Author: Pavani Kumar

Categories
Neurocognitive Disorders

A Deep Dive into Epilepsy and it’s (Not-So) Shocking Ramifications on Global Health

Epilepsy is a neurological condition characterized by a recurrent onset of seizures (Mayo Clinic, 2021). Seizures are abnormal electrical activity in the brain which can be divided into two categories: focal and generalized. Focal seizures originate from one area of the brain, whereas a generalized seizure involves all areas. Seizures are often short-lived events, lasting 30 seconds to two minutes; however, they may classify as a medical emergency if prolonged for a longer duration (Mayo Clinic, 2021). Because seizures may affect any location of the brain, symptoms vary considerably, ranging from temporary loss of awareness to physical twitches or disturbances in sensations. Not all seizures can be classified under epilepsy. As at least two unprovoked seizures, within a 24-hour timeframe, are usually needed for a complete diagnosis (Mayo Clinic, 2021). As individuals with epilepsy may experience seizures at a higher frequency, they consequently may experience more severe symptoms such as muscle spasms, injuries, behavioral changes, or psychological conditions such as anxiety. 

The causes and mechanism of action for epilepsy are widely unknown for about 50% of all cases (World Health Organization, 2022). Epilepsy can result from genetic, structural (physical abnormality/ injury), infectious, or immune causes. Some examples include oxygen deprivation during one’s prenatal stage, stroke, genetic conditions relating to brain malformations, or head trauma (World Health Organization, 2022). While treating the underlying cause of epilepsy is generally not feasible, treating the symptoms of seizures is largely an attainable goal for many patients. Medications, such as antiepileptic drugs (AEDs), are considered initial options for treatment plans because they treat seizures by reducing excessive electrical signals sent by neural cells (American Association of Neurological Surgeons, 2021). With numerous AEDs available on the market, individuals have more options to choose the right medication for them based on their physical and social needs. Treatment plans may also include prescribed diet modifications, such as a ketogenic diet, for children who do not benefit from medications (American Association of Neurological Surgeons, 2021). A ketogenic diet is high in fats and low in carbohydrates, which are believed to reduce glutamate concentrations in the brain and increase gamma-Aminobutyric acid (GABA) synthesis. These are excitatory and inhibitory neurotransmitters respectively which result in reduced electrical signaling between neighboring neural cells (Wnuk, 2018). While surgery is considered a final option for treatment, some individuals with epilepsy may greatly benefit from surgical options if they respond poorly to AEDs (American Association of Neurological Surgeons, 2021). 

With the increasing treatment options, epilepsy is increasingly becoming a manageable condition for most. Of patients with recorded epilepsy, 70% report no seizures largely due to the help of AEDs. When considering epilepsy and its effects, one must consider the global context for the condition as the rate of incidence falls higher in low and middle-income countries. Of all individuals with epilepsy, 80% reside in such countries where preventable health and accessible care are likely to be lacking (World Health Organization, 2022). Therefore, individuals in low and middle-income countries are more susceptible to an increased risk of infectious conditions or birth-related injuries. Further, treatment barriers exist for around 75% of these individuals where they do not have access to medications (World Health Organization, 2022). Thus, it is crucial to see the varying support levels provided to low and middle-income countries to assist in this global health issue which inevitably pushes individuals towards a greater inequitable fate. 

 

References

American Association of Neurological Surgeons. (2021). Epilepsy. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Epilepsy

Mayo Clinic. (2021, February 24). Seizures. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711

Mayo Clinic. (2021, October 7). Epilepsy. https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093

Wnuk, A. (2018, August 14). How Do Ketogenic Diets Help People With Epilepsy? BrainFacts. http://www.brainfacts.org/diseases-and-disorders/epilepsy/2018/how-do-ketogenic-diets-help-people-with-epilepsy-081418

World Health Organization. (2022, February 9). Epilepsy. https://www.who.int/news-room/fact-sheets/detail/epilepsy

Categories
Dissociative Disorders

A Break from the Oneself (and Maybe the World): Examining Depersonalization-Derealization Disorder

