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Progression of Alzheimer's disease in black and white patients

The CERAD experience, Part XVI

From the Center for the Study of Aging and Human Development (Dr. Fillenbaum), the Biometry Division, Community and Family Medicine (Dr. Peterson), Bryan Alzheimer's Disease Research Center (Dr. Welsh-Bohmer), and the Department of Medicine (Dr. Heyman), Duke University Medical Center, Durham, NC; and the Department of Epidemiology (Dr. Kukull), University of Washington, Seattle, WA.

Address correspondence and reprint requests to Dr. Gerda Fillenbaum, Center for the Study of Aging and Human Development, Box 3003, Duke University Medical Center, Durham, NC 27710.

We compared the progression of Alzheimer's disease (AD) in CERAD-enrolled black and white patients, as indicated by changes in selected clinical and neuropsychology measures, over a 1-year time interval. Of 225 black and 935 white AD patients who were enrolled, 148 (66%) black and 770 (82%) white patients remained in the study. Of these, 82 black and 532 white patients provided complete in-person information on first annual re-evaluation. Overall, with age, education, initial level of performance on each measure, and stage of disease at entry controlled, race had a very mild effect on change in disease (8 df multivariate analysis of variance[MANOVA], p < 0.047). Black patients showed less decline than white patients, most notably for the CERAD Boston Naming test (p< 0.02) and the third and final trial of the 10-item Word List Learning task (p < 0.003). Although unadjusted data indicate that black and white patients appear to differ notably at entry, our findings indicated that differences in progression of the dementing process are minor, suggesting that course of AD is comparable in these racial groups. Examination over a longer period is difficult because of the high attrition rate of black patients.

Supported by NIA grant no. AG06790.

Received June 21, 1996. Accepted in final form July 25, 1996.