Alzheimer’s diagnoses often come later, limiting access to early care and support. Dr. Sharon A. Brangman, a geriatrician and educator and board member of the McKnight Brain Research Foundation, states that cognitive decline rarely has a single cause. But she points to high blood pressure as an underestimated contributor, especially in Black adults. “Some people may not realize that there is a strong connection between long-standing high blood pressure, hypertension, and loss of cognitive or brain function,” she says.
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When Hypertension Goes Untreated
She explains how stress, discrimination, limited access to preventive care, and diets high in sodium contribute to early-onset hypertension. Left untreated, it increases the risk of stroke and contributes to brain damage. “Regular checks of blood pressure are critical, and anyone with high blood pressure should get treatment to help protect their brain.”
Defining Lack of Access to Care
When people talk about limited access to care, it can sound vague, but Dr. Brangman breaks it down in concrete terms. “Limited access to care can occur in a variety of ways, whether that’s a lack of health insurance, long wait times for an appointment, issues with transportation, or the inability to take time off from work to go to the doctor.” For someone navigating mental health concerns, these barriers aren’t minor. They can be the reason help isn’t reached in time.
The Struggle For Us is Real
The disparities Dr. Brangman describes reflect broader national trends. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 37.9% of Black adults with any mental illness received mental health treatment in 2022, compared to 56.1% of white adults.
In cognitive health, delays in diagnosis remain common. The Alzheimer’s Association reports that Black Americans are nearly twice as likely to develop Alzheimer’s or other dementias. However, a study from the National Institute on Aging noted that Black participants were 35% less likely to be diagnosed compared to their white counterparts, often entering care later when fewer options remain.
For many Black families, navigating dementia care means facing a system shaped by inequity. Whether it’s delayed diagnoses, limited access to specialists, or feeling dismissed in clinical settings, the barriers can be challenging to overcome.
What Change Looks Like on the Ground
Changing habits takes time and support, but Dr. Brangman has seen progress happen. “It can sometimes be a challenge to adjust long-term habits we may have, such as eating fast food or getting very little sleep,” she notes. “However, with the right information and support, many adults can make the changes that are needed to improve their brain health.”
She recommends starting with just one or two goals, such as switching from sweetened beverages to water or seltzer, and establishing a bedtime routine that helps people wind down gradually without the use of screens. These efforts are manageable and have made a difference in the patients and communities she’s worked with.
Meeting People Where They Are
Dr. Brangman pushes back on the notion that communities aren’t interested in brain health. She has found that engagement is high when the message fits the audience. Community is a vital force in shaping mental and brain health. “In general, people in the Black community are very interested in learning about health issues,” she says. “It is important to develop a trusting relationship and adjust the discussion to meet the needs of the person.”
Whether through one-on-one conversations or community workshops, she sees the most impact when the information reflects real challenges and respects lived experiences.
Building Representation into Brain Health Research
Progress in research hasn’t kept pace with the needs of diverse populations. Dr. Brangman sees this clearly in geriatric and brain health studies. “There is still much work to do to improve the participation of women, older adults, and non-white individuals in brain health and aging research,” she says.
Her team at Upstate Medical University created a Community Research Liaison role to address that gap—someone who steps into neighborhoods, builds trust, and invites people into research opportunities designed with them in mind. Because at the end of the day, good healthcare is shaped by compassion, not bias.
Brain Health Habits That Fit Different Lives
For those in under-resourced areas, practical steps matter most. Dr. Brangman encourages regular walking, starting with 15 minutes and gradually increasing to 30 minutes. “If you live in a neighborhood without sidewalks or a safe place to walk, you can try walking at a mall or maybe on the track at a local high school,” she says.
She also suggests pairing physical activity with social interaction, like walking with a friend. Other recommendations include quitting smoking with support, reducing alcohol consumption, and finding ways to learn something new, such as a hobby, music, or reading.
Making Prevention a Priority
The interest in brain health is growing, and Dr. Brangman finds it encouraging. “One of the most surprising things I’ve learned recently is how eager people are to learn about ways to improve their health,” she says.
She stresses that people shouldn’t wait until signs of decline appear. Discussing healthcare options with providers early can lay the groundwork for better outcomes in the future. For those ready to begin, she recommends the Brain Works campaign, a free resource hub created by the McKnight Brain Research Foundation, which offers clear steps and trusted information about cognitive aging.
Closing the Loop
Your mental health, physical wellness, and cognitive function aren’t separate tracks; they are interconnected. Protecting brain health means paying attention to all aspects of health, not just during times of crisis, but in day-to-day life. Let this be a quiet reminder to pause, reflect, and take care with intention.
Resources
Mental Health by the Numbers | National Alliance on Mental Illness (NAMI)
Still Ringing the Alarm: AN ENDURING CALL TO ACTION FOR BLACK YOUTH SUICIDE PREVENTION
Highlights by Race/Ethnicity for the 2022 National Survey on Drug Use and Health