*Top image is part of a comic drawn by a community member, with the account name as Planetmclulu, on Bored Panda. The individual’s name is Lulu, and they drew this comic to display what it is like to have depersonalization/derealization disorder. They are cited in the reference section; however, one may go on their account to view more of their illustrations.*

 

Dissociative disorders are characterized by an absence of connectivity between one’s perceptions, emotions, and understanding of self. The dissociation, defined by these types of disorders, usually results from prior experiences with trauma, and is thought to allow the individual to cope with their reality that is a result of situations associated with a painful or sorrowful memory or sentiment (Mayo Clinic, 2017). Depersonalization/derealization disorder (DPDR) is one type of dissociative disorder categorized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Within DPDR, one may experience significant aspects of depersonalization and/or derealization that are strongly likely to interfere with the routine functioning of daily life (Mayo Clinic, 2017). 

The depersonalization element of DPDR is defined by detachment from one’s self in terms of mind and body (2017). With this, an individual can feel that they are viewing themselves from a third-person perspective. Alexithymia may arise as a symptom in which one cannot identify or properly explain their emotions. Additionally, one may experience a physical loss of sensation or ability to control movement which can be further exacerbated by an idea that one’s limbs are disfigured (Fritscher, 2020). The derealization element of DPDR is defined by detachment from one’s environment and other people within one’s surroundings (2020). With this type of dissociation, an individual can feel separate and isolated from their surroundings to the point where they may feel objects and people near them are fabricated (2020). Hence, one’s senses of vision and hearing, which make up memory, may be warped (2020). A person experiencing derealization may have symptoms of hyper-awareness of their environment and visualizing objects in the nearby vicinity to be manipulated into two-dimensional, colorless, or cartoonish configurations (Fritscher, 2020).  

Whether an individual experiences both depersonalization and derealization aspects or just one, it is apparent that this disorder has strong potential to severely impact one’s behavior and capacity in daily function. An individual with DPDR is likely to experience initial symptoms and episodes of the disorder in their mid-teenage years to young adulthood (American Psychiatric Association, 2018). Although most episodes are not chronic, the respective episodes can persist over hours, days, weeks, and even months. The symptoms can also periodically return over several years (Fritscher, 2020). To be diagnosed as an individual with DPDR, along with identifying the presence of the depersonalization/derealization symptoms, it is also important to identify if the disorder is causing social or personal disturbance to the individual and if the individual recognizes that the dissociation they experience is not real (2020). To recognize that one’s reality is not the dissociation experience is a crucial criterion for a DPDR diagnosis, as it rules out other psychotic disorders (Fritscher, 2020).  

While there is no distinct cause for DPDR, it is possible for certain situations or predispositions, such as genetic or environmental causes, to pose a higher risk for individuals to be more susceptible to the disorder. Most often, individuals with DPDR have experienced or witnessed a past trauma such as emotional, physical, or sexual childhood abuse. In early years, a child is more readily able to learn how to view traumatic events from a third-person perspective as personal identity is still under development. Thus, it is possible for dissociation to unknowingly be a coping mechanism for later years of life (Fritscher, 2020). For treatment purposes, it is usually most effective for individuals with DPDR to undergo psychotherapy, such as cognitive-behavioral therapy (CBT). CBT serves to help an individual to reconnect with their emotions, mind, and body, so they may block out false perceptions of themselves and their surroundings. The second form of therapy, eye movement desensitization and reprocessing (EDMR), may also be used, in which an individual is trained to shift their negative thoughts and memories with a series of bilateral (side-to-side) eye movements (Fritscher, 2020). Through this therapy, it is hoped for the individual to focus on a specific memory or thought until it does not cause distress to the individual (Gotter & Raypole, 2022). 

