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. 1998 Feb;90(2):78–84.

Clinical aspects of Alzheimer's disease in black and white patients.

R Hargrave 1, M Stoeklin 1, M Haan 1, B Reed 1
PMCID: PMC2608323  PMID: 9510621

Abstract

This article examines the association between ethnicity and psychiatric symptoms in patients with Alzheimer's disease. Data from a cross-sectional study of patients evaluated at nine California Department of Health Alzheimer's Disease Diagnostic and Treatment Centers (ADDTCs) were used. Using the ADDTC patient database, sociodemographic and clinical variables in 207 black patients and 1818 white patients with probable and possible Alzheimer's disease were compared. Logistic and linear regression analysis indicated the following results: 1) black patients had fewer years of education and more often had hypertension, 2) black patients reported shorter duration of illness at the time of initial diagnosis of dementia, 3) black patients had lower Mini-Mental State Examination scores and higher Blessed Roth Dementia Rating Scale scores at the time of initial diagnosis, and 4) black patients more frequently reported insomnia and less frequently reported anxiety. Additional studies are needed to validate these findings and to generate hypotheses about the role of cardiovascular disease and pathophysiology of psychiatric symptoms in ethnic populations with Alzheimer's disease.

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Selected References

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  1. Baker F. M., Kokmen E., Chandra V., Schoenberg B. S. Psychiatric symptoms in cases of clinically diagnosed Alzheimer's disease. J Geriatr Psychiatry Neurol. 1991 Apr-Jun;4(2):71–78. doi: 10.1177/089198879100400203. [DOI] [PubMed] [Google Scholar]
  2. Bird H. R., Canino G., Stipec M. R., Shrout P. Use of the Mini-mental State Examination in a probability sample of a Hispanic population. J Nerv Ment Dis. 1987 Dec;175(12):731–737. doi: 10.1097/00005053-198712000-00005. [DOI] [PubMed] [Google Scholar]
  3. Bliwise D. L. Sleep in normal aging and dementia. Sleep. 1993 Jan;16(1):40–81. doi: 10.1093/sleep/16.1.40. [DOI] [PubMed] [Google Scholar]
  4. Buckwalter J. G., Sobel E., Dunn M. E., Diz M. M., Henderson V. W. Gender differences on a brief measure of cognitive functioning in Alzheimer's disease. Arch Neurol. 1993 Jul;50(7):757–760. doi: 10.1001/archneur.1993.00540070069018. [DOI] [PubMed] [Google Scholar]
  5. Cohen C. I., Carlin L. Racial differences in clinical and social variables among patients evaluated in a dementia assessment center. J Natl Med Assoc. 1993 May;85(5):379–384. [PMC free article] [PubMed] [Google Scholar]
  6. Cohen D., Eisdorfer C., Gorelick P., Luchins D., Freels S., Semla T., Paveza G., Shaw H., Ashford J. W. Sex differences in the psychiatric manifestations of Alzheimer's disease. J Am Geriatr Soc. 1993 Mar;41(3):229–232. doi: 10.1111/j.1532-5415.1993.tb06697.x. [DOI] [PubMed] [Google Scholar]
  7. Cooper J. K., Mungas D., Weiler P. G. Relation of cognitive status and abnormal behaviors in Alzheimer's disease. J Am Geriatr Soc. 1990 Aug;38(8):867–870. doi: 10.1111/j.1532-5415.1990.tb05701.x. [DOI] [PubMed] [Google Scholar]
  8. Escobar J. I., Burnam A., Karno M., Forsythe A., Landsverk J., Golding J. M. Use of the Mini-Mental State Examination (MMSE) in a community population of mixed ethnicity. Cultural and linguistic artifacts. J Nerv Ment Dis. 1986 Oct;174(10):607–614. doi: 10.1097/00005053-198610000-00005. [DOI] [PubMed] [Google Scholar]
  9. Fabrega H., Jr, Mezzich J., Ulrich R. F. Black-white differences in psychopathology in an urban psychiatric population. Compr Psychiatry. 1988 May-Jun;29(3):285–297. doi: 10.1016/0010-440x(88)90051-x. [DOI] [PubMed] [Google Scholar]
  10. Folstein M. F., Folstein S. E., McHugh P. R. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6. [DOI] [PubMed] [Google Scholar]
