Alzheimer’s Pathology Differs Between Blacks, Whites

The results suggest that specific Alzheimer's therapies may need to be developed to address differences in pathology.

Alzheimer’s disease may be more common in African-Americans, but it also presents differently than in Caucasians, according to results from a study published in Neurology.

“Studying how Alzheimer’s disease looks in the brain in individuals of different races may help us to further understand the disease and pinpoint strategies for prevention and treatment,” said researcher Lisa L. Barnes, PhD, of Rush University Medical Center in Chicago.

Researchers compared the brains of 41 deceased African-Americans with a clinical diagnosis of Alzheimer’s dementia to 81 deceased white Americans of European descent of the same level of disease severity, age, sex, and education level. The researchers sought to identify common brain pathologies of dementia, including Alzheimer’s disease, Lewy bodies, and infarcts, as well as arteriolar sclerosis and atherosclerosis.

Over 93% of all decedents included in the study were confirmed to have Alzheimer’s disease pathology. African-American decedents, however, were less likely to have Alzheimer’s pathology as a single dementia pathology than white decedents (19.5% vs. 42%). Over 70% of African-Americans had Alzheimer’s disease with an additional pathology, including Alzheimer’s pathology and Lewy bodies, and Alzheimer’s pathology, Lewy bodies, and infarcts, compared to just over 50% of whites. African-American decedents also showed more severe arteriolar sclerosis and atherosclerosis than their white counterparts.

“Our study has important clinical implications because it may suggest a need for different types of Alzheimer’s prevention and treatments in African-Americans,” said Barnes. “Given the mixed pattern of disease that we see in African American brains, it will be important to develop new treatments that target these other common pathologies, particularly for African-Americans.”


  1. Barnes LL et al. Neurology. 2015; doi:10.1212/WNL.0000000000001834.