 

References

American Psychiatric Association. (2018, August). What are dissociative disorders? https://www.psychiatry.org/patients-families/dissociative-disorders/what-are-dissociative-disorders

Fritscher, L. (2020, December 4). What Is Depersonalization/Derealization Disorder (DPDR)? Verywell Mind. https://www.verywellmind.com/derealization-2671582

Gotter, A., & Raypole, C. (2022, January 11). Considering EMDR Therapy? What to Expect. Healthline. https://www.healthline.com/health/emdr-therapy

Mayo Clinic. (2017, November 17). Dissociative disorders. https://www.mayoclinic.org/diseases-conditions/dissociative-disorders/symptoms-causes/syc-20355215#:~:text=Dissociative%20disorders%20are%20mental%20disorders,with%20functioning%20in%20everyday%20life

Planetmclulu. (2019). I’ve been suffering from DPDR for over 3 years now, and I want people to know what it’s like (10 comics) [Illustration]. Bored Panda. https://www.boredpanda.com/comics-life-with-depersonalization-derealisation-disorder-planetmclulu/?

Categories
Neurodegenerative Disorders

What is Multiple System Atrophy?

Multiple System Atrophy (MSA) is a progressive, neurodegenerative disorder characterized by the suspension of the standard function of the autonomic nervous system with a presentation of symptoms usually arising in the 50s or 60s of one’s adulthood (Mayo Clinic, 2020). The autonomic division of the nervous system regulates involuntary movements of an organism’s internal organs in response to environmental stimuli such as breathing patterns, heart rate, digestion, and metabolism (Kandola, 2020). An individual with MSA most commonly experiences frequent fluctuations in blood pressure, such as low blood pressure when one stands or sits up (orthostatic hypotension) or high blood pressure when lying down (supine hypertension) (2020). One may additionally experience a loss of urinary or bowel control, dysfunction in body temperature regulation due to reduced sweat production, and difficulty maintaining sexual function with a loss of libido (Mayo Clinic, 2020). 

MSA is divided into two categories: MSA-P, parkinsonian, and MSA-C, cerebellar (MedlinePlus, 2016). The most common form, MSA-P, is grouped by movement abnormalities such as rigid muscles, slow movement, trouble bending arms and legs, and difficulty keeping the body in a sustained, balanced position (2016). MSA-C is defined by cerebellar ataxia in which an individual faces complications with muscle coordination (2016). This may present as speech slurring, trouble focusing one’s eyes, or difficulty swallowing or chewing (Mayo Clinic, 2020). 

As of right now, there is no conclusive reasoning for why MSA occurs in the population; however, it is thought for the cause of the disorder to be a conglomerate of genetic and environmental elements (2020). By examining the brain and spinal cord of those who were impacted by MSA, researchers saw a significant shrinkage of the cerebellum, basal ganglia, and brainstem (Mayo Clinic, 2020). All three structures are crucial in their involvement for motor learning, balance, and coordination of body movements (Johns Hopkins Medicine, n.d.). Affected brain tissue has been revealed for neurons in the brain and spinal cord to be composed of an abnormal amount of alpha-synuclein protein, which form clumps, or inclusions, throughout the nervous system (n.d.). Accumulations of alpha-synuclein protein over nerve cells can block proper cell signaling, leading to a progressive loss of control in coordination and motor functions (n.d.). Studies suggest that variations in the SNCA gene, which encodes for the alpha-synuclein protein, have been associated with a greater risk of MSA (MedlinePlus, 2016). 

Unfortunately, no cure has been found for MSA. Although all individuals with MSA experience varying levels of the disorder throughout their years, the symptoms do not decrease in severity. The progression of the condition leads to a greater degree of difficulty in maintaining daily activities with further secondary complications (Mayo Clinic, 2020). 

 

References

Johns Hopkins Medicine. (n.d.). Brain anatomy and how the brain works. https://www.hopkinsmedicine.org/health/conditions-and-diseases/anatomy-of-the-brain

Kandola, A. (2020, January 10). What is the autonomic nervous system? Medical News Today. https://www.medicalnewstoday.com/articles/327450#function

Mayo Clinic. (2020, May 21). Multiple system atrophy (MSA). https://www.mayoclinic.org/diseases-conditions/multiple-system-atrophy/symptoms-causes/syc-20356153

MedlinePlus. (2016, July 1). Multiple system atrophy. National Library of Medicine. https://medlineplus.gov/genetics/condition/multiple-system-atrophy/

