Some patients less likely to get new Alzheimer's meds

Some minority groups are more likely to be diagnosed with dementia than their white counterparts and less likely to be eligible for new disease-slowing treatments.

According to an Oct. 3 report published in JAMA Neurology, cognitive or mental impairment in Black, Hispanic, and Asian patients is more likely to be caused by forms of dementia unrelated to the amyloid plaques, which are now being treated with anti-amyloid monoclonal antibodies.

Researchers examined differences in amyloid deposition among 17,000 patients who had dementia or mild cognitive impairment. About 61 percent of participants suffered from mild cognitive impairment, and about 31 percent had dementia. 

Investigators found that 45 percent of Asian participants tested positive for amyloid plaques, compared to 58 percent of the white participants. Additionally, researchers found that 54 percent of Black people had amyloid plaques compared to 58 percent of white people, and 55 percent of Hispanic people had plaques compared to 62 percent of white people.

In patients with mild cognitive impairment, the team found that percentages of positivity declined to 36 percent for Asians versus 53 percent for whites, 42 percent for Black people versus 49 percent for white people, and 46 percent for Hispanic people versus 53 percent for white people.

According to an Oct. 3 analysis in U.S. News & World Report, the new anti-amyloid monoclonal antibodies are the first class of drugs designed to address the underlying biology of Alzheimer’s disease rather than its symptoms. 

Gil Rabinovici, MD, the study co-author, told U.S. News & World Report that lack of access to diagnosis and care at an early stage of the disease could further exacerbate disparities in dementia care and outcome.

"A higher proportion of Black and Hispanic patients presented to specialists at the dementia stage, rather than at the MCI stage, but the benefit of these new therapies is expected to be greater in earlier stages of the disease," said Dr. Rabinovici.

Researchers found that other factors also increased the odds of amyloid positivity, including older age, female sex, and higher education.

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