OBJECTIVES:

To examine racial disparities in depression occurrence in US AD participants, and disparities in depression severity and antidepressant use among adults with AD.

METHODS:

Using the 2005-2022 National Alzheimer’s Coordinating Center (NACC) database, we measured depression occurrence and severity in AD participants (N= 11,906) stratifying by race and ethnicity. Depression severity was assessed by the 15-item Geriatric Depression Scale (GDS-15). Use of an antidepressant was obtained using Multum/Lexi-Comp therapeutic drug categories and identified prescription antidepressants.

RESULTS:

Among AD participants, 47.6% had depression. There is a significant difference in depression occurrence between race/ethnicity groups. Compared to Whites, African Americans (AAs) and Asians have lower rates of depression participants (OR, 95%CI: 0.769, (0.682, 0.866) and 0.677, (0.524, 0.857, respectively)), while Hispanics have a higher rates (OR, 95%CI: 1.491, (1.267, 1.753)). Among participants AD participants with depression, AAs and Hispanics have higher GDS-15 scores compared to White participants, suggesting more severe depression (Difference between means: 0.55, 95%CI (0.15, 0.95), 0.86, 95%CI (0.40, 1.33), respectively). Additionally, among AD participants, antidepressant use is significantly lower among AAs, Hispanics and Asians compared to white participants (OR, 95%CI: 0.41, (0.33, 0.50); 0.56, (0.44, 0.72), 0.46, (0.37, 0.85)).

CONCLUSIONS:

We found significant racial disparities in depression occurrence and severity, as well as antidepressant use among US AD participants. Hispanic participants have higher occurrence of depression compared to white participants and more severe depression. Black and Asian participants have lower depression occurrence but black participants have more severe depression. AAs, Hispanics and Asians all have lower antidepressant use compared to white participants.