Categories
Attention-Deficit/Hyperactivity Disorder

Clinical Presentation of ADHD in Women

Attention-deficit/hyperactivity disorder, commonly referred to as ADHD, is classified as a neurodevelopmental disorder in which symptoms often manifest in childhood and can persist throughout adulthood. As the name suggests, individuals with ADHD may have difficulty concentrating on tasks, paying attention to others or their surroundings, or regulating impulsive behaviors. ADHD is divided into three subtypes: inattentive, hyperactive/impulsive, or combined type. Inattentive type ADHD is characterized when an individual predominantly displays inobservant behaviors or distractibility relating towards a task. This may include having a difficult time focusing on lectures or classroom discussions, forgetting daily tasks, or having difficulty following details in a conversation. In the hyperactive/impulsive type, one predominantly displays symptoms associated with erratic or restless behaviors such as difficulty engaging in leisure activities, appearing to need constant movement, or inability to wait for their turns in social functions or activities. In combined type ADHD, one presents symptoms of both inattentiveness and hyperactivity (American Psychiatric Association, 2021). 

ADHD is mostly diagnosed in early childhood, school-aged children with boys more commonly being the recipients of the diagnosis in contrast to girls,12.9% compared to 5.6% respectively (Centers for Disease Control and Prevention, 2020). While the prevalence of ADHD may appear more apparent in boys than girls, research shows that this gap in diagnosis is not necessarily the result of boys being more susceptible to ADHD, but rather, it may be due to girls being misdiagnosed or undiagnosed for ADHD in their younger years. 

Physicians Quinn and Madhoo, who specialize in ADHD treatment, conducted a review of varying clinical presentation of ADHD in women in contrast to men to analyze the differing factors in the recognition of a diagnosis and treatment options. In their review, they examined 41 ADHD articles, on Pubmed, over the span of the years 2002 to 2012 to identify the relevance of ADHD in women. Results signified that women and girls with ADHD to prominently display inattentive behaviors rather than hyperactive or impulsive symptoms. Internalizing symptoms, such as distractibility or inability to remain focused on a task, are more likely to be overlooked by teachers and parents in comparison to externalizing symptoms, which are associated with more disruptive behaviors as markers for ADHD diagnosis (Quinn & Madhoo, 2014). With public perception of ADHD heavily focused on the presentation of hyperactivity or impulsivity, behavioral symptoms relating to inattention are widely neglected in individuals who may present a different set of ADHD symptoms but are equally impacted by the condition. Typically, there is a greater emphasis on noticing disruptive or loud behaviors as common symptoms of ADHD; however, most do not realize individuals with inattentive or varying levels of combined type ADHD may have their symptoms go unnoticed and untreated for a great length of time. This inevitably would exacerbate negative behaviors that can disrupt the daily lives of individuals with these subtypes of ADHD. Quinn and Madhoo additionally noted that women and girls with ADHD are more likely to develop secondary presentations of anxiety and depression in association with their ADHD symptoms. Females with ADHD are more likely to exhibit lower self-esteem than males with ADHD. This negative self-perception is correlated with impaired peer and family relationships which is evident as females with ADHD are more likely to exhibit inattentive behavior which may make it difficult for them to focus on conversation building with others (Quinn & Madhoo, 2014). Overlooking an ADHD diagnosis in childhood can directly correlate with further exacerbation of symptoms related to depression and anxiety which travel to adulthood in women.  In this manner, it is seen how ADHD symptoms in women may be misdiagnosed even in adulthood for the coexistence of anxiety and depression. 

ADHD symptoms of all subtypes need to have greater recognition, so more individuals with ADHD can be included in the conversation for proper treatment and diagnosis. Because most diagnoses of ADHD happen in childhood years, it would be very beneficial to have additional instruction given to teachers, caregivers, and family members of the manifestation of ADHD behavioral markers that commonly go unnoticed. Additionally, with growing awareness of how clinical presentations of ADHD may be different in various groups, there should be a greater research focus on obtaining ADHD data on underrepresented populations. With proper diagnoses, more individuals with ADHD will be able to seek out proper medications and therapies to help them better understand their condition.

