Jordan Meadows
Staff Writer
Wake County Public Libraries hosted a community education program Tuesday evening titled "Protecting Brain Health in African American Adults," featuring Dr. Ashley Sanderlin of North Carolina A&T State University, who presented research on dementia risk and prevention strategies tailored to Black communities.
Sanderlin, a neuroscientist and associate professor in NC A&T's biology department, is associate director of the university's Center for Outreach in Alzheimer's, Aging and Community Health (COAACH) and serves as the site principal investigator for the North Carolina Registry for Brain Health.
She noted NC A&T operates a dedicated aging center focused on older adults' health.
Sanderlin, who leads the Alzheimer's Lifestyle Interventions and Aging Neuroscience Lab, told attendees her research centers on how lifestyle factors influence the development and progression of Alzheimer's disease and how prevention strategies might reduce risk.
"I'm most interested in the development and the progression of Alzheimer's disease and why it happens, and how we can prevent it," she said.
Sanderlin opened with an overview of the disease's biology, explaining that dementia is a broad umbrella term for cognitive impairment and that Alzheimer's is its most common form, though not the only one; vascular dementia, Lewy body dementia and frontotemporal dementia are among the others.
She stressed that dementia is not a normal or inevitable part of aging.
"Some people believe that if you just keep living, the older you get, you will develop dementia," she said. "And that is not true."
She said early symptoms—most notably short-term memory loss, disorientation in familiar places and repeating recent statements—warrant seeking medical evaluation rather than being written off as ordinary aging. She cited older age, being female and having fewer years of formal education as primary risk factors for the disease.
Alzheimer's involves two main problems, she said: sticky clumps that build up between brain cells and get in the way of them "talking" to each other, and tangled fibers that build up inside the cells and cause them to break down from within.
"They're like a tombstone of where the neuron used to be," she said of the internal tangles. Over time, this damage kills off brain cells, usually starting in the part of the brain that handles memory before spreading further, in what she called "a progressive neurodegeneration."
She noted there's still no known cause or cure.
"Alzheimer's Disease, it is a terminal disease with no known cause, cure, or effective treatment," she said. Some FDA-approved drugs are available to ease symptoms, but "they are not actually stopping or slowing the progression of the disease."
Newer drugs actually target and clear out some of that sticky buildup in the brain but they come with real drawbacks: they require IV infusions, regular MRI scans to check for safety, they don't work for everyone, they can have side effects, and they cost tens of thousands of dollars.
Sanderlin also pointed out a problem with how those newer drugs were tested: more than 76% of the people in lecanemab's trials were white.
"It is very important that we have representation from all ethnicities," she said. "We have to have a seat at the table in helping to design the drugs and making sure that they're truly effective for everyone."
Sanderlin presented data showing Black and Hispanic Americans are 1.5 to 2 times more likely to develop Alzheimer's disease and other dementias than white Americans, yet are diagnosed later, delaying access to treatment. She cited Alzheimer's Association survey data indicating only 53% of Black Americans trust that future Alzheimer's treatments will be shared equally across racial groups, and that 62% of Black Americans believe medical research is biased against people of color.
Mistrust rooted in historical and ongoing discrimination remains a major barrier to clinical trial participation, noting that nearly half of Black Americans reporting experiencing racial or ethnic discrimination in health care settings, iterating a story of her own mother once telling her plainly that she didn't want to be a research subject.
"It's not that people of color, Black people, Hispanic people don't want to help or find a cure," she said. "It's that we need to make sure we can trust where it's coming from and understand exactly what is happening."
Sanderlin distinguished between health disparities—measurable differences in disease rates and outcomes between groups—and health care disparities, which involve differences in access to treatment and information; she said the two compounds against each other. She traced much of the gap to socioeconomic and generational inequities, including the lasting effects of redlining on the physical environments Black communities live in, which researchers increasingly link to dementia risk through factors such as soil and air quality.
She cited the Alzheimer's Association's 2026 report, which found that differences in socioeconomic conditions and higher rates of chronic illnesses like cardiovascular disease and diabetes among African Americans directly elevate dementia risk.
"Prevention is key," Sanderlin said.
