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The Surprising Impact of Racism on the Brain

New research suggests discrimination is linked to memory decline in middle-aged adults

a person points to scans of the brain
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People who encounter racism in their life may be more likely to experience declining memory in middle age, according to new research presented Aug. 1 at the Alzheimer’s Association International Conference. The link is especially prominent among Black adults, who in the U.S. are about twice as likely to develop Alzheimer’s disease or other related dementias as whites.

A team of researchers based out of Columbia University assessed experiences of racism among 942 middle-aged white, Latino and Black adults. They found that the Black participants were most exposed to racism on a personal level and a societal one: They were more likely to grow up and live in segregated, resource-deprived communities; and they were also more likely to experience civil-rights violations and routinely endure discrimination. And these exposures were associated with lower memory scores at midlife. 

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The study’s results suggest that “efforts to increase systemic equality may also decrease risk for cognitive impairment later in life,” said Jennifer Manly, a professor of neuropsychology at Columbia University Irving Medical Center and the study’s senior author. More than 16 million Americans are living with cognitive impairment, a condition that affects memory, thinking and everyday decision-making, according to a 2011 statistic from the Centers for Disease Control and Prevention. 

“While it’s important to focus on what individuals can do to improve their own brain health, health providers need to be aware that many accumulated risks are historical and structural, and are not controlled by the individual,” Manly added. 

Previous research has uncovered similar findings. For example, Boston University researchers found an association between racism and decreased memory and cognition among a large cohort of Black women. 

The study, published in 2020 in Alzheimer’s & Dementia: Diagnosis, Assessment and Disease Monitoring, found that women who experienced the highest levels of interpersonal racism — like racial slurs, for example — were 2.75 times more likely to report worsening or more frequent confusion or memory loss, compared with women who experienced the lowest levels of interpersonal racism. And those who reported the highest levels of institutional racism — for example, having been discriminated against in pay or promotions at work — had 2.66 times the risk of experiencing a decline in their memory and functioning. 

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What’s more, researchers at Emory University linked racial discrimination experiences with changes in the brain that could lead to future brain health problems in a 2021 study published in JAMA Psychiatry. 

How racism can affect brain health

Experts say a number of factors can help explain the association between racism and worsening brain health. For example, racism is a form of trauma that leads to increased stress, says Carl V. Hill, chief diversity, equity and inclusion officer at the Alzheimer’s Association. And stress “can result in negative biological changes such as inflammation, a known risk factor for cognitive difficulties, including dementia,” he says. 

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To complicate matters, many people who experience racism “are not provided a pathway to lower that risk,” Hill says, since long-standing health inequities make it harder for minorities to access disease prevention resources and quality health care. “It becomes a one-two punch,” he adds. 

Healthy food can also be harder to come by. Black and Hispanic households experience higher rates of food insecurity, which is associated with obesity and unhealthy eating habits. And ongoing research reveals a strong tie between cardiovascular health and brain health. For example, uncontrolled high blood pressure in midlife raises a person’s risk for dementia later in life. The same goes for high blood sugar.

“People need resources to sustain their best health, and in this case, brain health,” Hill says. “And we know that structural racism has [resulted in] communities where individuals don’t have the same access to these very important health-protecting resources.” 

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More than biology at play 

Hand in hand with Black Americans, Hispanics are expected to see the largest increase in Alzheimer’s disease and related dementias between 2015 and 2060, the CDC says. This population, which is affected by many of the same health inequities as Blacks, such as reduced access to health care, is about 1½ times as likely to have dementia as whites, according to the Alzheimer’s Association. 

Hill says this latest research on racism and brain health represents a step forward in the pursuit of health equity. “We’ve got to begin to better understand the unique perspectives and experiences of African Americans and Latinos and Asian Americans, Pacific Islanders and American Indian/Alaska Natives so that we can understand how all people come to risk [for cognitive decline],” he says. (AARP’s Global Council on Brain Health is also studying health equity as it relates to brain health and is expected to release a report addressing how to build brain health equity later in 2022.) 

What’s more, as researchers work to better understand the underlying causes of dementia, “it compels us to think of dementia in a broader way, not just from a biological standpoint” says Zaldy Tan, M.D., medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders at Cedars-Sinai in Los Angeles, who was not involved in the research. 

According to the CDC, nearly 6 million Americans have Alzheimer’s disease and related dementias, a number that the Alzheimer’s Association says could grow to 12.7 million by 2050. Currently there is no cure, and no treatment has been proven to stop or slow the progression of the disease. 

“I think it’s important to consider the totality of one’s lived experience and not just to look at the biology. And I think this shows that promoting equality and diversity is not just good for society but could potentially help us reduce the risk of people who experience cognitive decline and dementia later in life. So this has tremendous implications in terms of public health and promotion of brain health,” Tan adds. 

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