Misperceptions about Alzheimer's Delay Diagnosis, Treatment

Ethnicity plays a big role in attitudes about Alzheimer’s disease (AD)— attitudes that can have a profound effect on how quickly a patient is diagnosed and begins treatment, a new survey conducted by Harris Interactive on behalf of the Alzheimer’s Foundation of America indicates.

The survey included a cross section of 655 Americans (aged ≥ 18 years) who were classified as caregivers of a relative or friend with AD.

Respondents included 150 Hispanics, 252 blacks, and 253 persons of other ethnicities—whites, Asian/Pacific Islanders, Native American or Alaskan natives, and mixed.

Black and Hispanic caregivers were significantly more likely to consider the disease as a normal part of the aging process compared with caregivers of other ethnicities.

Nevertheless, blacks (70%) and Hispanics (67%) were more likely to dismiss the signs and symptoms of AD as normal features of old age than respondents of other races (53%).

Blacks and Hispanics were also more likely to say that they did not know enough about the disease to be able to recognize its symptoms compared with other ethnicities.

“Alzheimer’s disease is…by no means a normal part of aging,” said Warachal E. Faison, MD, assistant director of the Institute for Research Minority Training on Mental Health and Aging, and clinical director of the Alzheimer’s Research and Clinical Programs, Medical University of South Carolina, Charleston. “My concern is that caregivers who consider the disease normal and don’t know how to recognize its symptoms are not going to be able to make the best healthcare decisions for their loved ones.”

Patients with AD typically reported symptoms for 31 months before receiving a diagnosis. Neither blacks nor Hispanics felt that they had faced any particular ethnic barriers that delayed the diagnosis of their loved one, but blacks were somewhat more likely (36% vs 33%) to say that concern about AD stigma played a role in their delay in seeking care.

A majority of caregivers were not aware that combination therapy was available for AD. Blacks and Hispanics were less likely than other caregivers to be aware of combination therapy.

Feelings of responsibility (85%) or guilt (60%) were cited as the top reasons for caregivers’ not considering placing their loved one in an assisted-living facility or a nursing home. Among caregivers whose loved one was not currently in such a facility, other ethnicities were nearly twice as likely to think that placing their loved one in a facility would be an option compared with blacks and Hispanics.

“Facing Alzheimer’s disease is never easy, but getting a diagnosis and taking advantage of support services are crucial steps to treating and managing the disease,” said Eric J. Hall, chief executive officer of the Alzheimer’s Foundation of America.

Key points

• Pay close attention to signs and symptoms of AD in blacks and Hispanics, who often dismiss them.

• Only about 33% of AD caregivers are aware of the availability of combination therapies.

• Concerns about AD stigma often delay seeking treatment.