Alzheimer’s Disease: The Long Goodbye 

By Dr. Thomas Stratton & MHM Team

Editor’s Note: Alzheimer’s disease affects millions of families, yet conversations about memory loss, caregiving, and brain health often happen too late, especially in Black communities, where the disease disproportionately impacts families.

Earlier this summer, a New York Times story about a Black church leading dementia awareness prompted us to ask what this issue looks like in our own community. We invited a trusted local voice to help explain what Alzheimer’s disease is, why it matters, and what our community should know.

In Part 1, you’ll learn about Alzheimer’s disease, risk factors, and early warning signs. Part 2 will focus on reducing risk, supporting caregivers, and connecting readers with local resources.

At Our Times, we believe information is a form of care, and we hope this series encourages conversations that lead to greater awareness and support for families navigating this disease.

Losing a loved one to dementia can be one of the most physically, emotionally, and spiritually exhausting ways to say, “the long good-bye.”  Often you see someone who seems physically well or even fit, but who is losing the capacity to function and losing those bits of themselves that make them who they are.  There is the deep personal tragedy of gradual loss of identity and meaning for the person living and dying with Alzheimer’s or another dementia.  There is that enormous toll of caregiver burden. And while a number cannot be put on those losses, what can be measured is staggering.  A recent study from University of Southern California projects that Alzheimer’s and other dementia will cost $818 billion in 2026 alone.   

Disparities in dementia 

As with many health outcomes, Alzheimer’s disease and other dementias disproportionately affect Black families, with a risk double that of White families.   Researchers point to several contributing factors, including the chronic stress associated with systemic and institutional racism, along with environmental factors such as air pollution and limited access to healthy foods. Together, these conditions contribute to “weathering”- the accelerated aging that results from prolonged exposure to chronic stress. These are racial disparities that are tied not to race but racism. 

What is Alzheimer’s? 

Alzheimer’s disease is the most common type of dementia. Dementia is a condition that results from physical and functional changes in the brain.  It affects memory, thinking processes, and personality.  Dementia is progressive and in late stages those living with dementia will lose the capacity for self-care.   

What causes Alzheimer’s? 

There are several theories for what causes Alzheimer’s, although many environmental, lifestyle, and genetic factors play a role.  One theory is that Alzheimer’s develops when abnormal clumps of protein build up in the brain and interfere with the ability of brain cells to communicate with each other.  This buildup likely occurs over a long time and begins before symptoms may be noticed.   

What are risks for Alzheimer’s? 

Risks factors for Alzheimer’s include:

• Age: Alzheimer’s risk progresses with time.  After age 65, the risk doubles every five years.  
• Genetics and family history: If your biological kin have a history of Alzheimer’s, you are more likely to also develop it.  
• Two-thirds of those living with Alzheimer’s are women.

What are some of the symptoms of Alzheimer’s?   

According to Familydoctor.org, these are 10 warning signs that may indicate Alzheimer’s disease or another form of dementia.

• Memory loss affecting daily life. Forgetting important dates or what you’ve just learned. 
• Change in ability to follow a plan or problem-solve: Think about executive function, that ability to focus and organize.   
• Change in ability to complete familiar tasks: Having more difficulty or being unable to complete chores at home, tasks at work, or running errands. 
• Confusion about time and place: Losing track of the time of day, the day itself, even getting lost in familiar places.   
• Problems with vision or understanding visual information: This could involve loss of reading comprehension, judging distances, and ability to identify what you see. 
• Difficulty with words: Forgetting words, repeating a conversation, and calling things by the wrong names.
• Losing things: Misplacing things in unusual places, being unable to retrace steps to find misplaced items 
• Loss of judgment: This could include loss of attention to hygiene.  Also, poor decisions with finances, like giving large amounts of money to solicitors.   
• Isolation and withdrawal: Includes withdrawal from social activities, hobbies, work, family outings, and faith communities.
• Personality changes: One may become unusually confused, suspicious, fearful, depressed, or anxious.   

These symptoms are not diagnoses for Alzheimer’s.  Testing may include blood tests, brain scans, and detailed questions about medical history and daily routines.  Testing may also involve detailed cognitive evaluations.  Early testing and diagnosis can be important for getting and managing the chronic progression of Alzheimer’s. 

Unfortunately, there is no Alzheimer’s cure.  Current medications can help slow progression, but management includes additional measures, including support for caregivers. 

Alzheimer’s disease is an incredibly challenging disease to receive as a diagnosis and to manage. Alzheimer’s risks are borne disproportionately by Black families because of a myriad of socioeconomic and environmental disparities tied to persistent racism.  Alzheimer’s is progressive and eventually leads to total loss of capacity for self-care. 

While there is no cure, early recognition, strong support systems, and access to resources can make a meaningful difference for individuals living with Alzheimer’s and for those who care for them. In Part 2, we’ll explore those resources and the steps families can take to navigate this journey together. Basically, it takes a village!