Palms Jordan D, Sol Ketlyne, Zahodne Laura B
Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA; email:
Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Annu Rev Clin Psychol. 2025 May;21(1):113-137. doi: 10.1146/annurev-clinpsy-081423-032631. Epub 2025 Jan 13.
Individuals from minoritized racial/ethnic groups face a disproportionate burden of Alzheimer's disease and related dementias. This health inequality reflects structural racism, which creates and sustains racial differences in social determinants of health, including education access and quality, economic stability, social and community context, neighborhood and built environment, and health care access and quality. Thus, understanding pathways that lead to dementia inequalities requires addressing individual- and system-level factors. This article summarizes evidence linking each social determinant of health to racial/ethnic inequalities in dementia, emphasizing upstream factors and mechanisms as potential levels of intervention. The importance of resilience in marginalized groups as well as critical research considerations for dementia inequalities are also discussed. Future directions highlight the need to understand the common and unique mechanisms driving inequalities across minoritized groups, where research is lacking.
来自少数族裔群体的个体面临着不成比例的阿尔茨海默病及相关痴呆症负担。这种健康不平等反映了结构性种族主义,它在健康的社会决定因素中造成并维持了种族差异,这些因素包括教育机会和质量、经济稳定性、社会和社区环境、邻里和建筑环境以及医疗保健机会和质量。因此,要理解导致痴呆症不平等的途径,就需要考虑个体层面和系统层面的因素。本文总结了将每个健康社会决定因素与痴呆症的种族/民族不平等联系起来的证据,强调上游因素和机制作为潜在的干预层面。还讨论了边缘化群体恢复力的重要性以及痴呆症不平等的关键研究考量。未来的方向强调需要了解在研究匮乏的少数族裔群体中推动不平等的共同和独特机制。