The Forgotten Silent Killer

Updated: May 8

Alzheimer’s. Old timers. All timers. It goes by different names, however no matter what you call it, the debilitating disease steals away those we love. For centuries, Blacks have been at higher risks for diseases from influenza to cancer. But Alzheimer’s disease is different. Each year, nearly 6 million Americans are diagnosed with Alzheimer’s. Couple that with the statistic that African Americans are between 14 and 100 percent more likely to develop Alzheimer’s disease than our white counterparts, according to reports from the Alzheimer’s Association. These are sobering statistics about a disease that most Black people I know still know very little about. So, let’s do a little digging, shall we?

What Is Alzheimer’s Disease?

Alzheimer’s disease is a gradual loss of brain cells that most notably affects areas of the brain where memory is stored. The disease was discovered by clinical psychiatrist and neuroanatomist, Dr. Alois Alzheimer, in 1906. During the autopsy, Dr. Alzheimer recognized unusual findings in the patient’s brain including:

  1. The brain was estimated to be at least a third smaller than normal.

  2. Many nerve cells, or neurons, were absent.

  3. Unusual deposits in the brain’s outer layer, called the cerebral cortex.

  4. A portion of the cerebral cortex had been invaded by knotty tangles called by a protein known as tau.

  5. Across the cerebral cortex, another substance was lodged between neurons and disrupted likely disrupted their function. This substance is now known as beta-amyloid.

Since Dr. Alzheimer’s discovery, there has been continuous research and increased attention on the disease function of Alzheimer’s. Today, the disease is described as gradual and progressive loss of short-term memory and is classified as a form of dementia. It is estimated that Alzheimer’s disease affects approximately 10% of people 65 and above and more than 30% of the population for those 85 and above.

Breaking Down Alzheimer’s Disease

(source: Christine Kohler)

Formally known as Dementia of the Alzheimer’s Type, or DAT, Alzheimer’s accounts for two-thirds of all dementia cases. That is likely why Alzheimer’s and dementia are often used interchangeably although they are not the same. As Columbus Memory Center founder, Dr. Jonathan L. Liss, explains, “dementia is a category the same way that sports is a category. Alzheimer’s disease is a specific type of dementia the same way that soccer is a specific type of sport.” A person with Alzheimer’s disease suffers from dementia, however a person with dementia does not have to suffer from Alzheimer’s.

Patients may exhibit symptoms of cognitive decline and/or short-term memory loss three to five years before diagnosis. Once a positive diagnosis of Alzheimer’s disease is handed down, the disease is classified as mild, moderate or severe.

Mild Alzheimer’s disease typically starts with short-term memory loss and word finding difficulties that worsen over time. A patient with mild Alzheimer’s disease may be able to hide the diagnosis, however it is likely they will also:

  1. Lose interest in hobbies

  2. Undergo subtle changes in personality

  3. Have increasing difficulty with tasks like cooking and/or paying bills

  4. Get lost more easily

  5. Repeat questions, words or stories

Moderate Alzheimer’s disease is a progression of the mild symptoms, however patients will need assistance with a variety of daily activities such as dressing or cooking. These patients are also likely to:

  1. Have confusion about recent conversations

  2. Argue more often than usual

  3. Wander

  4. Hear and see things that aren’t present

  5. Experience increased irritability, anxiety and depression

Severe Alzheimer’s disease is identified when a sufferer needs assistance with all phases of daily life. A person with severe Alzheimer’s disease is unlikely to participate in meaningful conversation and may have difficulty:

  1. Recognizing family and friends

  2. Helping with their own care

  3. Recognizing themselves in a mirror

Why Blacks Get It More

For Black people, accessing Alzheimer’s research trials and/or healthcare in general has long been a struggle. As a result, a cycle of seeing doctors less frequently and missed diagnoses are far too common. Whether it’s the dentist or the optometrist, lack of health literacy and health insurance create significant barriers to preventative and comprehensive health care. Add to that cyclical poverty and systemic inequality in underprivileged population to inch a little closer to the million dollar question: why are Black people more prone to illness, specifically Alzheimer’s disease.

So, why is this another disease that we get more than nearly any other ethnic group? Of course, lack of access to appropriate health care is a major factor. But there’s more. Medical research shows that people with high blood pressure and/or high cholesterol are twice as likely of developing Alzheimer’s. Think about it: we all know Nana or Big Ma’ who loves her pork ribs and southern slicked bacon for those big, Sunday morning breakfasts. A CARDIA research study concluded that 75% of Black people have high blood pressure. Another hard, cold, fact for you: Black Americans account for the highest ethnic percentage of those with heart disease in the world. High blood pressure, or hypertension, can lead to heart disease – the number one killer in our country – stroke and a plethora of additional ailments.

Another factor that could play a role in why Blacks get Alzheimer’s disease at a higher rate is high cholesterol. High cholesterol can cause plaque build up in your arteries. That build up can dislodge, at times, and land anywhere in your body, including your brain. As we know from earlier, plaque building up is what causes the tangles that disrupt your memory and, ultimately, cause Alzheimer’s disease. Typically, the cholesterol issues come with a full bag of diabetes, heart disease, high blood pressure and genealogical markers that make us predisposed to opportunistic diseases like this one.

How You Can Prevent the Disease

While there is currently no identified cure for Alzheimer’s disease, there are several known was to slow the progression of the disease to include:

  1. FDA approved research

  2. Preventative exercises

  3. Annual thinking tests

  4. Spreading awareness

  5. Improving health literacy

As it stands, research continues to inch closer to cracking the code that will help cure Alzheimer’s disease. In fact, one trial, for an investigational medication called aducanumab, is in Phase III right now – which is the last phase before the FDA approves the drug for regulation and prescription. If approved, aducanumab could modify the course of the disease by up to 42 percent; effectively slowing the progression of the disease.

In 2019, the U.S. surgeon general declare Alzheimer’s a national health crisis. In 2020, it needs to be added to the list of items Black people are cancelling this year. We have to develop a plan to routinely ask about your brain health, the same as you do when you get your annual physical. We have to make it a habit. We have to understand the cliché, that knowledge is power, and pack our minds with as much knowledge possible. This will help protect us against the effects of Alzheimer’s disease. We have to take better care of our bodies because what goes on in our bodies will undoubtedly make its way to our brains. If we neglect to do these things, we will surely become a target of more that cyclical poverty and diabetes or high blood pressure and heart disease.

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If we drop the ball on showcasing the importance of Alzheimer’s disease and reducing the stigma among our community, we throw ourselves at the mercy of the other silent killer – the one that takes our minds, long before our bodies.

(source: Warchi)