Department of Translational Science and Molecular Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.
Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
J Alzheimers Dis. 2017;58(4):979-992. doi: 10.3233/JAD-161261.
Alzheimer's disease (AD) is the most common type of dementia among individuals 65 or older. There are more than 5 million diagnosed cases in the US alone and this number is expected to triple by 2050. Therefore, AD has reached epidemic proportions with significant socioeconomic implications. While aging in general is the greatest risk factor for AD, several additional demographic factors that have contributed to the rise in AD in the US are under study. One such factor is associated with the relatively fast growth of the Latino population. Several reports indicate that AD is more prevalent among blacks and Latinos. However, the reason for AD disparity among different ethnic groups is still poorly understood and highly controversial. The Latino population is composed of different groups based on nationality, namely South and Central America, Mexico, and Caribbean Hispanics. This diversity among the Latino population represents an additional challenge since there are distinct characteristics associated with AD and comorbidities. In this review, we aim to bring attention to the intersection between social determinants of health and genetic factors associated with AD within the Latino community. We argue that understanding the interplay between identified social determinants of health, co-morbidities, and genetic factors could lead to community empowerment and inclusiveness in research and healthcare services, contributing to improved diagnosis and treatment of AD patients. Lastly, we propose that inserting a neuroethics perspective could help understand key challenges that influence healthcare disparities and contribute to increased risk of AD among Latinos.
阿尔茨海默病（AD）是 65 岁及以上人群中最常见的痴呆症类型。仅在美国就有超过 500 万确诊病例，预计到 2050 年这一数字将增加两倍。因此，AD 已经达到了流行的程度，对社会经济产生了重大影响。虽然一般来说，衰老是 AD 的最大风险因素，但一些导致美国 AD 发病率上升的其他人口统计学因素正在研究中。其中一个因素与拉丁裔人口的快速增长有关。有几项报告表明，AD 在黑人和拉丁裔人群中更为普遍。然而，不同族裔群体之间 AD 差异的原因仍未被充分理解，存在很大争议。拉丁裔人口由基于国籍的不同群体组成，即南美和中美洲、墨西哥和加勒比海西班牙裔。拉丁裔人口的这种多样性构成了另一个挑战，因为 AD 与合并症存在明显的特征。在这篇综述中，我们旨在引起人们对健康社会决定因素和与拉丁裔社区 AD 相关的遗传因素之间的交叉点的关注。我们认为，了解已确定的健康社会决定因素、合并症和遗传因素之间的相互作用，可以促使社区在研究和医疗保健服务中获得权力和包容性，从而改善 AD 患者的诊断和治疗。最后，我们提出插入神经伦理学观点可以帮助理解影响医疗保健差距的关键挑战，并导致拉丁裔人群 AD 风险增加。