 

References

Image Citation: (Open Learn, 2021)

American Psychiatric Association. (2021). What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhd

Centers for Disease Control and Prevention. (2020, November 16). Data and statistics about ADHD. https://www.cdc.gov/ncbddd/adhd/data.html

Open Learn. (2021, February 3). Understanding ADHD [Animated Photograph of a Young Girl with ADHD.]. The Open University. https://www.open.edu/openlearn/health-sports-psychology/understanding-adhd/content-section-0?active-tab=description-tab

Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/Hyperactivity disorder in women and girls. The Primary Care Companion For CNS Disorders, 16(3). https://doi.org/10.4088/PCC.13r01596

Categories
Autism Spectrum Disorder

Art and Music Therapies for Individuals with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is classified as a neurological and developmental condition characterized by behavioral difficulties in areas of social interaction and communication. Individuals with ASD may display patterns of repetitive behaviors or restricted interests which can conflict with their proficiency to use verbal or non-verbal gestures, interpret their own and others’ emotions, or adjust to new environments and scenarios (American Psychiatric Association, 2021). As a result, individuals with ASD may be hindered from successfully communicating their thoughts and wishes to others. Children and adults with ASD experience different degrees of impairment with respect to the severity, number, or presentation of their symptoms. Early intervention, focused on different forms of training and therapy, have been shown to improve functionality of social and speech skills which can help individuals to better understand social situations. While most individuals with ASD opt for common forms of intervention such as applied behavior analysis and occupational and speech therapy, non-traditional programs such as art and music therapy have been seen to be very effective in increasing social adaptation and communication skills (Centers for Disease Control and Prevention, 2019). 

Art therapy is emerging as a new tool to successfully mitigate some symptoms of ASD by promoting a stimulating outlet to help individuals use artwork and media to explore their emotions while developing self-awareness skills to better acclimate to new surroundings (The Carmen B. Pingree Autism Center of Learning, 2021). Art therapy is a creative process which is facilitated by an art therapist who is a licensed, master-level clinician with expertise on how to integrate sensory and symbolic art modes into improvement of cognitive and emotional function (American Art Therapy Association, 2017). As individuals with ASD may experience difficulty expressing themselves verbally, art therapy provides a non-verbal outlet where one may develop and enhance their ability to express themselves in a less restrictive environment. As art therapy tends to be individualized, one may choose what materials, mediums, and colors they want to use to form their own visual work. In this manner, those with ASD are able to integrate abstract thinking and their emotions into their art to reveal their perspective and creative expression. Art therapists can cater their exercises to seeing which materials are most preferable or popular to their patient so they can be most comfortable in their own learning environment (Van Lith et al., 2017, p. 78-84). The preference in choosing different materials can help individuals with ASD increase their tolerance to experience new stimuli. Art strategies, such as sand art or playdough sculptures, are forms of different sensory materials which can help individuals to be more desensitized to new textures and smells. While participating in this creative play, individuals can be more comfortable with various stimuli which will inevitably improve their interaction to similar situations in their daily life. Here, art therapy is able to enhance visual and spatial skills in individuals to allow them greater behavioral regulation (The Carmen B. Pingree Autism Center of Learning, 2021).      

Similar to art therapy, music therapy is an intervention, facilitated by an accredited therapist, that focuses on instrument play, musical improvisation, and various musical activities to foster social and communicative skills. Music therapy helps to provide a predictable structure to sessions that may help to better accommodate individuals with ASD for their learning environment. Because of heavy sensory engagement, music based therapy sessions can help one to be accustomed to different social environments and increase the likelihood of positive engagement in daily activities. Additionally, music therapies can often be presented in group activities which can encourage individuals with ASD to collaborate with others and increase their interaction. As ASD may make it difficult for individuals to understand others’ expressions and emotions, these group activities can help their social skills and communication (American Music Therapy Association, 2015).

Through efforts to expand therapy and intervention practices, one can see how there are options for individuals with ASD to learn new social and communicative skills in a manner most comfortable to them. Interventions such as art and music therapy provide innovative learning styles where an individual with ASD can foster abilities to be confident and secure in themselves in their own environment.   

