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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2000 Jan;92(1):15–21.

Clinical aspects of dementia in African-American, Hispanic, and white patients.

R Hargrave 1, M Stoeklin 1, M Haan 1, B Reed 1
PMCID: PMC2640513  PMID: 10800282

Abstract

This article examines the relationship between ethnicity, cognitive deficits, functional impairment, and psychiatric symptoms in patients with dementia. The data are from a cross-sectional study of patients evaluated at the Northern California Alzheimer's Disease Center (ADC). Using the ADC database of patient information, the authors compared sociodemographic and clinical variables in 187 African-American patients, 69 Hispanic patients, and 1317 white patients with Alzheimer's disease (AD), ischemic vascular dementia (IVD), and mixed dementia (AD/IVD). Multivariate analysis indicated the following results: 1. African-American patients and Hispanic AD patients had lower risk of depressed mood compared to white patients; 2. African-American patients had lower risk for anxiety than whites; 3. Hispanic patients with mixed dementia had lower rates of apathy compared to whites. Future studies are needed to examine how ethnic group differences in dementia are based on the interaction of cultural differences; effects of age, education, and psychosocial variables; and biological differences in the course of dementia.

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Selected References

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  1. 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]
  2. Blessed G., Tomlinson B. E., Roth M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968 Jul;114(512):797–811. doi: 10.1192/bjp.114.512.797. [DOI] [PubMed] [Google Scholar]
  3. Charletta D., Gorelick P. B., Dollear T. J., Freels S., Harris Y. CT and MRI findings among African-Americans with Alzheimer's disease, vascular dementia, and stroke without dementia. Neurology. 1995 Aug;45(8):1456–1461. doi: 10.1212/wnl.45.8.1456. [DOI] [PubMed] [Google Scholar]
  4. Chui H. C., Victoroff J. I., Margolin D., Jagust W., Shankle R., Katzman R. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology. 1992 Mar;42(3 Pt 1):473–480. doi: 10.1212/wnl.42.3.473. [DOI] [PubMed] [Google Scholar]
  5. Class C. A., Unverzagt F. W., Gao S., Hall K. S., Baiyewa O., Hendrie H. C. Psychiatric disorders in African American nursing home residents. Am J Psychiatry. 1996 May;153(5):677–681. doi: 10.1176/ajp.153.5.677. [DOI] [PubMed] [Google Scholar]
  6. Clayton P. J., Grove W. M., Coryell W., Keller M., Hirschfeld R., Fawcett J. Follow-up and family study of anxious depression. Am J Psychiatry. 1991 Nov;148(11):1512–1517. doi: 10.1176/ajp.148.11.1512. [DOI] [PubMed] [Google Scholar]
  7. Clayton P. J. The comorbidity factor: establishing the primary diagnosis in patients with mixed symptoms of anxiety and depression. J Clin Psychiatry. 1990 Nov;51 (Suppl):35–39. [PubMed] [Google Scholar]
  8. 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]
  9. Cohen C. I., Hyland K., Magai C. Depression among African American nursing home patients with dementia. Am J Geriatr Psychiatry. 1998 Spring;6(2):162–175. [PubMed] [Google Scholar]
  10. 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]
  11. Fillenbaum G., Heyman A., Williams K., Prosnitz B., Burchett B. Sensitivity and specificity of standardized screens of cognitive impairment and dementia among elderly black and white community residents. J Clin Epidemiol. 1990;43(7):651–660. doi: 10.1016/0895-4356(90)90035-n. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. Husaini B. A., Moore S. T. Arthritis disability, depression, and life satisfaction among black elderly people. Health Soc Work. 1990 Nov;15(4):253–260. doi: 10.1093/hsw/15.4.253. [DOI] [PubMed] [Google Scholar]
  14. Kemp B. J., Staples F., Lopez-Aqueres W. Epidemiology of depression and dysphoria in an elderly Hispanic population. Prevalence and correlates. J Am Geriatr Soc. 1987 Oct;35(10):920–926. doi: 10.1111/j.1532-5415.1987.tb02293.x. [DOI] [PubMed] [Google Scholar]
  15. Kennedy G. J., Kelman H. R., Thomas C., Wisniewski W., Metz H., Bijur P. E. Hierarchy of characteristics associated with depressive symptoms in an urban elderly sample. Am J Psychiatry. 1989 Feb;146(2):220–225. doi: 10.1176/ajp.146.2.220. [DOI] [PubMed] [Google Scholar]
  16. Krasuski J. S., Gaviria M. Neuropsychiatric sequelae of ischaemic cerebrovascular disease: clinical and neuroanatomic correlates and implications for the concept of dementia. Neurol Res. 1994 Aug;16(4):241–250. doi: 10.1080/01616412.1994.11740235. [DOI] [PubMed] [Google Scholar]
  17. Lawton M. P., Brody E. M. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969 Autumn;9(3):179–186. [PubMed] [Google Scholar]
  18. Loewenstein D. A., Argüelles T., Argüelles S., Linn-Fuentes P. Potential cultural bias in the neuropsychological assessment of the older adult. J Clin Exp Neuropsychol. 1994 Aug;16(4):623–629. doi: 10.1080/01688639408402673. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Rosenthal M. P., Goldfarb N. I., Carlson B. L., Sagi P. C., Balaban D. J. Assessment of depression in a family practice center. J Fam Pract. 1987 Aug;25(2):143–149. [PubMed] [Google Scholar]
  21. Shadlen M. F., Larson E. B., Gibbons L., McCormick W. C., Teri L. Alzheimer's disease symptom severity in blacks and whites. J Am Geriatr Soc. 1999 Apr;47(4):482–486. doi: 10.1111/j.1532-5415.1999.tb07244.x. [DOI] [PubMed] [Google Scholar]
  22. Teri L., Ferretti L. E., Gibbons L. E., Logsdon R. G., McCurry S. M., Kukull W. A., McCormick W. C., Bowen J. D., Larson E. B. Anxiety of Alzheimer's disease: prevalence, and comorbidity. J Gerontol A Biol Sci Med Sci. 1999 Jul;54(7):M348–M352. doi: 10.1093/gerona/54.7.m348. [DOI] [PubMed] [Google Scholar]
  23. Williams D. H. The epidemiology of mental illness in Afro-Americans. Hosp Community Psychiatry. 1986 Jan;37(1):42–49. doi: 10.1176/ps.37.1.42. [DOI] [PubMed] [Google Scholar]

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