Tom Murphy
RedwoodAge.com
Antonia Lopez started showing signs of Alzheimer's disease at around 60, but it was a decade later before her family sought help, making treatment more difficult, more costly and less effective.
Her plight reflect a combination of cultural, lifestyle, genetic and medical factors that make Hispanics more susceptible to Alzheimer's at an earlier age and more at risk of a rapid decline to the disease that will eventually kill them.
Health experts are especially concerned for a number of reasons, including the rapid rise of Hispanics as a proportion of the general population.
Today, Hispanics make up about 5 percent of the US population. By 2050, they're projected to comprise about 16 percent. Over the same timeframe, the number of Hispanics with Alzheimer's is expected to balloon more than six-fold from 200,000 to 1.3 million, according to the Alzheimer's Association.
However, the trend is also important to researchers studying the general onset of Alzheimer's, the most prevalent of diseases that lead to dementia. While genetics plays a limited and confused role in Hispanics, researchers believe a complex of environmental factors deserves broad blame, according to research published by Duke University's Alzheimer's research center in 2004.
"It's a complex problem, one that involves both genetic and environmental factors," Duke neuropsychologist Stephanie Johnson, said at the time. "But we can certainly attribute some of this disparity to the incidence of chronic diseases that minority demographics deal with, for example type 2 diabetes, hypertension and high cholesterol. All of these have been related to the development of Alzheimer's disease and minority groups suffer from a higher rate of these cardiovascular risk factors."
Hispanics, for example, are 64 percent more likely to develop diabetes than non-Hispanic whites.
As that list of diseases suggests, diet plays a role. "Regular exercise, a diet rich in leafy greens and omega-3 fatty acids, and keeping your mind active can all help shield you from developing dementia and Alzheimer's disease," said Johnson. "What's good for the heart is also good for the head."
A lack of treatment for health problems contributes, too. "This failure of the health care systems may increase the risk of dementia for Hispanics/Latinos," the Alzheimer's Association reported four years ago, while calling for an increased focus on these connections. "It delays identification and diagnosis of dementia and leads to high levels of impairment and heavy and prolonged caregiver burden."
Not So Simple
But stress, education levels and strong family
connections are also related.
Education is thought to have some sort of preventative effect, perhaps by keeping the mind active longer. But one in 10 Hispanic elders have no formal education and over half never finished grade school.
The association also noted a "high sense of filial responsibility" for elders, particularly among daughters who tend to become the primary caregivers for elders. Some studies have found "a high acceptance of cognitive impairment and dementia as anormal part of aging to be managed by the family," the Alzheimer's group said.
Antonia Lopez' daughter, Carol Franklin, is testament to that phenomenon.
“My mom was telling people, in her confusion, that I spanked her,” she told The New York Times, which recently ran a front page story about Hispanics and Alzheimer's. “My brother believed that. He said to me at one point, ‘Don’t say that my mom has Alzheimer’s, because I believe it’s just part of being old.’ ”
The association proposed a four-point program to help reduce the impact of Alzheimer's for Hispanics and other Americans, including: research, community services, education and payment for chronic care.
"Alzheimer's is too big a challenge for families and voluntary organizations to conquer without a concerted public commitment to research, education and culturally competent health care and supportive services," the group concluded.
