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(HealthNewsDigest.com) – A dramatic health disparity is receiving a literally dramatic response: A touring stage play has been calling attention to the disproportionate impact Alzheimer’s disease has on African-Americans, who are up to three times more likely to develop Alzheimer’s disease than white Americans, yet far less likely to be diagnosed. The disease is the fourth leading cause of death for older African-Americans, yet only one in 20 participants in clinical trials targeting Alzheimer’s disease are African-American.
These disparities provide the context for the play “Forget Me Not,” which presents one family’s struggle with the disease to illustrate its impact on extended families, friends, and an entire community. African Americans Against Alzheimer’s presented a local production of the play in mid July at the Du Sable Museum of African American History. “Forget Me Not” also has been performed previously in Boston, Philadelphia and Washington, D.C.
“A play can promote health education and action in a culturally-appropriate way,” said Neelum Aggarwal, MD, an associate professor of neurology and researcher at the Rush Alzheimer’s Disease Center. Because the lead character is offered the opportunity to participate in a clinical trial, “the audience can begin to understand how physicians think about the disease and treatment options,” Aggarwal adds.
Recruitment of African-Americans into clinical trials has been challenging for a host of reasons, “especially the lack of trust in the health care system in general and medical research in particular” says Lisa L. Barnes, PhD, director of Rush’s Center of Excellence on Disparities in HIV and Aging.
Supporting the cause by understanding causes
Negative social forces may be a key factor in why there is a such high prevalence of Alzheimer’s disease among African-Americans. Both Barnes and Aggarwal say increasing awareness of these social determinants is a key to increasing African-Americans participation in clinical trials.
Aggarwal points out that when physician researchers attempt to explain differences in rates of medical conditions among racially diverse populations, they take into consideration genetics, lifestyle issues, medical history and social determinants. She has led studies in the field that identified specific genes and lifestyle issues that may increase the risk of developing Alzheimer’s disease among African-Americans.
From her field work field conducting cognitive and neurological assessments during home visits, “I am particularly interested in how socioeconomic factors affect and can increase the risk of Alzheimer’s disease. We know that lower levels of education and socioeconomic factors may contribute to risk, but recently we have been looking at other issues, such as neighborhood environment, loneliness, depression as potential risk factors.”
Scientists have long known that stress triggers the release of hormones that physically prepare both humans and animals for a “fight or flight” response. In a recent article, Barnes shared data that demonstrates that higher levels of anxiety and vulnerability to stress are associated with increased risk of Alzheimer’s.
“For minority populations, particularly older minorities, social inequalities lead to poorer quality education, lower paying occupations, less access to healthcare, greater likelihood of experiencing discrimination, etc., and these factors typically are experienced as stressful,” she says.
She believes more research is needed to better determine whether years of social inequalities – and being in prolonged “fight or flight” physical state – makes African-Americans more likely to develop Alzheimer’s disease. The more that efforts such as “Forget Me Not” raise awareness of Alzheimer’s disease and motivate larger numbers of African Americans to participate in clinical trials either for prevention of Alzheimer’s disease or treatment of Alzheimer’s disease, the sooner that research can take place.
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