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A stratified random sample of 83 black and 81 white community residents aged 65 years and older in a five-county area in the Piedmont region of North Carolina was evaluated for dementia, using the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, and the National Institute of Neurological Disorders and Stroke--Alzheimer's Disease and Related Disorders Association criteria. Of 164 subjects, 26 were found to be demented, resulting in an estimated prevalence rate of dementia in the five-county area of 16% (95% confidence interval, 7.92 to 24.08) for blacks and 3.05% (95% confidence interval, 0 to 6.91) for whites. The estimated prevalence of dementia for white women (2.9%) was similar to that for white men (3.3%), but the rate for black women was distinctly higher than for black men (19.9% and 8.9%, respectively). Blacks were more likely than whites to have a history of stroke, hypertension, and other chronic disorders that might have contributed to the development of dementia. Apart from differences in rates of institutionalization, no other relevant factors were identified that might explain the difference in the prevalence of dementia in these black and white community residents.
Heyman et al. (Sat,) studied this question.