President Obama has made it known that both health care and education are essential domestic policy points he wants to improve during his administration, and in recently praising heroes of one, he placed a spotlight on a lesser known crisis within the other.
That's because last week, when he invited Dr. Goldie S. Byrd to the White House, he inadvertently drew attention to a surging disease among African Americans – Alzheimer's.
Byrd, the Nathan F. Simms endowed distinguished professor of biology at North Carolina A&T University, was among the dozens of educators and mentors Obama honored for their dedication to science, technology, engineering and mathematics education. She also is on the vanguard of academic researchers exploring causes and cures for Alzheimer's, with a particular bent to how the disease is picking up speed among African Americans. Advocates say such work can't come soon enough.
While hypertension, HIV, diabetes and obesity are better known and are more frequently addressed health concerns among Blacks, Alzheimer's disease is poised to overtake those. Already it is one of the top 10 killers of adults in the United States, surpassing even diabetes-related deaths, according to the Centers for Disease Control and Prevention.
With African Americans facing greater disparity in two risk factors – overall cardiovascular health and access to quality education – this health crisis stands to loom even larger for them than the general population in just a matter of years as baby boomers continue to age. The human and financial costs of this disease that, to date, has largely swelled under the radar may well push communities to the brink unless a focus shifts to its eradication.
"Alzheimer's is not a phantom disease; it's real," Byrd said. "It's robbing family members of livelihood, of loved ones. And it is a health disparity."
As diseases go, Alzheimer's research is relatively nascent. The disorder kills brain cells, resulting in diminished and deteriorating memory, thinking and reasoning abilities. Yet much like cancer generations ago and HIV later, conversations about those coping with Alzheimer's, be it patient or caregiver, often come in hushed tones, if at all.
According to the Alzheimer's Foundation of America's most recent caregivers' survey, one in three African Americans cited fear of social stigma as why they delayed pursuing diagnosis for loved ones. Most – seven in 10 – still consider dementia, a hallmark symptom, a natural, inevitable part of aging when growing research shows the contrary. Age is a major risk factor, but others include compromised circulatory functions, system failures heightened by ailments such as hypertension, diabetes and heart disease.
Reported incidents of Alzheimer's disease among African Americans is higher than whites, though the exact reasons why remain under investigation. Some have questioned the assertion, attributing the spike in reporting to the cognitive assessment tests used, arguing that results are skewed because those interviewed may have educational backgrounds below the established baseline.
Still, there are connections to subpar education or intellectual stimulation as a risk factor for the disease, possibly because without such, the brain muscle and nerves never fully develop, making it more susceptible to attack in later years, said Dr. William Thies, chief medical officer of the Alzheimer's Association.
Investigators like Byrd are digging deeper into genetics. As of right now, there is simply not enough existing research for the "a-ha" breakthroughs that could lead to cures. Of the nearly 750 reported National Institutes of Health-funded clinical trials involving Alzheimer's just five were specifically targeted to African Americans.
That's, in part, due to funding and, in part, due to an educational stopgap among African Americans on the disease and its impact.
Overall, heart disease, breast cancer, prostate cancer and stroke deaths have been decreasing since 2000, yet deaths due to Alzheimer's disease have grown by nearly 50 percent. Attributable deaths in 2006 surpassed both breast and prostate cancers combined. The induced dementia tends to decrease brain functions for mobility or swallowing, which can lead to malnutrition or pneumonia, and then death.
Normal levers for rallying mass attention among Blacks have been lacking. A vociferous, organized push from the Congressional Black Caucus, for example, has not yet materialized. However, at least one member, U.S. Rep. Maxine Waters (D-Los Angeles), has recently introduced bills to ramp up Alzheimer's research funding and support for caregivers.
One calls for expanding a registry of those who may wander off – some three in five with the disease tend to wander from home, and up to half of those who do are at risk of injury of death if not found within 24 hours. That bill has cleared the U.S. House of Representatives and awaits further action in the U.S. Senate.
