Getting access to a certain Alzhiemer’s drug requires a positive result on PET scans, which happens less frequently for Black, Hispanic, and Asian patients.
The problem thus far, according to the researchers behind the new study, is a common one across clinical trials: PET scans “have largely been studied in individuals identified as White, with minimal inclusion of racially and ethnically diverse groups,” they wrote.
In contrast, their trial represented a collaboration among universities across the country and a sample that included 321 Asian, 635 Black, and 829 Hispanic participants—making this one of the largest nonwhite samples studied. Even though Black and Hispanic populations have higher rates of Alzheimer’s and dementia diagnoses than whites do, all three nonwhite groups had lower odds of their PET scans coming back positive.
According to the researchers, these differences may mean that the causes or symptoms of Alzheimer’s and dementia vary across the populations—Black and Hispanic individuals, for instance, have higher rates of hypertension and diabetes than white people do, in part due to structural inequities and other social determinants of health. These conditions are associated with specific presentations and progressions of Alzheimer’s.
Worryingly, these results could indicate that Alzheimer’s therapies that, like aducanamab, require the presence of amyloid or others that work by reducing amyloid plaques may not be equally beneficial for all patient populations. Further research and clinical trials should emphasize representation in their recruitment; otherwise, these new therapies may worsen existing health care disparities, the researchers wrote.
“If diverse groups are less likely to benefit from amyloid-directed therapies and likely to experience considerable financial hardship from the associated cost, there is a risk these novel treatment options may exacerbate existing racial and ethnic disparities in dementia care,” they wrote.
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