Britons of black and south Asian origin with dementia die

Britons of black and south Asian origin with dementia die younger and sooner after being diagnosed than white people, research has found.

South Asian people die 2.97 years younger and black people 2.66 years younger than their white counterparts, according to a study by academics from University College London and the London School of Hygiene and Tropical Medicine.

A team led by Dr Naaheed Mukadam, from UCL’s division of psychiatry, reached their conclusions after studying health records covering the 21 years between 1997 and 2018 of 662,882 people across the UK who were aged over 65.

It was the first study to investigate the incidence and prevalence of dementia, as well as age of diagnosis, survival and age of death, across white, black and south Asian ethnic groups using electronic records kept by GP surgery and hospital staff.

They found that:

Dementia rates have increased across all ethnic groups.

Black people are 22% more likely to get dementia than their white peers.

Dementia is 17% less common among those of south Asian background.

But they have voiced concern about also discovering that south Asian and black people are diagnosed younger, survive for less time and die younger than white people.

“The earlier age of dementia diagnosis in people of black and south Asian [origin] … may be related to the higher prevalence of some risk factors for dementia such as, in older south Asians, fewer years of education, and in both groups hypertension [high blood pressure], diabetes and obesity,” they write in their paper, published in the medical journal Alzheimer’s & Dementia.

“Black and south Asian people survived for less time after dementia diagnosis and they died at a younger age.

“Overall, our findings show black and south Asian patients are diagnosed with dementia at a younger age and die at a younger age with dementia than white patients, losing more years of life,” added Mukadam and her five co-authors.

They also found that 11.8% of over-65s have dementia. That is the highest figure for the prevalence of dementia in Britain that any study has yet arrived at. For example, the NHS website says that one in 14 people – about 7% – have the brain-wasting condition, which is thought to be closely linked to unhealthy lifestyles. The researchers say the difference is due to rising life expectancy since the previous estimates were drawn up.

The stark disparities between ethnic groups are “concerning”, said Mukadam. Asked to explain why black and south Asian people die sooner than white people, she replied: “We do not know if earlier death after dementia diagnosis is because dementia is picked up at a later stage in minority ethnic groups and therefore people decline faster, if underlying risk factors in these groups contribute to worse overall health or if there is a difference in post-diagnostic support that results in these differences.”

Dr Habib Naqvi, the director of the NHS Race and Health Observatory, said the findings showed that minority-ethnic patients needed more help after they had been diagnosed.

“Dementia is a ‘silent killer’ affecting Asian, black and other ethnic minority groups disproportionality, and tragically, at a younger age. These findings are critical and should be a call to action for the NHS and wider social care profession.

“Evidence shows ethnic minority patients and carers are already more likely to be isolated from mainstream healthcare services. Prolonged delays in seeking support, combined with health and care services that often do not meet diverse needs, can leave vulnerable dementia patients and their families in ‘crisis’,” he said.

Health and social care services “need to be more culturally appropriate and sensitive to help close gaps in health access, experience and outcomes”, he added.

Mukadam said that “targeted interventions” to raise awareness about the greater prevalence of certain risk factors in some ethnic minorities, and how they can affect brain health, such as diabetes among south Asians, could help prevent dementia developing.

Mental Health