  11. Gorelick P. B., Freels S., Harris Y., Dollear T., Billingsley M., Brown N. Epidemiology of vascular and Alzheimer's dementia among African Americans in Chicago, IL: baseline frequency and comparison of risk factors. Neurology. 1994 Aug;44(8):1391–1396. doi: 10.1212/wnl.44.8.1391. [DOI] [PubMed] [Google Scholar]
  12. Harrell L. E., Callaway R., Powers R. Autopsy in dementing illness: who participates? Alzheimer Dis Assoc Disord. 1993 Summer;7(2):80–87. doi: 10.1097/00002093-199307020-00003. [DOI] [PubMed] [Google Scholar]
  13. Heyman A., Fillenbaum G., Prosnitz B., Raiford K., Burchett B., Clark C. Estimated prevalence of dementia among elderly black and white community residents. Arch Neurol. 1991 Jun;48(6):594–598. doi: 10.1001/archneur.1991.00530180046016. [DOI] [PubMed] [Google Scholar]
  14. Jones B. E., Gray B. A. Problems in diagnosing schizophrenia and affective disorders among blacks. Hosp Community Psychiatry. 1986 Jan;37(1):61–65. doi: 10.1176/ps.37.1.61. [DOI] [PubMed] [Google Scholar]
  15. Jorm A. F., Korten A. E., Henderson A. S. The prevalence of dementia: a quantitative integration of the literature. Acta Psychiatr Scand. 1987 Nov;76(5):465–479. doi: 10.1111/j.1600-0447.1987.tb02906.x. [DOI] [PubMed] [Google Scholar]
  16. Lopez O. L., Boller F., Becker J. T., Miller M., Reynolds C. F., 3rd Alzheimer's disease and depression: neuropsychological impairment and progression of the illness. Am J Psychiatry. 1990 Jul;147(7):855–860. doi: 10.1176/ajp.147.7.855. [DOI] [PubMed] [Google Scholar]
  17. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  18. Morris J. C., Edland S., Clark C., Galasko D., Koss E., Mohs R., van Belle G., Fillenbaum G., Heyman A. The consortium to establish a registry for Alzheimer's disease (CERAD). Part IV. Rates of cognitive change in the longitudinal assessment of probable Alzheimer's disease. Neurology. 1993 Dec;43(12):2457–2465. doi: 10.1212/wnl.43.12.2457. [DOI] [PubMed] [Google Scholar]
  19. Mukherjee S., Shukla S., Woodle J., Rosen A. M., Olarte S. Misdiagnosis of schizophrenia in bipolar patients: a multiethnic comparison. Am J Psychiatry. 1983 Dec;140(12):1571–1574. doi: 10.1176/ajp.140.12.1571. [DOI] [PubMed] [Google Scholar]
  20. Murden R. A., McRae T. D., Kaner S., Bucknam M. E. Mini-Mental State exam scores vary with education in blacks and whites. J Am Geriatr Soc. 1991 Feb;39(2):149–155. doi: 10.1111/j.1532-5415.1991.tb01617.x. [DOI] [PubMed] [Google Scholar]
  21. Reisberg B., Ferris S. H. A clinical rating scale for symptoms of psychosis in Alzheimer's disease. Psychopharmacol Bull. 1985;21(1):101–104. [PubMed] [Google Scholar]
  22. Riemann D., Hohagen F., Bahro M., Lis S., Stadmüller G., Gann H., Berger M. Cholinergic neurotransmission, REM sleep and depression. J Psychosom Res. 1994;38 (Suppl 1):15–25. doi: 10.1016/0022-3999(94)90132-5. [DOI] [PubMed] [Google Scholar]
  23. Rubin E. H., Drevets W. C., Burke W. J. The nature of psychotic symptoms in senile dementia of the Alzheimer type. J Geriatr Psychiatry Neurol. 1988 Jan;1(1):16–20. doi: 10.1177/089198878800100104. [DOI] [PubMed] [Google Scholar]
  24. Schoenberg B. S., Anderson D. W., Haerer A. F. Severe dementia. Prevalence and clinical features in a biracial US population. Arch Neurol. 1985 Aug;42(8):740–743. doi: 10.1001/archneur.1985.04210090004002. [DOI] [PubMed] [Google Scholar]
  25. Sultzer D. L., Levin H. S., Mahler M. E., High W. M., Cummings J. L. A comparison of psychiatric symptoms in vascular dementia and Alzheimer's disease. Am J Psychiatry. 1993 Dec;150(12):1806–1812. doi: 10.1176/ajp.150.12.1806. [DOI] [PubMed] [Google Scholar]
  26. Zubenko G. S., Moossy J., Kopp U. Neurochemical correlates of major depression in primary dementia. Arch Neurol. 1990 Feb;47(2):209–214. doi: 10.1001/archneur.1990.00530020117023. [DOI] [PubMed] [Google Scholar]
  27. Zubenko G. S., Moossy J., Martinez A. J., Rao G., Claassen D., Rosen J., Kopp U. Neuropathologic and neurochemical correlates of psychosis in primary dementia. Arch Neurol. 1991 Jun;48(6):619–624. doi: 10.1001/archneur.1991.00530180075020. [DOI] [PubMed] [Google Scholar]

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