Older Blacks and Latinos with Cognitive Impairment Live Longer Than Whites

Older blacks and Latinos with significant cognitive impairment are less likely to end up in nursing homes and tend to live longer than older whites, say researchers.

"These results have significant implications for caregiver burden and community resources," said Maria Carrillo, Ph.D., senior director of medical and scientific relations for the Alzheimer’s Association. "If, as the study suggests, more African-American and Latino families are taking care of their loved ones with significant cognitive impairment in their homes for longer periods of time, there is a greater than anticipated need for culturally-appropriate dementia care resources and home and community- based services for these populations."

Another study reported at the conference suggests that the bereavement process and mourning experience for Alzheimer’s caregivers after the death of their loved one varies greatly among different racial and ethnic groups. A third research report suggested that cultural and spiritual beliefs of African-Americans, American Indians and whites greatly influence how long it takes for a family to seek a medical diagnosis of Alzheimer's.

"Alzheimer's leads so many families through unfamiliar territory. The need for education, information, supportive services is paramount," Carrillo said. "The more we learn about the similarities and differences that exist in how various groups perceive and experience Alzheimer's, the more effective we can be in developing culturally-appropriate information, services, and tools that are respectful of these perceptions and closely held values, and that contain authentic relevance that empowers families."

While few studies have examined how significant cognitive decline impacts minority older adults in the United States, Kala M. Mehta, DSc, MPH, at the University of California, San Francisco, and colleagues examined the relationship between significant cognitive decline and two health consequences -- nursing home placement and mortality -- in a representative sample of older adults participating in the Health and Retirement Study. More than 7,500 older people – 10% African-American and 6% Latino -- were assessed over an eight-year period.

During the study, 23% of participants died and 14% experienced significant cognitive decline. However, the researchers found that the proportion of persons with significant decline did not vary by race. In fact, of those with significant cognitive decline, older African Americans and Latinos had statistically significantly less placement in nursing homes compared to older whites, and were statistically significantly less likely than similar whites to die during the follow up period.

"Our results may indicate that African-American and Latino adults have a higher burden from significant cognitive decline than white older adults," Mehta said. "This may impact the adults themselves, their caregivers and their communities. Thus, our findings support the need for culturally-appropriate dementia care, support services and home care resources for African-American and Latino communities in the United States."

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