A decade ago, Rushern Baker III started seeing signs that something was wrong with his wife when she was still in her late 40s. Christa Beverly was forgetting things and losing things. Then, she was hopelessly lost only blocks from her parents’ home. It took some doing, but he convinced her to see a doctor. She was tested, and at age 49 was diagnosed with early-onset Alzheimer’s, reports USA Today.

At the time, Baker was preparing to run for county executive in Prince Georges County, Md., which borders Washington, D.C., an election he won in 2010. Within a few years of the diagnosis, Christa had lost most of her functions. Today, at age 58, she is unable to talk, walk or eat on her own, but she remains at home. Baker, 60, was re-elected county executive in 2014, and mounted an unsuccessful primary campaign for Maryland governor in 2018, but remained his wife’s primary caregiver through it all.

An estimated 5.7 million people live with Alzheimer’s in the United States, including 1 in 10 older than 65, according to the Alzheimer’s Association. What may surprise many is that African Americans such as Christa are far more likely to be afflicted with Alzheimer’s or dementia than Whites. Researchers say that may be partly related to some of the health issues that are more prevalent in the African American community.

“Everyone should be concerned, but African Americans are twice as likely to have Alzheimer’s, less likely to receive a diagnosis and more likely to be diagnosed in later stages,” says Joanne Pike, vice president of programs for the Alzheimer’s Association in Chicago. Daniel Bateman, assistant professor of psychiatry at the Indiana University School of Medicine and a scientist at the university’s Center for Aging Research, says a number of studies show a higher rate of Alzheimer’s in African Americans.

“There has been some hypothesis as to why,” he says. “There are higher rates of hypertension, high cholesterol, heart disease and diabetes in African Americans compared to Whites. All of those are risk factors for Alzheimer’s and dementia.” He says a 2018 study that also looked at a number of factors of people have had a stroke found that African Americans had an increased rate for all five types of dementia. Robert Newton Jr., associate professor at Louisiana State University, says researchers are looking at many avenues to understand the link.

“Part of it is genetics. Are there some genetic markers that African Americans have higher risks that predispose them to higher risk of dementia? Is it lifestyle? Are there social factors? Is it education or stress? Researchers are looking at many avenues.” Pike says other probable causes may be lower education and income. One of the problems with determining the reason for the higher rate of Alzheimer’s cases is that African Americans are not well represented in clinical trials, research studies and screenings that produce earlier diagnoses. “We need more information,” Pike says.