A heat map that visualizes the highest percentages of Alzheimer’s cases blazes red and orange in the southern part of Virginia, based on statistics from a new study released Monday.
“This report shows that the southeast part [of Virginia] has the highest prevalence of Alzheimer’s disease [in the state],” said Jeanne Snyder, community executive with the Alzheimer’s Association of Central and Western Virginia chapter. “It’s higher there because in those regions of Virginia there is a higher percentage of people 65 and older and there’s a higher percentage of Black and Hispanic people.”
Alzheimer’s disease is a type of dementia caused by the breakdown of brain tissue. It affects older people and can result in problems with memory, reasoning, concentration and loss of function.
While no Virginia county hit the Top 10 list for the nation — Florida and California top the list in terms of the total number of people with Alzheimer’s disease — Virginia is among the top states in terms of having areas with a high percentage of people 65 and over with Alzheimer’s disease, with a statewide average of 11.7%.
The report, conducted by a team at Rush Medical College in Chicago, said there is now more of a likelihood that there will be a greater prevalence of people with Alzheimer’s disease and dementia, as the population ages and grows more diverse.
Older Black Americans are about twice as likely to have Alzheimer’s or other dementias as older whites, according to the researchers. And older Hispanics are about one-and-one-half times as likely to have Alzheimer’s or other dementias as older white people, the report said.
Dr. Brian Unwin, section chief for geriatrics and palliative medicine and medical director at Carilion Home Health at the Carilion Clinic Center for Healthy Aging in Roanoke, said Black and Hispanic Virginians are more likely to suffer from Alzheimer’s disease because of other social determinants of health.
“It’s a very complicated topic that intersects health care, including structural racism and community resources that all impact the health of our communities and especially our older adults,” said Unwin. “Those are big factors in caring for patients who have dementia.”
People are also at an increased risk of developing problems with dementia if they are poor, lack education, don’t have health care resources or are disenfranchised in society, Unwin said.
“People who have problem health behaviors of smoking, obesity, have high blood pressure or diabetes — those individuals are more likely to develop problems with dementia than people that don’t have those conditions,” Unwin said.
The localities in Virginia showing a highest prevalence of 65-plus residents with Alzheimer’s dementia are:
- Petersburg: 18%
- Sussex County: 15.5%
- Portsmouth County: 14.9%
- Richmond: 14.8%
- Hampton: 14.8%
- Charles City County: 14.7%
- Franklin city: 14.6%
- Brunswick County: 14.6%
- Prince Edward County: 14.5%
- Richmond County: 14.2%
- Nottoway County: 14%
- Halifax County: 14%
“If you look at south Virginia, you’re not going to see a major medical center anywhere east of Danville until you get to Richmond, so health care access is also different in that area,” said Unwin. “So, no, I’m really not surprised by what you see on the map there.”
The information comes from the research article “Prevalence of Alzheimer’s disease dementia in the 50 US states and 3142 counties,” which was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. The report was released Monday at the Alzheimer’s Association International Conference in Amsterdam, and online.
The research was conducted by Kumar Rajan, professor in the Department of Internal Medicine at Rush Medical College, and colleagues, who used cognitive data from the Chicago Health and Aging Project and population estimates from the National Center for Health Statistics to estimate the prevalence of Alzheimer’s in adults 65 years and older in all U.S. counties.
The researchers focused on two data sources: a population-based study composed of a large number of minorities including Black people to estimate the effect of the race on the risk of Alzheimer’s, and census-based population estimates that account for the distribution of age, sex and racial-ethnic groups at the county level.
So, just as political pollsters use a sample study to gauge wider public opinion, Unwin stressed that this study is a county-by-county estimate, not an exact count, of people with Alzheimer’s disease. This study is not the first ever to tally people with dementia in Virginia. A Virginia Department of Health study from 2007-2018 took a count of people with Alzheimer’s disease using data collected through Medicare billing.
This newest county-level Alzheimer’s prevalence data will help public health officials develop region-specific strategies and show them where there is more need, Snyder said.
Unwin added that the study also gives a sense of the impact that Alzheimer’s is having on a community — meaning that children and grandchildren are probably taking a lot of time, energy and effort to take care of their loved ones suffering from dementia.
The report found more Alzheimer’s patients in Virginia than the association had expected, based on its numbers — a total of 164,000, which is approximately 14,000 more than Virginia officials had estimated.
While there is no cure for the disease yet, the Alzheimer’s Association works to slow the disease’s challenging health effects and raise funds for research and services, with approved pharmaceuticals being the key to treating the condition, Snyder said. She also said the need for early treatment and detection is important, as are a healthy diet and exercise.
“This report will help public health officials care for people with dementia,” said Snyder. “It will be helpful for people living with Alzheimer’s and their caregivers.”
Unwin said the findings can also help public health officials work in a more focused way to help people in the highlighted areas reduce their risk of dementia by addressing obesity, diabetes, tobacco use, untreated alcohol use, high cholesterol and high blood pressure.
“All of those things are risk factors that increase your risk of developing late life dementia,” said Unwin. “If we can reduce our cardiovascular risk factors, we will reduce dementia risk in the long term.”
But Snyder said reaching people with Alzheimer’s in rural areas can be challenging.
“What we do is go into the community and often work with police and sheriffs because they are the ones who see a lot of people suffering from Alzheimer’s disease. It’s become a part of police training — how to deal with people with dementia who are sometimes angry. It’s important to educate law enforcement about it because sometimes people with Alzheimer’s go missing or are taken advantage of.”
How the Alzheimer’s Association does outreach in each community can differ and it can be difficult when there are few resources. The group will often engage with rural communities to come up with a plan, Snyder said, with programs such as a community forum at a church or a library.
“This information will help us help people who need the help the most,” said Snyder. “This report will also increase awareness of the disease and give us a roadmap going forward of where to concentrate our efforts.”