Amplifying the Voice of a Community: A Scoping Review of Attitudes, Beliefs, and Perceptions Among Black and African Americans About Dementia

Background and Objectives African Americans (AA) are twice as likely as White Americans to develop Alzheimer’s disease and related dementias (ADRD) but half as likely to receive a timely diagnosis. Factors contributing to underdiagnosis among AA include lack of healthcare access and provider bias, but little is known about attitudes, beliefs, and perceptions that may be patient-related drivers of dementia underdiagnosis. Research Design and Methods We performed a scoping review of attitudes, beliefs, and perceptions regarding ADRD among AA by searching PubMed, CINAHL, Web of Science, and Black Studies Periodicals Database from 2002-2024. Eligible studies were written in English and discussed attitudes, beliefs, or perceptions toward ADRD among AA in the U.S. A primary reviewer identified key themes, which were then discussed and summarized by the team. Results 49 studies met inclusion/exclusion criteria after title, abstract, and full manuscript review. We identified six themes: AA display gaps in knowledge about dementia; inclusive resources and support can help address the knowledge gap; stigma and losing autonomy are important barriers to seeking care; uncertainty in the relationship between the AA and medical communities is an additional barrier; the AA community has strengths that can be leveraged to support earlier dementia diagnosis if used carefully; and the AA community is not monolithic. Discussion and Implications It may be possible to address dementia-related disparities in diagnosis by leveraging underlying barriers and facilitators within the AA community. Additional research is needed to understand variations in attitudes, beliefs, and perceptions toward ADRD among AA.