 

References

American Art Therapy Association. (2017). Becoming an art therapist. https://arttherapy.org/becoming-art-therapist/

American Music Therapy Association. (2015). Fact sheet: music therapy and autism spectrum disorder (ASD). https://www.musictherapy.org/assets/1/7/Fact_Sheet_ASD_and_MT__8-26-15.pdf

American Psychiatric Association. (2021, August). What is autism spectrum disorder? https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder

The Carmen B. Pingree Autism Center of Learning. (2021, May 25). Art therapy activities for autism. https://carmenbpingree.com/blog/art-therapy-activities-for-autism/

Centers for Disease Control and Prevention. (2019, September 23). Treatment and Intervention Services for Autism Spectrum Disorder. https://www.cdc.gov/ncbddd/autism/treatment.html

Van Lith, T., Stallings, J. W., & Harris, C. E. (2017). Discovering good practice for art therapy with children who have autism spectrum disorder: The results of a small scale survey. The Arts in Psychotherapy, 54, 78-84. https://doi.org/10.1016/j.aip.2017.01.002

Categories
Neurodegenerative Disorders

Racial Disparities Seen in Prevalence of Alzheimer’s Disease

Alzheimer’s disease is a progressive neurodegenerative disorder characterized by compromised memory, thinking, and behavioral patterns. It is believed that Alzheimer’s is a result of aggregations of beta-amyloid protein fragments between neurons as well as neurofibrillary tangles inside neurons that result from accumulations of tau protein. These protein accumulations grow to effectively disrupt communication and signaling between neurons (“What happens to the brain in Alzheimer’s disease?,” 2017). The nature of these biological markers surrounding Alzheimer’s often leads to symptoms of cognitive impairment to appear much later in one’s life than the true start of the disease. Current research still cannot explain what conclusively causes these harmful protein aggregations; however, the biggest risk for Alzheimer’s has been linked to aging.

While the discussion surrounding this disease has generally been restricted to genetic and biological associations, recent data suggests communities of color are disproportionately impacted in the risk of developing and obtaining a diagnosis for Alzheimer’s. Compared to white individuals, African Americans are twice more likely to develop Alzheimer’s, and Hispanics are one and one-half times more likely to have Alzheimer’s (Alzheimer’s Association, 2020). Despite the higher prevalence rate of Alzheimer’s, these respective groups are still less likely to be given a timely diagnosis in earlier stages which inevitably restricts potential treatment options contingent on early intervention. It is reported for the age of initial symptoms to be, on average, 6.8 years earlier in Hispanic individuals than the average age of initial symptoms in white individuals (Alzheimer’s Prevention Initiative, 2012). With an earlier onset of initial symptoms and a delayed awareness of the proper diagnosis, one can see how the gap of accessing correct treatment may worsen the prognosis of the Alzheimer’s condition. The racial and ethnic disparities that are seen in Alzheimer’s data may suggest how socioeconomic factors play into the development of this disease in certain groups.

Socioeconomic factors have been linked to neurocognitive disorders and cognitive function as individuals with more access to educational and occupational resources are more likely to have normal cognitive function throughout adulthood. It is typically seen that higher educational resources are quite beneficial for memory-based function in elders which ties back to the prevalence of Alzheimer’s disease between different groups of varying socioeconomic backgrounds (Racial and Ethnic Disparities in Alzheimer’s Disease: A Literature Review, 2014). Research conducted by Amy Kind, a physician-scientist in the Division of Geriatrics and Gerontology of the University of Wisconsin, focused on analyzing the prevalence of Alzheimer’s biomarkers and baseline cognition in terms of a socioeconomic context. Kind pooled her cohort of participants, late-to-middle-aged adults with a parental history of Alzheimer’s, from the Wisconsin Registry for Alzheimer’s Prevention (WRAP) study. Through the American Community Survey and Census data, neighborhood and socioeconomic quantifications were created to compile a metric, Area Deprivation Index (ADI) which accounts for poverty, education, housing, and employment indicators to predict health-disparity related outcomes (Kind et al., 2017, p.195). All participants were thereby ranked into deciles of neighborhood disadvantage using ADI and measured for their baseline cognitive function and levels of Aβ42 and P­tau181 in their cerebrospinal fluid. Results had shown those living in more disadvantaged neighborhoods were associated with a lower baseline of cognitive outcome and function in areas of memory and speed despite being controlled for age and education. Although Aβ42 levels did not vary considerably within the different neighborhood deciles, it was noted that those in the most disadvantaged neighborhoods measured disproportionately higher levels of phosphorylated tau in their cerebrospinal fluid with an average of 11.61 P-tau units higher than those in the lesser disadvantaged neighborhoods (Kind et al., 2017, p.196). With these observed differences in biomarker levels and cognitive performance, one may say that socioeconomic and neighborhood disadvantage may be correlated to a higher risk of developing Alzheimer’s.

