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.