Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Nat Rev Neurol. 2022 Jan;18(1):56-62. doi: 10.1038/s41582-021-00589-3. Epub 2021 Dec 6.
Research on racial differences in Alzheimer disease (AD) dementia has increased in recent years. Older African American individuals bear a disproportionate burden of AD and cognitive impairment compared with non-Latino white individuals. Tremendous progress has been made over the past two decades in our understanding of the neurobiological substrates of AD. However, owing to well-documented challenges of study participant recruitment and a persistent lack of biological data in the African American population, knowledge of the drivers of these racial disparities has lagged behind. Therapeutic targets and effective interventions for AD are increasingly sought, but without a better understanding of the disease in African American individuals, any identified treatments and/or cures will evade this rapidly growing at-risk population. In this Perspective, I introduce three key obstacles to progress in understanding racial differences in AD: uncertainty about diagnostic criteria, disparate cross-sectional and longitudinal findings; and a dearth of neuropathological data. I also highlight evidence-informed strategies to move the field forward.
近年来，针对阿尔茨海默病（AD）痴呆的种族差异的研究有所增加。与非拉丁裔白人个体相比，年龄较大的非裔美国人个体承受着不成比例的 AD 和认知障碍负担。在过去的二十年中，我们对 AD 的神经生物学基础有了巨大的认识进展。然而，由于研究参与者招募方面存在众所周知的挑战，以及非裔美国人中持续缺乏生物学数据，这些种族差异的驱动因素的知识一直滞后。人们越来越多地寻求 AD 的治疗靶点和有效干预措施，但如果对非裔美国人个体的疾病没有更好的了解，任何确定的治疗方法和/或治愈方法都将无法惠及这个快速增长的高危人群。在本观点中，我介绍了理解 AD 种族差异方面进展的三个关键障碍：诊断标准的不确定性、不同的横断面和纵向研究结果；以及神经病理学数据的缺乏。我还强调了推动该领域前进的循证策略。
