Many of the cognitive issues of Alzheimer’s disease (AD) such as memory, attention and executive functioning problems are less noticeable in Hispanic patients, according to a new study conducted by researchers at Shiley-Marcos Alzheimer’s Disease Research Center (ADRC), part of the University of California San Diego School of Medicine.
The findings, published in the Journal of Alzheimer’s Disease, suggest it may be more difficult for clinicians to detect AD in its mild to moderate stages among Hispanic patients compared to non-Hispanic patients. As a result, intervention and treatment could be delayed and less effective.
The research involved the autopsies of 14 Hispanic and 20 non-Hispanic persons. All had been diagnosed with Alzheimer’s disease while they were alive and their diagnosis had been confirmed by the autopsy.
The patients were matched by age, education, global mental status and severity of functional decline at first diagnosis. The study also included an equal number of autopsies of cognitively healthy Hispanic and non-Hispanic individuals without an AD finding.
The scientists looked at patterns of neuropsychological deficits, vascular risk factors and neuropathological differences between the Hispanic and non-Hispanic patients. They discovered that mild-to-moderately affected Hispanic patients with AD were significantly less impaired than non-Hispanic AD patients, relative to their respective culturally appropriate control groups, on measurements of memory, attention and executive functioning.
While the patient groups had similar overall AD pathology, Hispanics with AD exhibited greater small blood vessel disease in the brain than non-Hispanics with AD, as well as increased amyloid angiopathy, the accumulation of protein fragments in blood vessels associated with AD.
“There have been very few autopsy studies in Hispanic elderly with Alzheimer’s disease that have allowed researchers to gain insight about factors that might make it more difficult to clinically diagnose the disease in this demographic,” said senior author David P. Salmon, Ph.D., professor in the Department of Neurosciences and Helen A. Jarrett Chair in Alzheimer’s Research at UC San Diego School of Medicine.
“Information from our study can help guide how we assess living Hispanic patients who may have Alzheimer’s, to more accurately detect the disease in its early stages.”
AD affects 5.7 million Americans, with that number expected to nearly triple by 2050 without prevention or cure. Some studies suggest that the prevalence of dementia might be higher among Hispanics than non-Hispanic whites.
“The evidence we found is important to moving forward because early identification of Alzheimer’s disease can allow for earlier implementation of treatments and interventions that prolong the life and well-being of patients and their caregivers,” said first author Gali Weissberger, Ph.D., a postdoctoral researcher at USC Keck School of Medicine.
“The majority of Alzheimer’s disease research has focused on non-Hispanic White populations, and findings from this study suggest that certain contextual factors may contribute to a different and less salient profile of cognitive deficits in Hispanic older adults. Findings support the critical need for additional research with minority groups.”