As new Alzheimer’s treatments move from the laboratory to the clinic, health advocates and researchers are warning that a lack of diversity in clinical trials could limit how well those therapies serve the communities most affected by the disease.

Alzheimer’s disease currently affects more than seven million Americans, according to the Alzheimer’s Association. Yet despite facing a disproportionately high burden of the disease, Black and Hispanic communities continue to be underrepresented in many of the clinical trials that shape the future of Alzheimer’s care. Recent research suggests that this gap has persisted for decades, raising concerns about whether new treatments are being adequately studied in the populations that need them most.

A systematic review published in 2025 in JAMA Network Open examined U.S.-based Phase 3 Alzheimer’s drug trials conducted between 1997 and 2023. Researchers found that nearly half of published trials did not report participants’ race or ethnicity. Among those that did, White participants made up the overwhelming majority of enrollment, while Black, Hispanic, Native American, and Asian participants were represented at much lower rates. The authors concluded that these gaps limit the ability to evaluate treatment safety and effectiveness across diverse populations.

The issue is especially concerning because Alzheimer’s does not affect all populations equally. Studies have consistently shown that older Black Americans are about twice as likely to develop Alzheimer’s disease or other dementias as White Americans. Hispanic Americans face approximately one-and-a-half times the risk. Despite this elevated burden, participation in Alzheimer’s clinical research remains disproportionately low.

Researchers and advocacy organizations say that representation in clinical trials is not simply a matter of fairness. Clinical trials help determine whether treatments work, identify potential side effects, and guide decisions about who may benefit most from a therapy. When trial participants do not reflect the diversity of the broader population, important differences in disease progression, treatment response, and risk factors may go unnoticed.

“Black/African Americans are twice as likely to be diagnosed” with Alzheimer’s disease while Hispanic and Latino individuals are approximately 1.5 times more likely to develop the condition, according to the Alzheimer’s Association’s ALZBrainTrust initiative. The organization notes that these groups remain significantly underrepresented in Alzheimer’s clinical studies, highlighting the need for more inclusive research practices.

One challenge is that barriers to participation extend far beyond recruitment. Historical abuses in medical research have contributed to mistrust among some communities of color. Limited access to specialty care, transportation challenges, caregiving responsibilities, language barriers, and a lack of awareness about available studies can also reduce participation. Researchers increasingly recognize that improving diversity requires long-term community engagement rather than simply asking more people to enroll in trials.

Advocates say there has been progress in recent years. Federal agencies, academic medical centers, and nonprofit organizations have launched initiatives designed to improve outreach and build trust with historically underserved communities. Programs such as the Alzheimer’s Association’s ALZBrainTrust work with researchers, healthcare providers, and community organizations to expand access to dementia research and increase Black and Hispanic participation in clinical studies.

For individuals considering participation, experts emphasize that clinical trials are governed by strict ethical and safety standards. Participants must provide informed consent, studies are reviewed by independent oversight boards, and volunteers may withdraw at any time. While participation involves risks and commitments that vary by study, many researchers view clinical trial volunteers as essential partners in advancing scientific discovery.

The stakes are growing as scientists race to develop more effective treatments capable of slowing, preventing, or even delaying Alzheimer’s disease. Every approved therapy begins with research participants willing to contribute to that process. Health equity advocates argue that if communities of color are absent from those studies, future treatments may not fully reflect the needs of the populations most affected by the disease.

As Alzheimer’s cases continue to rise nationwide, organizations including the National Minority Quality Forum are calling for explicit representation in research and greater community engagement in clinical trials. Advocates say the goal is straightforward: ensuring that tomorrow’s Alzheimer’s treatments are developed with all communities in mind, not just a select few. For individuals interested in learning more about Alzheimer’s research participation, early detection, and community resources, information is available through TalkAboutALZ.org.