the department of Neurology. They affect not only the patient, but also their families, caregivers and communities, as well as the current healthcare system in which we live.
In 1983, former President Ronald Reagan designated this disease as a health priority, recognizing the need for increased awareness. There were less than 2 million Americans with Alzheimer’s disease at that time, according to the non-profit Senior Living. Today, that number has increased to almost 6 million nationally. Latinos are one of the ethnic groups with the highest prevalence of Alzheimer’s. Approximately 13% of Latinos who are 65 or older have Alzheimer’s or another form of dementia, according to the Alzheimer’s Association.
MIRELLA DÍAZ-SANTOS, 38, CULVER CITY, NEUROPSYCHOLOGISTS AND ASSISTANT PROFESSOR IN NEUROLOGY, ELLA,/SHE/ HER, LATINA/BIRACIAL
Dr. Mirella Díaz-Santos is an assistant professor in the department of neurology with the Easton Center for Alzheimer’s Research & Care, and the director and founder of the Equity for Latinx-Hispanic Healthy Aging Lab at UCLA.
Díaz-Santos is also a neuropsychologist with expertise in Alzheimer’s disease and related dementias, working primarily with the Latino older adult community and their families.
(Learn more about her here)
Dr. Díaz-Santos said that “literature will always talk about the high associated risk factors in our communities.” Those risks include low education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol consumption, traumatic brain injury and air pollution.
“Los Angeles, Orange, and San Diego counties account for the greatest portions of the population living with Alzheimer’s disease,” Dr. Díaz-Santos said.
The Alzheimer’s Association stated that in 2021, the U.S. cohort showed higher levels of beta amyloid in the blood after long-term exposure to air pollutants, indicating a possible biological connection between air quality and physical changes in the brain that lead to Alzheimer’s.
“We’ve known for some time that air pollution is bad for our brains and overall health, including a connection to amyloid buildup in the brain,” said Claire Sexton, the Alzheimer’s Association director of scientific programs and outreach in the Alzheimer’s Association website. “But what’s exciting is we’re now seeing data showing that improving air quality may actually reduce the risk of dementia. These data demonstrate the importance of policies and action by federal and local governments and businesses that address reducing air pollutants.”
In the chart below, you can see how Alzheimer’s disease will increase over the years, affecting people who are older than 75 years.
In a study published in 2020, researchers from the U.S., including from the University of Southern California and Harvard Medical School, studied data from 998 women aged 73 to 87. All of the women who participated were asked to take cognitive tests and magnetic resonance imaging scans.
The studies revealed two major differences between women exposed to high levels of air pollution for three years and those exposed to lower levels of air pollution. In terms of cognitive performance, those exposed to more air pollution showed a greater decline in learning a list of words. “Anatomically, they showed more atrophy (shrinkage) in those areas of the brain that typically shrink due to Alzheimer’s disease,” according to Harvard Health Publishing.
Dr. Díaz-Santos said pollution definitely increases dementia risks. Additionally, she also said that we should examine how big companies affect our soil and pollution, as those are examples of how a disease could be spread in the future. “Determining the social structure of health and the life-long daily exposure will also increase your chances of being high risk as well.”
Aside from air pollution, factors related to Alzheimer’s disease and dementia also disproportionately affect ethnically diverse communities. According to EHLA and the Care Department of Neurology, those factors include lack of access to healthy whole foods and predisposition to chronic illnesses like cardiovascular diseases, hypertension and diabetes. In addition, they emphasize the importance of increasing the participation of communities of color in the development of research directed toward promoting optimal health for all.
“The data shows that Latinos are 1.5 times more likely to develop the disease,” Dr. Díaz-Santos said. “Often, barriers within the Latino community prevent or delay diagnosis, which makes treatment impossible.” She said that’s why it is important for her that Latinos participate in clinical trials.
By 2040, there will be a 223% increase in the number of people 65 and over with Alzheimer’s disease in Los Angeles County, as shown in the chart below.
Also by 2040, it is estimated that 138,725 Latinos will have Alzheimer’s disease, which is a more than threefold increase from 2019. Alzheimer’s disease is known to affect the Latino community more than any other ethnic groups.
Additionally, EHLA stated that Alzheimer’s disease is known to affect women the most, as 3.5 million women 65 and older are diagnosed with the disease.
“In the United States, more than 10 million women are either living with Alzheimer’s or caring for someone who has it,” according to the Alzheimer’s Association. While the association doesn’t have a definitive answer to preventing Alzheimer’s, research has shown that people can take action to reduce the risk of developing it by leading a healthy lifestyle. That includes physical exercise, social connections, a healthy diet and keeping mentally active.
Understanding the disease and related risk factors can help those with Alzheimer’s disease who still haven’t been diagnosed. Whether you or a loved one has been diagnosed with Alzheimer’s or another dementia, the Alzheimer’s Association is your trusted resource for reliable information, education, referrals, and support.
For free bilingual consultation in English and Spanish, call the Alzheimer’s Association hotline at 1 (800) 272-3900. To learn more about Alzheimer’s disease and ways you can support families and people living with the disease, visit the Alzheimer’s Association website.