Recent research has indicated that Americans face an increased lifetime risk of developing dementia. This finding has served as the topic of conversation from the New York Times to Saturday Night Live. Beneath the main headline, the increased lifetime risk of dementia was particularly pronounced among Black adults, who were in danger of developing dementia at three times the rate of White adults and with dementia arriving earlier. Dementia is life-changing for the person with cognitive impairment but also affects the spouses, adult children, and other supporters of older adults.
In the article that sparked much of the recent attention, colleagues from NYU rightfully set forth policy advancements that might decrease dementia risk among the general American population. Yet, research toward drug development, intervention implementation, clinical practice guidelines, and policy advancements all will be essential to address the coming onslaught of dementia – and this research must address disparities in dementia risk, burden, and even research participation among Black adults.
Research must expand in critical ways to diminish dementia risk and facilitate optimal aging among Black adults. An imperative first step requires the research community to fully understand the dimensionality of the Black population within the United States (US). The field of aging and dementia largely conceptualizes the US Black population as a monolithic or homogenous group. It is true that structural racism serves as a throughline of the US Black experience, one that shapes and intersects with personal pathways to impact dementia risk. However, the lived experiences of US Black people also vary by diverse geographic areas, socioeconomic backgrounds, and cultural practices – all contributing to a person’s aging trajectory. Researchers must design studies that utilize the expanse of methodologies, methods, and analytic strategies to examine the complexity and nuance of dementia risk and related factors among US Black adults. For example, mixed-methods research designs can provide a deep phenotype of US Black adults in relation to dementia risk.
Deep phenotyping implicitly requires an exclusive focus on the US Black population, meaning, without explicit comparison to other racial demographic groups, such as US White adults. Within-group approaches will not only illuminate diversity within the US Black population regarding dementia risk but also allow researchers to pinpoint challenges for specific subgroups of Black adults that place them at increased dementia risk. For example, dementia risk may be exacerbated by environmental exposures in certain geographic areas where a specific group of Black people reside; thus, requiring localized polices and strategies to address the issue. Conversely, within-group examinations will showcase levers of resilience, mechanisms of protective factors, and profiles of exceptional longevity within the US Black population. These positive insights can provide intervention targets for further development and implementation among the broader US Black population to enact optimal outcomes in aging.
One thing is for certain – people are talking about dementia risk. Now is the time for the research community to seize the moment and design and conduct studies that will inform policies and strategies focused on people facing increased dementia risk, especially Black adults. As the country recently celebrated Dr. Martin Luther King, Jr. Day, it is important to recognize the progress represented by Black people living longer, but it is just as important to ensure they can spend their later years in optimal health.