title: Prevalence of dementia in African-Caribbean compared with UK-born White older people: two-stage cross-sectional study.
abstract: BACKGROUND
  Preliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African-Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures.
  
  
  OBJECTIVE
  To determine the prevalence of dementia in older people of African-Caribbean country of birth compared with their White UK-born counterparts.
  
  
  METHODS
  A total of 218 people of African-Caribbean country of birth and 218 White UK-born people aged ≥60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria.
  
  
  RESULTS
  African-Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African-Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3-7.3, P = 0.012).
  
  
  CONCLUSIONS
  There is an increased prevalence of dementia in older people of African-Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.
authors.affiliation: Department of Mental Health Sciences, UCL, 67-73 Riding House Street, 2nd Floor, Charles Bell House, London W1W 7EJ, UK. simon.adelman@candi.nhs.uk
authors.forename: Simon
authors.initials: S
authors.lastname: Adelman
authors.forename: Martin
authors.initials: M
authors.lastname: Blanchard
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
authors.forename: Gerard
authors.initials: G
authors.lastname: Leavey
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data; D017691:Caribbean Region; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology* / Q000208:ethnology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D054242:Emigrants and Immigrants / Q000523:psychology / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006172:Guyana; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D038801:International Classification of Diseases; D007406:Interview, Psychological; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population; D044465:White People / Q000706:statistics & numerical data