SALUD: Early Signs of Alzheimer's Disease Among Hispanics and Latinos
Hector M. González, Associate Professor of Epidemiology and Biostatistics at Michigan State University, recently received a $5.67 million grant from the National Institute on Aging (NIA) to fuel a study to find very early signs of Alzheimer's disease among middle-age and older Latinos.
September is World Alzheimer's Month, thus news regarding the tremendous $5.67 million, five-year grant from the NIA is both timely and necessary, particularly because the U.S. Hispanic population is largely one of the most uninvestigated populations when it comes to the disease and Latinos may be at increased risk for the disease.
According to Dr. González, who spoke at length with Latin Post about the impact of Alzheimer's disease on the U.S. Latino population, it's expected that there will be a 178 percent increase in Alzheimer's disease in the U.S. over the next 34 years. During the same period, the increase will be greater than 400 percent in Latin America, signifying that Alzheimer's disease isn't just a problem in the U.S. The disease is a problem all across the Americas, and no nation, rich or poor, is in economic position to handle this devastating disease. This is a global health priority.
Dr. González, who is a clinical scientist by training, has always been interested in the brain ever since he was a kid. Epidemiology offered him an opportunity to take his work further on the population level, which is important to him as a Mexican-origin Latino in the U.S. He asserted that he's on a journey to get to "the bottom line." Alzheimer's is inarguably a disabling and costly disease. There is no cure, and patients suffer from the disease for years or decades. Its damaging effects are numerous, and it can be economically overwhelming.
"Economically, it's just devastating," he said. "Growing up Mexican American, and seeing my friends, my families and my loved ones... these are the people who really cannot afford this. Not many can afford it and the country can't afford it. When 1-in-3 Americans will be Latino in the next 34 years, it will become an even larger public health priority of the nation that is largely Latino."
Before Dr. González began doing work on the population level, he worked at the UC Davis Medical Center in Sacramento. There he primarily worked with Mexican and Central American patients. During his time there, he saw a remarkable contrast between more affluent white patients and Latino patients. Many of the white patients were "worried well," concerned that their memory didn't work quite as well as it once did. However, Latino patients with limited English often arrived in wheelchairs, they were non-communicative and in the later stages of Alzheimer's disease.
The long-term dedication to Alzheimer's patients has a profound affect on the caregivers. Latino caregivers tend to endure many years of dementia before seeking help. Those extra years of caregiving are challenging and simply unaffordable.
The prevention of dementia will likely be cheaper and more effective than treating it once it has developed, according to Dr. González. He stated, "When we spend money on someone that's really sick, that's a good thing to do. However, it's better to prevent the disease from ever happening, or least slow it down and make it a little less impactful. Then, we can affect more people, I hope. What's nice about this study, although it was really hard to get it funded, is we're looking for really early risk factors ... for people in their 50s to help us identify who's at risk."
Dr. González's team will gather health data from nearly 7,000 middle-aged and older adults residing in San Diego, Chicago, the Bronx and Miami. The research will include diverse Latinos between the ages of 50 and 80 who experience mild cognitive impairment (MCI), which could be an early form of the disease. Also, as the principal investigator for the Neurocognitive Reading Center portion of the landmark Hispanic Community Health Study/Study of Latinos, he can look at already collected data containing detailed genomic and cardiovascular risk factors, which could be vital for detecting early signs of Alzheimer's disease.
"There are so many misunderstandings about the disease, and Alzheimer's disease research has been neglected too long. Also, education needs to happen for research we do," Dr. González said. "It's important that we provide Latino-specific information. It's great to study the dominant culture, that's fine, but we don't have the information that Latinos need. I guess the other assume Latino families are all loving, care for one another and they don't need any help. Nonsense. They're people, too. And they need help. I hope to spend my funding well. I want to come out of this with discoveries, not just findings...but discoveries that will matter."
Alzheimer's public health work isn't terribly sexy, but it's important to investigate risk factors and research how life and systems impact memory disorders. According to Dr. González, 20 percent of blood and 25 percent of oxygen is delivered to the brain, so it's important to consider how smoking, diabetes and obesity can be threaten the brain and the body. Sage wisdom from mothers, such as eat well, exercise and get plenty of sleep, can do just as much for brain function as the waist line.
The research poses an opportunity for Latinos to look at health from the preventative angle rather than the treatment angle. The nation's healthcare system is geared toward treating disease, and not prevention. Alzheimer's patients receieve much of their care from informal systems, such as the family. The Alzheimer's Association provides "respite care for patients who may have been up all night with their love one dealing with a host of problems. That precious time-off can allow the caregiver time to regroup, rest and get help. That's just a broader social network of care, to help provide support, and provide information.
"We're not just talking about a neuron, were not just talking about a brain, we're also talking about bodily systems, we're also talking about social system and healthcare systems, and public health care systems, that's the really grand scale that we must think in terms of how to deal with Alzheimer's disease," said Dr. González.
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