ABSTRACTALZHEIMER’S, VASCULAR, AND MIXED DEMENTIA IN AFRICAN AMERICAN POPULATIONS:A REVIEW OF METHODOLOGICAL STRENGTHS AND LIMITATIONS OF THE EPIDEMIOLOGICLITERATURE FROM 1990-2015BySamuel John WisniewskiDementia, a chronic syndrome and public health concern, remains a disease not fullyunderstood (1, 2). In moving forward more research is needed to prevent, identify causal pathways,and treat dementia (1, 2). Recommendations from the recent National Institute of NeurologicalDiseases and Stroke-Alzheimer’s Disease and Related Dementias (NINDS-ADRD) conference of2013 rank as a top priority for future research the development of population-based studies ofdementia incidence and prevalence in diverse ethnic groups (2). Further, discordant outcomes havebeen observed in studies examining these metrics in African Americans specifically (3). Amethodological issue relevant to studies of African Americans is case ascertainment, with breadth ofdiagnosis a critical component that can affect the number of cases identified (3). In addition, the stateof dementia research as whole is in a transition (1, 2). A review systematically describing caseascertainment strengths and limitations of the epidemiological literature in this population has notpreviously been performed.With heterogeneity of methods an issue limiting comparisons between studies, and the state ofresearch in flux, now is an optimal time to examine what can be learned from the methods of paststudies. The aim of this review is to address this gap in the literature by examining breadth ofdiagnostics utilized across studies, systematically describing strengths and limitations of caseascertainment methodology for the three most common types of dementia, Alzheimer’s (AD), Vascular(VaD), and Mixed Dementia (MD), of African Americans from 1990 to 2015.
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