Black, Asian Individuals May Experience More Severe Dementia Symptoms

By Rob Dillard - September 13, 2023

Findings from a recent study suggest that racial disparities exist in the presentation of frontotemporal dementia (FTD), with Black and Asian individuals experiencing worse symptoms than their White counterparts. Results were published in JAMA Neurology.

 In this exploratory cross-sectional study, researchers assessed 2478 patients (2.4% Asian, 2.5% Black, 95.1% White) with a confirmed diagnosis of FTD (behavioral variant FTD or primary progressive aphasia) from National Alzheimer’s Coordinating Center (NACC) data collected between June 2005 and August 2021. The main outcome of interest was racial differences at initial NACC visit, which were measured with the Clinical Dementia Rating Dementia Staging Instrument, NACC Frontotemporal Lobar Degeneration Behavior & Language Domains (FTLD-CDR), Functional Assessment Scale, and Neuropsychiatric Inventory using regression models.

Findings Highlight Racial Disparities

Researchers found that Black individuals experienced a higher degree of dementia severity with respect to FTLD-CDR (β, 0.64; standard error of the mean [SE], 0.24; P=.006) and FTLD-CDR sum of boxes (β, 1.21; SE, 0.57; P=.03). They also had greater functional impairment (β, 3.83; SE, 1.49; P=.01). Moreover, Black individuals exhibited a higher frequency of delusions, agitation, and depression (delusions: odds ratio [OR], 2.18; 95% CI, 1.15-3.93; P=.01; agitation: OR, 1.73; 95% CI, 1.03-2.93; P=.04; depression: OR, 1.75; 95% CI, 1.05-2.92; P=.03).

The study also showed that Asian individuals exhibited a higher frequency of apathy (OR, 1.89; 95% CI, 1.09-3.78; P=.03), nighttime symptoms (OR, 1.72; 95% CI, 1.01-2.91; P=.04), and were more affected with respect to appetite/eating (OR, 1.99; 95% CI, 1.17-3.47; P=.01) compared with White individuals.

This exploratory study suggests there are racial disparities in dementia severity, functional impairment, and neuropsychiatric symptoms,” the researchers concluded. They added that future studies “must address racial disparities and their underlying determinants as well as the lack of representation of racially minoritized individuals in nationally representative dementia registries.”

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