For the majority of Alzheimer’s research, there has been a dominant bias of acquiring information and data from largely white participants which unfortunately has created a lack of understanding of how this disease can first appear or develop in different groups of people. A 2019 study conducted by John C. Morris, a neurologist and professor at Washington University in St. Louis, measured the differences in Alzheimer’s disease manifestations in African American and white individuals. 1,255 participants of ages 43 or more, based in the St. Louis area, volunteered in studies conducted at Knight Alzheimer Disease Research Center. This cohort aimed to be a representative sample proportional to the different backgrounds within St. Louis. Biological data was extracted from the participants through different testing such as PET scans, MRI scans, or spinal taps to detect and measure amyloid protein buildup, levels of Alzheimer’s biomarkers, and signs of brain shrinkage or damage (Bhandari, 2019). Although PET and MRI scans did not show significant differences between African American and white individuals, it has been seen African Americans who exhibited mild to very mild signs of Alzheimer’s measured lower than threshold levels of expected tau. As stated previously, tau protein accumulations inside neurons create disruptions in how neurons communicate. Larger tau levels signify a greater likelihood of cognitive decline. Therefore, normal and high levels of tau may have been previously misrepresented and could have caused misdiagnoses in African Americans (Bhandari, 2019).

Socioeconomic and racial inequalities continue to create disparities in the prevalence of diseases such as Alzheimer’s. In future research, hopefully, such neurodegenerative disorders can be analyzed carefully into both biological and social factors to create a more health-equitable future.

 

References

Alzheimer’s Association. (2020, March). Race, Ethnicity, and Alzheimer’s. Alzheimer’s Disease & Dementia Help. https://www.alz.org/aaic/downloads2020/2020_Race_and_Ethnicity_Fact_Sheet.pdf

Alzheimer’s Prevention Initiative. (2012). Alzheimer’s Disease Facts and Figures. Alzheimer’s Prevention Registry. https://www.endalznow.org/storage/documents/Cor/alzheimers%20disease%20facts_figures_factsheet_updated_aug.pdf

Bhandari, T. (2019, January 21). Racial differences in Alzheimer’s disease unveiled. Washington University School of Medicine in St. Louis. https://medicine.wustl.edu/news/racial-differences-in-alzheimers-disease-unveiled/

Kind, A. J., Bendlin, B. B., Kim, A. J., Koscik, R. L., Buckingham, W. R., Gleason, C. E., Blennow, K., Zetterberg, H., Carlsson, C. M., & Johnson, S. C. (2017). Neighborhood socioeconomic contextual disadvantage, baseline cognition and Alzheimer’s disease BIOMARKERS in the Wisconsin registry for Alzheimer’s prevention (Wrap) study. Alzheimer’s & Dementia, 13(75), 195-196. https://doi.org/10.1016/j.jalz.2017.07.054

Racial and Ethnic Disparities in Alzheimer’s Disease: A Literature Review. (2014, January 31). Racial and ethnic disparities in Alzheimer’s disease: A literature review. ASPE. https://aspe.hhs.gov/reports/racial-ethnic-disparities-alzheimers-disease-literature-review-0

What happens to the brain in Alzheimer’s disease? (2017, May 16). National Institute on Aging. https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease