Rutgers Researchers Leading the First Study to Track Risk Factors for Alzheimer’s Disease and Related Dementias in South Asian Americans

Researchers at the Krieger Klein Alzheimer’s Research Center within the Rutgers Brain Health Institute reviewed twenty-five years of data on prevalence and risk factors for dementia in India. The study, published in Alzheimer’s & Dementia, identified the need for longitudinal studies such as SAMARTH– the first U.S. study tracking the brain health of South Asian Americans to discover modifiable risks and protective factors for Alzheimer’s Disease and related Dementias.

India has one of the fastest aging populations in the world: by 2050, the number of Indians aged 60 and older is expected to reach 340 million, roughly 1 in 6 adults worldwide. This demographic shift brings a rising dementia burden with major socio-economic consequences. A growing body of evidence indicates that risk factors for dementia in South Asians differ from those in non-Hispanic White/European ancestry populations.

What are some of the key modifiable risk factors for dementia in India?

• Diabetes and Metabolic Disorders: While the 2024 Lancet Commission report lists type 2 diabetes and other metabolic disorders such as high blood pressure, high cholesterol, and obesity as known risk factors for dementia and Alzheimer’s, there is very limited information if these risk factors are relevant to South Asians. Unlike other ethnicities, South Asians tend to develop diabetes and other metabolic disorders earlier in life, often at a normal body weight. Importantly, diabetes is known to double or even triple the risk of dementia. India had an estimated 74 million adults with diabetes in 2021, which is projected to reach 125 million by 2045. Despite India’s status as a global epicenter of diabetes, few studies have examined the association between diabetes and dementia risk in the Indian context.
• Education: Limited education accounts for 22% of modifiable dementia risk in India versus 8% worldwide. In one study, dementia was more than 3 times as common among adults with no schooling (12.6%) compared to those with a primary education (3.4%).
• Vision: 3 in 4 Indian adults over 50 have some form of vision impairment compared to about 1 in 10 in the US. Untreated vision loss accounts for an estimated 14% of dementia cases in India.
• Hearing: Hearing loss affects 41% of adults in India and across studies it is linked to a 59% higher risk for dementia and roughly double the risk for Alzheimer’s disease.
• Physical Activity: Despite the observation that as little as 35 minutes of physical activity per week is linked to a 41% lower dementia risk, more than half of Indian adults (57%) fall short of recommended activity levels.
• Body Weight: Unlike Western countries, where excess weight drives much of the risk, in India, being underweight and undernourished also appears to increase risk of developing dementia.

Other findings from the review

The review, by Dr. Oberoi and colleagues, found that, as in Western countries, dementia is more common among women in India. Prevalence in India was found to be higher among people in rural areas, most likely due to under-diagnosis of the risk factors contributing to dementia.

Interestingly, the review reported that genetic variants associated with dementia in populations from European ancestry appear to play a relatively limited role in increasing the risk for the disease in South Asians. This could mean that yet unknown genetic risk factors may contribute to dementia risk among South Asians or, alternatively, modifiable health and environmental risk factors may play a bigger role in the South Asian population.

The authors concluded that to determine if the 14 modifiable risk factors named by the 2024 Lancet Commission are relevant to South Asians, and to understand which factors genuinely influence dementia risk over time, longitudinal research studies which follow the brain health of South Asian individuals over time is necessary. The SAMARTH study led by Dr. Michal Schnaider Beeri, Director of the Krieger Klein Alzheimer’s Research Center aims to do just that.

The South Asian Middle Age Risk Tracking for brain Health study (SAMARTH)

SAMARTH is the first research study in the US to follow brain health in South Asian Americans over time. The research study is enrolling 750 adults between the age of 45 and 70 across New Jersey and surrounding region, home to the largest South Asian community in the country. So far, approximately 170 participants have been recruited.

Why focus on ages 45-70?

The pathological changes in the brain that lead to dementia begin decades before memory problems appear. By following people through their 40s, 50s, and 60s, researchers can identify risks early while there is still time to act and watch how each person’s brain health changes with age.

Who can participate in the SAMARTH study?

If you are a South Asian adult living in New Jersey or a nearby area, we encourage you to take part. To join the study, you will need to be:

• Between 45 and 70 years old
• Of South Asian origin (India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan, Bhutan, or the Maldives)
• Fluent in English

Study participants complete a series of assessments every 18 months for factors that have been linked to Alzheimer’s disease. During the study visits, participants take life-style surveys, and undergo cognitive and language assessments, motor function tasks, blood tests, physical and neurological exams, and brain imaging. All participants are compensated up to $175 for their time.

Why the SAMARTH study is so important?

South Asians are currently underrepresented in Alzheimer’s research, meaning there is a lack of tailored information and treatment options for them. This research study could lead to personalized treatments, early diagnostic tools and prevention strategies specifically designed for South Asians.

Learn more about the SAMARTH study here and enroll by filling out the screening form. You can also call 848-932-8415 or email adrd@bhi.rutgers.edu for more information.

References

• Oberoi A, Cai K, West R, et al. The landscape of dementia in India: Prevalence, risk factors, and opportunities ahead. Alzheimer’s & Dementia. 2026. https://doi.org/10.1002/alz.71526
• SAMARTH Study, Rutgers Krieger Klein Alzheimer’s Research Center. https://adrd.rutgers.edu/about-us/our-research/samarth/
• Krieger Klein Alzheimer’s Research Center. https://adrd.rutgers.edu/
• Rutgers Brain Health Institute. https://brainhealthinstitute.rutgers.edu/