Exploring Racial Dynamics in Dementia Caregiving Challenges

By Office of the President | Mar 19, 2024

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New findings from the Center of Excellence for Alzheimer’s Disease at Downstate illuminate the complex relationship between race and the burdens faced by caregivers, as well as the impact of physical frailty and the behavioral and psychological symptoms of dementia (BPSD). This study reveals substantial, albeit sometimes subtle, connections that call into question conventional methods of dementia management.

The study examined a varied group of patient-caregiver pairs in New York State, employing crucial assessments like the Clinical Dementia Rating, Mini-Mental State Examination, and additional diagnostic instruments to gauge frailty, daily functioning, and BPSD. The results confirmed a significant association among these elements and their cumulative influence on caregiver strain, which is particularly pronounced in dementia compared to other ailments.

An essential aspect of this study was its consideration of race as a critical factor. The researchers identified that Black/African American individuals have twice the likelihood, and Hispanic/Latino individuals have 1.5 times the likelihood of developing Alzheimer’s dementia compared to their White counterparts. Additionally, the prevalence of frailty was nearly doubled among Black and Hispanic individuals in contrast to White individuals, with socioeconomic status and lower education exacerbating these racial discrepancies.

Moreover, Behavioral and Psychological Symptoms of Dementia (BPSD), which are linked to accelerated cognitive decline and higher rates of institutionalization, were found to be more common in Black participants with dementia compared to White participants. In models adjusted for age, sex, and education, Black individuals with dementia were approximately twice as likely to experience delusions and hallucinations.

Additional findings and insights include a vital need to emphasize and confront Racial Disparities in Healthcare, particularly in the domain of dementia care; the importance of promoting care that acknowledges the racial backgrounds of patients and caregivers with uniquely inclusive tailored resources, and understanding how additional research about how race intersects with other facts of dementia care delivered by caregivers from different racial groups.

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This research signifies a pioneering effort as the inaugural examination of the influence of race on caregiver burden in dementia care. It is in collaboration with researchers from SUNY’s four Alzheimer’s Disease Assistance Centers, including here at SUNY Downstate and at SUNY Upstate, Buffalo, and Stony Brook, showcasing the collective prowess and statewide influence of SUNY’s academic health centers.

Thank you to lead author Carl I. Cohen, M.D., Distinguished Service Professor and Director of Geriatric Psychiatry, and final author Michael Reinhardt, M.D., Assistant Professor and Director of the Geriatric Psychiatry Fellowship, for their invaluable contributions to this critical study.