Alzheimer's Disease and Related Dementia among Black Adults Stratified by Nativity

Abstract Purpose: To explore ADRD prevalence by nativity, comparing US-born and non-US-born Black individuals to uncover risk factor differences and inform targeted interventions. Methods: We conducted a retrospective cohort study with 77,069 Black individuals from the All of Us Research Program. We analyzed two cohorts, US-born and non-US-born individuals with ADRD, using 1:1 propensity score matching to balance key factors. Analyses were performed in R and Python with significance set at α = 0. 05. Results: Of 72,311 US-born and 4,758 non-US-born Black individuals, 1:1 propensity score matching resulted in 4,758 matched participants per group. ADRD prevalence was 3.76% in US-born and 4.12% in non-US-born Blacks, with rates increasing with age and being higher among retirees and the unemployed. Conclusion: Non-US-born Black individuals have a higher ADRD risk than US-born Blacks due to socioeconomic and demographic factors, supporting the need for targeted interventions and further research to address health inequities.