Black patients with Alzheimer’s disease dementia are much more likely to have an Alzheimer’s pathology mixed with another pathology than are white patients, according to Dr. Lisa Barnes and her associates.

In a prospective study of 122 patients enrolled in the Rush Alzheimer’s Disease Clinical Core, just under 20% of black patients had Alzheimer’s pathology as the only cause of dementia, compared with 42% of white patients. About 71% of black patients had Alzheimer’s pathology mixed with another pathology, such as Lewy bodies and infarcts, while just over half of white patients had mixed pathology. Black dementia patients also had higher rates of arteriolar sclerosis and atherosclerosis. The 41 black decedents were matched two-to-one to 81 white decedents according to age at death, sex, years of education, and cognition proximate to death.

“Given that most current therapeutic strategies focus primarily on the modification of amyloid, a central AD pathology, it will be important to develop new treatments that target other common pathologies, particularly in African Americans, to lessen the burden of AD dementia,” the investigators noted.

The full study was published online July 15 in Neurology ( doi:10.1212/WNL.0000000000001834 ).


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