Underrepresentation of African-Americans in Alzheimer's Trials: A Call for Affirmative Action.

Abstract

Personalized medicine aims to tailor diagnosis and treatment based on an individual's personal genetic make-up and other predictive biomarkers—rather than a one-size fits all approach. African-Americans comprise 13.2% of the U.S. population (U.S. Census Bureau, 2014) and minorities (consisting of all but non-Hispanic Caucasian), now 37% of the U.S. population, are projected to reach closer to 57% in 2060 (U.S. Census Bureau, 2012). Indeed in coming decades minority population, including African-Americans, may exceed the Caucasian population in the U.S. Dementia, especially Alzheimer's disease (AD), has emerged as one of the biggest threats to public health and personal wellbeing among older adults. Epidemiological studies, by nature of their community sampling, have been able to study risk for AD in racially representative populations. In such studies, older African-Americans have been reported as being more likely than older Caucasians to develop AD and other dementias (Gurland et al., 1999; Dilworth-Anderson et al., 2008; Potter et al., 2009; Barnes and Bennett, 2014; Alzheimer's Association, 2015). Potter et al. (2009), Gurland et al. (1999), and Barnes and Bennett (2014) report that prevalence of cognitive impairment or AD among African-Americans may be two or three times higher than in Caucasians. By 2050, according to The Alzheimer's Association annual report from 2010, proportion of racial minorities with AD will increase from 20 to 42%, with African-Americans increasing from 9 to 12% (Alzheimer's Association, 2010). A more recent 2015 report suggests that 16% of African-Americans were diagnosed with AD or other dementias compared to 8% of Caucasians (Alzheimer's Association, 2015).