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Epidemiology of vascular and Alzheimer's dementia among African Americans in Chicago, IL

Baseline frequency and comparison of risk factors

Section of Cerebrovascular Disease (Dr. Gorelick and Y. Harris, T. Dollear, M. Billingsley, and N. Brown), Department of Neurological Science, Rush Medical College; and the Epidemiology and Biometry Program (Drs. Gorelick and Freels), School of Public Health, University of Illinois at Chicago, Chicago, IL.

We compared demographic, medical, and other epidemiologic factors among 113 African-American Alzheimer's disease (AD) patients and 79 African-American vascular dementia (VaD) patients. The typical background profile of our AD and VaD patients who entered into the study was that of women who were born and raised on farms in the southeastern United States, currently lived in an apartment or home in Chicago with other family members, and were retired, widowed, and had some form of medical insurance. The following distinct patient profiles emerged: (1) African-American AD patients were generally older than their VaD counterparts, more likely to have a family history of AD, Parkinson's disease and dementia, a history of head injury with loss of consciousness and hip fracture, and more severe cognitive impairment and difficulty with instrumental activities of daily living. (2) African-American VaD patients had a higher frequency of cardiovascular disease risk factors and focal neurologic findings, more difficulty with activities of daily living, and a higher frequency of medication use. Differences in risk-factor profile may help explain differential susceptibility by dementia subtype. Since ethnic minorities will constitute a higher proportion of the United States population in the future, targeted epidemiologic research to better understand etiology and risk factors for the dementias of middle and later life among minorities is needed.

Address correspondence and reprint requests to Dr. Philip B. Gorelick, 1725 W. Harrison St., Suite 755, Chicago, IL 60612.

Supported in part by NIA Grant No. R01-AG10102-03 (P.B.G.), the M.R. Bauer Foundation, and the Marjorie and Herbert Fried Scholarship Fund.

Received October 6, 1993. Accepted in final form January 27, 1994.

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