2024 Health Disparities, Policy and Ethics in Alzheimer’s Disease and Dementia Research (HPE-ADRD)

Psychosis in Neurocognitive Disease for Ethnoculturally Diverse Persons

How does a form of mental illness impact the progression of dementia in Black and Hispanic individuals?

Estevana Isaac, M.D.
Icahn School of Medicine at Mount Sinai
New York, NY - United States

Background

Studies indicate that Black Americans and Hispanic Americans are more likely to develop Alzheimer’s and other “neurocognitive disorders” as White Americans. Black and Hispanic Americans may also experience more severe forms of these disorders compared with Whites. Though it remains uncertain exactly the reasons for the disparities, research suggests that the presence of psychosis (a type of mental illness) in Black and Hispanic individuals with dementia may play a significant role in the severity of their dementia. This link between psychosis and dementia severity may be exacerbated by factors such as social determinants of health (i.e., discrimination and reduced access to health care).

Research Plan

Dr. Estevana Isaac and team plan to study the role of psychosis in neurocognitive disorders among Black and Hispanic individuals. For this, they will analyze brain and mental health data collected over time from a large number of diverse older adults with both psychosis and dementia or mild cognitive impairment (MCI, a condition of subtle memory loss that may precede dementia). First, after assessing the data, the researchers will measure how psychosis may have impacted factors related to dementia progression (such as memory loss and molecular brain changes) in Blacks and Hispanics compares with Whites. Next, they will examine data on the caregivers of these older adults, in order to assess what makes certain caregivers more likely to report psychosis symptoms to primary care providers. Part of this analysis will involve studying how social determinants of health may hinder the ability of caregivers to report symptoms.     

Impact

The work of this project could shed new light on why Black and Hispanic Americans experience dementia – and dementia care – differently from Whites. They could also lead to novel solutions for providing better care to people living with these disorders in underserved communities.