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Article type: Review Article
Authors: Bayram, Ecea; * | Holden, Samantha K.b | Fullard, Michelleb | Armstrong, Melissa J.c; d | Lewy Body Dementia Association Community Engagement Working Group
Affiliations: [a] Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA | [b] Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA | [c] Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA | [d] Fixel Institute for Neurological Diseases, Gainesville, FL, USA
Correspondence: [*] Correspondence to: Ece Bayram, MD, PhD, Department of Neurosciences, University of California San Diego, 9500 Gilman Dr, MC 0886, La Jolla, CA, USA. Tel.: +1 858 246 2546; E-mail: drecebayram@gmail.com.
Abstract: Lewy body dementia is the third most common and costliest type of dementia. It is an umbrella term for dementia with Lewy bodies and Parkinson’s disease dementia, both of which place a substantial burden on the person and society. Recent findings outline ethnoracial differences in dementia risk. Delayed and misdiagnosis across ethnoracial groups contribute to higher levels of burden. In this context, we aimed to summarize current knowledge, gaps, and unmet needs relating to race and ethnicity in Lewy body dementia. In this narrative review, we provide an overview of studies on Lewy body dementia focusing on differences across ethnoracial groups and outline several recommendations for future studies. The majority of the findings comparing different ethnoracial groups were from North American sites. There were no differences in clinical prevalence and progression across ethnoracial groups. Compared to people identifying as non-Hispanic White, co-pathologies were more common and clinical diagnostic accuracy was lower for people identifying as Black. Co-morbidities (e.g., diabetes, hypertension) were more common and medication use rates (e.g., antidepressants, antiparkinsonian agents) were lower for people identifying as Black or Hispanic compared to people identifying as White. More than 90% of clinical trial participants identified as non-Hispanic White. Despite increasing efforts to overcome disparities in Alzheimer’s disease and related dementias, inclusion of individuals from minoritized communities in Lewy body dementia studies continues to be limited and the findings are inconclusive. Representation of diverse populations is crucial to improve the diagnostic and therapeutic efforts in Lewy body dementia.
Keywords: Alzheimer’s disease, dementia, diversity, equity, ethnicity, inclusion, Lewy body disease, racial groups
DOI: 10.3233/JAD-230207
Journal: Journal of Alzheimer's Disease, vol. 94, no. 3, pp. 861-878, 2023
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