Prevention Intervention

The evidence is clear that racial discrimination, physical health and the environment contribute to Alzheimer's and other dementias. Now researchers are looking for ways to intervene

-  Jyoti Madhusoodanan

ABOUT FOUR YEARS AGO Clifford Harper, then 85, announced to his wife that he was quitting alcohol. Harper wasn't a heavy drinker but enjoyed a good Japanese whiskey. It was the first of a series of changes Linda Kostalik saw in her husband. After he'd cleared out the liquor cabinet, Harper, a prolific academic who has authored several books, announced he was tired of writing. Next the once daily runner quit going to the gym. Kostalik noticed he also was growing more forgetful.

The behaviors were unusual enough that, at an annual physical, the couple's physician recommended they consult a neurologist. A battery of medical tests and brain scans revealed that Harper's surprising actions and memory loss were the result of dementia.

Harper's neurologist at Oregon Health Sciences University (OHSU) asked whether he might like to enroll in a long-running study of dementia in African Americans. The study's focus on Black health piqued Harper's interest, and he decided to participate for as long as he could. "I hope it will help other men like me," Harper says.

As a Black American, Harper faces a risk of Alzheimer's disease and other dementias that is twice that of white Americans his age. The reasons for this disparity are still unclear, but researchers know Black Americans are particularly vulnerable to a number of confirmed risk factors, such as living in areas with higher rates of air pollution and encountering difficulties accessing healthy foods and high-quality education. Some studies suggest that experiencing racism and other forms of discrimination contributes to a higher risk of cognitive decline. Race or gender discrimination also raises a person's risk of heart disease and, as a result, some forms of dementia.