The Silent Disease: Dementia in the African-American Community

Aunt Jessie left this morning, as she does every Thursday morning. The
next-door neighbor saw her as she left; he checked his watch and
smiled. To the bank, the grocery store, the filling station, the
cleaners, but this time . . . Aunt Jessie didn\’t come home.

For two days the whole town looked for Aunt Jessie, scared, perplexed,
worried about what had happened to her. The police said they found Aunt
Jessie wandering around a town, some 47 miles away; no vehicle, hungry,
dirty, broke, and in a daze. She said she had a little “spell,” when
she turned the wrong way.

How many Aunt Jessies do you know who have little “spells?” How many
Poppa Zekes who “just forgot” why they\’re in the front yard in pajamas?
How many Grandmas who get out a frying pan “to mix some batter up?” How
many others who get lost, confused, bewildered by everyday life?

Dementia, which includes Alzheimer\’s disease, is a progressive illness
that can destroy parts of the brain responsible for memory, judgment,
reasoning, learning, and language. Dementia limits a person\’s ability
to function independently

According to a new report prepared by the Alzheimer\’s Association and
released by the Congressional Black Caucus, Alzheimer\’s disease appears
to be more prevalent among African-Americans, with estimates that it
afflicts 14 percent to almost 100 percent as many blacks than whites.

The report brings together for the first time an accumulating body of
evidence about the scope and nature of Alzheimer\’s disease in
African-Americans. “Each scientific study is important research on its
own, but when put together with other studies, the magnitude of this
crisis becomes clear,” said Orien Reid, chair of the Alzheimer\’s
Association Board of Directors.

Behavior disorders in dementia may resemble African American culturally
specific syndromes including “worriation” and “spells.” “Worriation” is
felt to be the result of overusing the mind to the detriment of the
brain, and may resemble the anxiety, agitation, and obsessional
thinking observed in some dementia patients.

“Spells” refers to a period of unusual consciousness that may range
from periods of extreme anger or irritability, fugue states, trances,
or waking visions (e.g., when someone is awake and believes that he
sees a dead relative). The fluctuations in mood, cognition and
perceptual distortions characteristic of some forms of dementia may be
interpreted as the person having “spells.”

Many African American caregivers view memory deficits and behavioral
difficulties as an expected consequence of normal aging. Thoughts of
dementia may evoke little concern among these caregivers until the
disease is in the advanced stage, limiting the effectiveness of
available treatments and interventions.

Statistical Information

The age-specific prevalence of Alzheimer\’s among African-Americans, and
the cumulative risk of dementia among first-degree relatives of persons
with Alzheimer\’s disease is 43.7 percent. African Americans aged 55-64
years of age are three times more likely to get Alzheimer\’s disease
than Caucasians; at ages 65-84, they are twice as likely to be
affected. Over age 85, the rate is 1.5 times higher. Chronic illnesses
such as diabetes or high blood pressure increase risk of developing
memory problems by putting additional stress on brain tissues and
increasing risk of stroke; African Americans have a 60 percent higher
risk than Caucasians of developing type II diabetes.

Warning Sign for Dementia — According to the Alzheimer Association: