New Study Shows Dementia in Latin Brains is its Very Own Thing

A new study out of UC Davis Alzheimer’s Center has found that there are significant differences between the brains of Hispanics with dementia compared with those of non-Hispanic whites and African Americans. To be clear, this is a really big deal. There is still so much we don’t know or understand about dementia, and these findings could have a lasting impact on how we diagnose, treat and look at risk factors for dementia among the Latino population.

Dementia is the loss of cognitive functioning necessary to perform everyday tasks and activities. We often take for granted the ability to perform basic cognitive skills, including language, problem solving, basic reasoning, memory, visual perception and focus. When someone has dementia they lose those fundamental abilities, which can impact their emotions, their personality and their ability to manage their health and well being. Dementia, in its various forms and levels of severity, affects millions of people in the United States every year; the chronic symptoms and often irreversible decline in health can be devastating to patients and family members of those with dementia.

While we have always assumed that dementia does not discriminate and we know that the greatest risk factor for cognitive decline is age, these new findings suggest that Latinos are at a higher risk, and that dementia looks differently in the brains of Hispanics.  

It is important for everyone to know and understand this growing body of research and these groundbreaking findings, because you or someone you love might be at a higher risk of developing dementia in his or her lifetime, and knowledge is power in the fight to protect your cognitive health.

What Is Dementia?

Dementia is a general term that applies to a group of symptoms involving declining cognitive functioning. Contrary to what many people believe, dementia is not a disease itself, but more of an overall term that describes symptoms associated with a decline in your thinking skills. Think memory loss, inability to access language skills and knowledge, impaired reasoning and judgment, trouble focusing, and changes to a person’s personality. While all of these symptoms can and often do occur in cases of dementia, they do not all occur in all instances, and the severity can vary greatly from person to person.

People are often confused about the relationship between Alzheimer’s disease and dementia; they assume that they are the same thing, and are conditions and terms that can be used interchangeably, but that is incorrect. It’s important to note that Alzheimer’s disease is not the same thing as dementia. Alzheimer’s disease is the most common cause of progressive dementia in older adults, and dementia is a general term for memory loss and loss of other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 percent to 80 percent of dementia cases.

In addition to Alzheimer’s, which is clearly the most common cause of dementia, there are other causes as well, including vascular dementia, which occurs after a stroke, and dementia that results in damage to brain cells as the result of a vitamin deficiency or thyroid problem.

While memory loss is the most common and most well known symptom of dementia, there are other symptoms to look for as well. Other symptoms of dementia include cognitive changes such as loss of motor skills, difficulty communicating or finding words, trouble with problem solving and organizational struggles, confusion and disorientation. Psychological changes that can also signal an impending dementia diagnosis include depression, anxiety, behavior that is out of character, paranoia and agitation.

Dementia Impacts Millions of People

According to the 2019 Alzheimer’s Disease Facts and Figures published by the Alzheimer’s Association, an estimated 5.8 million Americans of all ages are living with Alzheimer’s dementia in 2019. And that number is expected to escalate rapidly in coming years, as the population of Americans ages 65 and older is projected to grow from 55 million in 2019 to 88 million by 2050.

On a larger scale, the World Health Organization estimates that there are 47 million people living with dementia worldwide. And that number is projected to increase to 75 million by 2030, with the cases of dementia potentially tripling by 2050.

Alzheimer’s disease is the sixth-leading cause of death in the United States, and 61 percent of those with Alzheimer’s dementia are expected to die before the age of 80, which is significantly higher than those without Alzheimer’s (only 30 percent risk). The numbers are staggering, and they are even more severe for the Latino community. Studies show that Hispanics are about one and one-half times as likely to have Alzheimer’s or other dementias compared to older whites.

Risk of Dementia is Greater Among Latinos

We already know that one of the greatest risk factors of Alzheimer’s and dementia is age. And while the risk of impaired cognitive functioning does increase as people grow older, it is not a normal part of aging. And because older adults, especially adults over the age of 65 are at an increased risk, the fact that there are more and more aging Latinos puts them at an elevated risk.

According to a report from the National Institute on Aging, the Centers for Disease Control and Prevention (CDC) reports that “by 2060 the number of Latinos age 65 and older is expected to nearly quadruple, and Latinos will face the largest increase in Alzheimer’s disease and related dementia cases of any racial/ethnic group in the United States.” The findings indicate that by 2060 there could be more than 3.5 million Latinos living with dementia and Alzheimer’s in the United States.

Latinos are also at an increased risk due to several factors involving their lifestyle, overall health and socioeconomic status. An increased risk of cardiovascular disease, plus a higher prevalence of conditions such as diabetes, high blood pressure, obesity, and depression all contribute to the increased risk of dementia in Latino adults.

A 2018 study called Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) looked into health data from the Hispanic Community Health Study/Study of Latinos to try and draw further conclusions about risk factors for dementia among Latinos. The findings indicate a strong relationship between lower cognitive function and diabetes, high blood pressure, and other cardiovascular disease risk factors. “Having various vascular-disease risk factors seems to accelerate cognitive decline in Latinos even more than for non-Hispanic whites,” explained Hector M. González, Ph.D., co-director of the Latino Core of the University of California.

The issue is that up until recently, we didn’t know why. We knew there was an increased risk for Latinos, we knew that dementia was often diagnosed at a younger age among Latinos, but according to Dr. González, “we’d like to understand why.”

This New Study has Found Dramatic Differences in the Brains of Hispanics with Dementia

This new study, recently published in the Journal of Alzheimer’s Disease, examined and analyzed brain autopsies from 423 people who had died after a dementia diagnosis. The findings indicate that Hispanics diagnosed with dementia were much more likely to have cerebrovascular disease than either non-Hispanic whites or African Americans. And in addition, the findings show that Hispanics and African Americans were more likely to have a combination of Alzheimer’s disease and cerebrovascular disease, compared to non-Hispanic whites.

According to Charles DeCarli, director of the Alzheimer’s Disease Center and principal investigator on the study, these findings are a real game changer in terms of future dementia diagnoses and treatment plans. “If you are Latino and diabetic or black and hypertensive, you are probably at higher risk for dementia and these risks should be addressed aggressively,” he explained. The real takeaway is that now that we know that Hispanics are at a higher risk, and that dementia manifests differently in Latino brains, doctors can tailor their treatment plans and approaches to those specific cases.

The researchers knew that there would be both similarities and differences in the brains of white and non-white Hispanic dementia patients, and regardless of your ethnicity or genetic background, a shrinking brain and diminished cognitive functioning is never a good thing. But they wanted to know if the cause of the dementia was different depending on whether you are white, black or Latino. And they found decent evidence to support differences among these ethnicities.

“These differences can be due to numerous factors including cultural, social, economic, and/or behavioral influences,” DeCarli explained.

While this study is relatively small, and there is still much work to be done to truly understand the cause of dementia and the increased risk among Hispanics, the findings of this first-of-its-kind study do shed a lot of light on dementia among Latinos. “It looked very clear to us that vascular disease plays a much stronger role in the Latino population, and is a contributing factor in the black population and that it may account for an overall higher incidence of dementia in these groups,” DeCarli said in his report.

It’s important for everyone to pay attention to this growing body of research, and it’s especially crucial that the Latino community really listen and take note, because the risk is real and it is increasing. But the good news is that while some of the risk factors for dementia cannot be changed, such as genetics and age, some risk factors, such as cardiovascular factors and diet, can be managed. Taking steps to control blood pressure, maintain a healthy weight, protect your heart health and protect your brain can all help reduce risk factors for dementia. Regular physical exercise and a healthy diet can also help reduce the risk of obesity and Type 2 diabetes, both of which are also risk factors for Alzheimer’s and dementia.