By Ed Martinez – May 2, 2008
I often refer to the metaphor “Alzheimer’s tsunami” because it helps communicate an appropriate sense of urgency relative to how Alzheimer’s threatens the health and well-being of Latino communities. The similarities between a tsunami and Alzheimer’s are noteworthy: both often evolve undetected and strike their victims without warning; both result in great loss of human life and cause extreme distress for loved ones families; and both require a high state of community awareness and preparedness to minimize future losses.
Latinos are now the fastest growing population in the United States, and are generally considered to be at higher risk for developing Alzheimer’s disease (AD) due to three factors: (1) an increasing life expectancy with an average age of 87 by 2050; (2) higher rates of cardiovascular diseases such as diabetes and high blood pressure; and (3) lower utilization of available health services.
According to the National Institute on Aging (NIA), Alzheimer’s disease and related dementias among Latinos are projected to increase more than 600 percent in the U.S. during the first half of the 21st century. This increase, a looming tsunami, means that 1.3 million Latinos will have Alzheimer’s by 2050, compared to the fewer than 200,000 currently living with the disease. Based on these alarming estimates from public health demographers, community health advocates fear that unprepared and unsuspecting Latino communities are vulnerable to an epidemic of Alzheimer’s that could strike with the power of a destructive tsunami. It is a daunting challenge to prepare the Latino community for a thunderous wave of this proportion – particularly since safety net providers work so hard to provide health care services to thousands of elderly, at-risk Latinos, many of whom already have symptoms of Alzheimer’s disease and other related dementia.
Upon reviewing the following challenges facing our Latino community, there is the strong belief that the tsunami-like characteristics of this disease will gradually engulf the community’s capacity to maintain the health and well-being of its elderly residents:
- In 2000, approximately 1,900 elderly Latinos with Alzheimer’s lived in San Diego. The Alzheimer’s Association recently reported that in the South Bay area, there are t 9,012 elderly Latinos at risk for the disease, and by 2050, the prevalence of Alzheimer’s among Latinos in San Diego county is estimated to increase to 23,300 – an alarming increase of 1,233 percent.
- Elderly Latinos report lower utilization of medical services due to language/communication problems and cultura1 misunderstandings. These access barriers often lead to higher levels of physical impairment due to delays in early diagnosis and treatment. Without adequate resources to expand the availability of culturally competent health and social support services, elderly Latinos at risk for Alzheimer’s disease will continue to underutilize institutional-based programs offering diagnostic and treatment services.
- Latino families typically refer to care for loved ones with Alzheimer’s in their homes. A recent AARP study reported that approximately two-thirds of Alzheimer’s caregivers perform physically demanding personal care services, such as bathing, feeding, helping individuals to the toilet, and dealing with the loss of bladder or bowel control. As a result of this, caregivers suffer from higher incidences of depression, physical illness, social isolation, sleep problems, and diminished quality of life. Given the estimated increase of Alzheimer’s disease in the Latino population, communities will require significant new resources to respond to the urgent needs of caregivers of people with Alzheimer’s.
The situation clearly is urgent. Yet, despite the ominous swell of the Alzheimer’s tsunami charging coward the Latino community, governmental allocated only limited resources for community-based preventive, diagnostic, and treatment services.
However, in 2004, the Alzheimer’s Association received a three-year grant from the California Endowment to establish a pilot dementia care network targeting the South Bay’s Latino community. San Ysidro Health Center (SYHC) and Casa Familiar collaborated with the Alzheimer’s Association in implementing community-based dementia care services, including community outreach and health education, family counseling, recreational activities and health care referrals for diagnosis and medical treatment. Additionally, in early 2006, South Bay Supervisor Greg Cox’s office funded a one-year community outreach program sponsored by the Alzheimer’s Association. This initiative focused on the South Bay community and was designed to raise the Latino community’s awareness of Alzheimer’s and related dementia.
Although these two funding programs were of limited scope, they proved to be very successful in demonstrating the effectiveness of public-private partnerships in developing and implementing community-based Alzheimer’s services. Given the urgency of maintaining essential risk-reduction, early diagnosis and primary care services for at-risk elderly Latinos, SYHC, Casa Familiar, and the Alzheimer’s Association have agreed to continue funding the dementia care network on a limited basis until additional funding is secured.
The Latino community also supports the Alzheimer’s Association’s effort co increase federal funding for Alzheimer’s research at $1 billion per year. This level of funding would help support the Association’s research program and expand its efforts to better understand long-standing access barriers in the Latino community that delay early diagnosis and treatment.
Clearly, we can only prepare for the Alzheimer’s tsunami char is bearing down on the Latina community through collaboration, networking, and leveraging of scarce resources. Given the magnitude of chis public health challenge, SYHC remains committed to exploring new, innovative strategies for improving the scope and quality of Alzheimer’s services for our community’s elderly, at-risk population.
Ed Martinez is a resident of El Cajon and former CEO/President of San Ysidro Health Center