Staff Writer
Community Awareness Feature: Alzheimer’s and Estate Planning
For many Black and Brown families in Cleveland and across Northeast Ohio, multigenerational gatherings, especially during the holidays, can bring moments of joy and concern. Health professionals say it is often during these visits that families notice subtle changes in memory, behavior, or daily functioning among older relatives.
Those observations matter, researchers say. African Americans and Hispanics face higher rates of both diabetes and Alzheimer’s disease, conditions that public health experts have identified as disproportionately affecting communities of color. According to National Library of Medicine (NLM) 2024 national health data, the combined risks of both diseases highlight the importance of early planning, not only for medical care, but also for protecting family assets and documenting personal wishes.
A disproportionate health burden
African Americans are disproportionately affected by diabetes, with rates more than twice those of the overall U.S. population, according to the U.S. Department of Health and Human Services Office of Minority Health.
Alzheimer’s disease and related dementias also affect African Americans at higher rates. African Americans are about twice as likely as white Americans to develop Alzheimer’s disease, while Hispanics face about 1.5 times the risk, according to the Alzheimer’s Association.
Researchers have found associations between diabetes and an increased risk of cognitive decline, though medical experts caution that the relationship is complex and not fully understood. What is well established, according to the National Institute on Aging, is that delayed diagnosis of Alzheimer’s disease can limit treatment options and complicate long-term care planning.
Why early planning matters
Alzheimer’s disease is the most common form of dementia, a progressive brain disorder that affects memory, reasoning, and the ability to perform daily activities, according to the National Institute on Aging.
As symptoms advance, individuals may lose the legal capacity to make medical or financial decisions. When planning has not been completed in advance, families may face sudden challenges, including arranging care, navigating guardianship proceedings, and managing finances under urgent conditions.
The National Institute on Aging notes that recognizing symptoms early allows families more time to plan, seek support services, and maintain quality of life for both patients and caregivers.
Gaps in estate planning
Estate planning is a key factor in protecting families affected by neurodegenerative disease, yet national data show significant disparities.
A 2024 report by Trust & Will, a digital estate planning company, found that, despite having a higher rate of neurodegenerative diseases, Black and Hispanic adults are the least likely demographic groups to have estate planning documents. About 64% of Black respondents and 62% of Hispanic respondents reported having no formal estate plan, compared with lower rates among white respondents.
Legal experts note that estate planning is not limited to households with significant wealth. Documents such as powers of attorney, health care proxies, and written instructions for personal property can help families avoid confusion and conflict when medical decisions arise.
Local impact in Cleveland
In Cleveland, the lack of estate planning can have lasting consequences. Housing advocates and legal aid organizations warn that unclear inheritance arrangements can lead to “heirs’ property” disputes, a condition in which property is passed informally across generations without clear title.
Such disputes can result in forced property sales, family displacement, and neighborhood instability, according to housing policy researchers. They also increase demands on local probate courts and social service systems.
In response, community clinics, churches, and nonprofit organizations across Northeast Ohio have expanded outreach efforts focused on Alzheimer’s awareness and basic estate planning education, often tailored to communities of color.
Looking ahead
Public health experts say awareness is a critical first step toward prevention and preparedness. Recognizing warning signs, such as memory loss, confusion, or changes in judgment, can prompt earlier medical evaluation, according to the Alzheimer’s Association.
Legal advocates emphasize that conversations about medical preferences and financial responsibilities are most effective when they occur before a crisis.
For Cleveland’s Black and Brown communities, early planning can help preserve stability, protect generational wealth, and ensure that elders’ wishes are respected, experts say.
