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African American families face Alzheimer’s disease


MINNEAPOLIS, Minn.—“He was saying that some fellow across the street was taking gas out of his truck,” said Ann Small about her husband, James. “I know that [the neighbor] would never do such a thing—and then [James] accused someone of taking tires off of his truck. I didn’t pay much attention to it. Then after he was diagnosed, a lot of these little things come to mind.”

James Small, who is African American, was diagnosed with Alzheimer’s disease in 2011. African Americans living in the United States are two to three times more likely than whites to be diagnosed with the disease, according to the Alzheimer’s Association.

Small’s wife didn’t see it coming. She wondered if the changes in his personality — his angry outbursts — just meant that the two were spending too much time together.

“Anything I’d say, he would be negative about it,” Small remembered. “Every day it was something new.”

The couple’s daughter described her father as a handyman around their house, yet routine home improvement projects started taking him hours. She ended up taking him to a neurologist, who made the diagnosis.

While someone can live with Alzheimer’s disease an average of eight to 10 years, and up to 20 years in some cases, the disease is ultimately fatal, and there is no cure.

Juanita Williams said she screamed and cried alone in her car for more than 10 minutes after learning that her husband, Chuck Williams, had early-onset Alzheimer’s disease.

In the doctor’s office, she said, her husband slumped forward as though a weight had come upon him. She was strong for him then, but broke down as she rode alone to pick up his prescription.

Now, nine years later, Williams continues to care for her husband as he nears the advanced stages of the disease. “I’m not in denial. It’s getting worse for him,” she said, “and I think he needs so much more help.” She now considers assisted living or long-term care.

Dangerous Silence

“People aren’t comfortable about telling people about it because they feel embarrassed, and they don’t understand it. That’s their business,” said Dorothea Harris, a licensed social worker.

Harris heads the Family Memory Care for African Americans program at Volunteers of America-Minnesota.

Alzheimer’s is a progressive disease of the brain and results in memory loss as well as personality and behavior changes in those afflicted. In the end stages of the disease, sufferers have difficulty swallowing and may be unable to control movement.

According to the National Institute on Aging, 5.1 million people in the United States have Alzheimer’s, the most common form of dementia. In Minnesota, the Alzheimer’s Association estimates that 110,000 people, age 65 or older, will have the disease by the year 2025.

Education to Combat Denial

Combating the disease includes increasing awareness and education about Alzheimer’s disease among African Americans. “What’s needed first is education after they come out of denial,” said Ellen Johnson, senior aide at Volunteers for America.

Johnson, who works with Harris, commented, “Most people don’t know what it is. They don‘t know why the person is doing what they’re doing.”

Early diagnosis is important because some of the limited medication available can help some patients more effectively manage symptoms. Yet many African Americans do not become diagnosed until the later stages of the disease.

Post Diagnosis: What’s Next?

A diagnosis of Alzheimer’s disease does not necessarily mean immediate, drastic life changes. But there are ways for families to prepare and plan for the future stages.

On May 15, the U.S. Department of Health and Human Services released its National Plan to Address Alzheimer’s Disease, which includes among its goals strategies to support families and caregivers of those with Alzheimer’s disease and to address ethnic and racial health disparities.

Additionally, the Alzheimer’s Association has a webpage for African Americans explaining Alzheimer’s disease and the 10 warning signs. They also provide information for caregivers, such as the support group finder and Alzheimer’s helpline (1-800-272-3900).

Also, those new to family caregiving will find useful information at

This is the first in a series focusing on Alzheimer’s disease in the African American community. Andrea Parrott wrote this series as part of a MetLife Foundation Journalists in Aging Fellowship, a project of New America Media and the Gerontological Society of America.

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