The Alzheimer’s Association Discriminated on Race, Sexuality in Allocating Research Funding

The Alzheimer's Association allocated significant funding to support DEI initiatives, including offering specific financial awards for "underrepresented" individuals — and because the organization receives millions in federal funding, those programs may run afoul of civil rights law.

The Alzheimer's Association, a nonprofit organization founded in 1980 that "leads the way to end Alzheimer’s and all other dementia," describes "inclusivity" as one of its values and states that diversity, equity, and inclusion is "vital" to its mission. In fact, the organization boasted in 2023 that it has more than 150 active research projects totaling over $24 million to "promote diversity in the scientific community," while it has spent upwards of $20 million on more than 200 active research initiatives related to addressing "health disparities." According to the organization's most recent Form 990, the organization's "Chief DE&I Officer" Carl Hill earns a salary around $500,000.

"We are leading the way by developing strategic partnerships with trusted national and local organizations to create a pathway to greater health equity, mission engagement, and inclusion for everyone," reads the Form 990. "The Alzheimer's Association is building an organizational culture of understanding while pursuing diversity, equity, and inclusion through education and policies."

However, the Alzheimer's Association may be violating antidiscrimination laws in its provision of financial awards.

According to a publicly available document from the organization, the Alzheimer's Association has currently active research grants and fellowship programs with maximum awards in the $200,000 to $250,000 range — but each has a separate "diversity" track for applicants with particular demographic traits. In its guidelines, the association says candidates for the distinct "Promote Diversity Program" tracks must submit a "Diversity Self Statement."

"The Alzheimer's Association recognizes the need to increase the number of scientists from underrepresented groups in the research enterprise," says the organization's guidelines. "Researchers from these groups are encouraged to apply."

The organization is currently financially supporting projects through its "Alzheimer's Association Research Grant," "Alzheimer's Association Research Grant — New to The Field," "Alzheimer's Association Research Fellowship," and "Alzheimer's Association Clinician Scientist Fellowship" programs, each of which has a separate track specifically for applicants of "underrepresented" backgrounds. The organization's definition of "underrepresented" individuals includes a range of racial and sexual minorities, impoverished people, disabled people, people from rural areas, and natives of  "economically developing" nations.

The Alzheimer’s Association says those DEI-focused programs are no longer accepting new applicants, but projects funded through these programs remain active.

Lawyers and legal experts who spoke to National Review said the Alzheimer's Association limits eligibility with respect to race in the awarding of conditional funding and thus likely violates 42 U.S.C. Section 1981, a federal law that prohibits racial discrimination in contracting.

"42 U.S.C. 1981 has been understood for decades to make it illegal to contract with anyone because of their race, or refuse to contract with anyone because of their race. The defining feature of a contract is that there are reciprocal obligations, and these grants and fellowships do not appear to be a prize that’s awarded with no reciprocal obligations," said Dan Morenoff, the executive director of the American Civil Rights Project organization and an adjunct fellow at the Manhattan Institute. "It is difficult to imagine these aren't 1981 violations."

The Alzheimer's Association receives federal funding. It was awarded about $10 million from the Department of Health and Human Services to be distributed among projects that "enhance respite services for dementia caregivers." And, in 2019, the organization announced that it received a grant totaling $1.34 million from the National Institutes of Health.

Because it is a private organization that receives federal funding and it appears to be principally engaged in the business of providing education, health care, and social services, the Alzheimer's Association is likely obligated to comply with the Title VI of the Civil Rights Act of 1964 — but its eligibility criteria seemingly violate the law by discriminating against applicants with respect to race and national origin.

"The question would be whether the separate tracks define qualifying and disqualifying people with criteria based on race, color, and national origin, and whether this means that people are being excluded from participating in or denied the benefits of the program on those bases," Morenoff told National Review. "It looks like the answer is yes, since this involves the disparate treatment of otherwise similarly situated individuals because of their race and ancestry."

In emails to National Review, the Alzheimer's Association said the eligibility descriptions were "outdated." The organization claimed that the association's Research Grant to Promote Diversity and the Research Grant to Promote Diversity — New to the Field programs "no longer exist," while the application cycles for the Research Fellowship to Promote Diversity and the Clinician Scientist Fellowship to Promote Diversity are now closed.

However, initiatives funded through those programs remain active. Each program states in its description that eligible projects should have a minimum duration of two years, and recipients of the awards were contacted no later than late February 2025, according to a document from the organization.

The Alzheimer's Association confirmed in an email that it continues "to honor the contracts of grant awardees that were made when these programs were open" but added that it is not accepting new applications and will not be entering into new contracts under these programs.

"Closing applications might limit [the association's] liability, but the violation is seemingly ongoing," Morenoff said.

Aside from the funding opportunities with discriminatory eligibility requirements, the Alzheimer's Association has promoted DEI through its activism and informational materials.

The Alzheimer's Association operates the International Society to Advance Alzheimer's Research and Treatment (ISTAART), which hosts a "Diversity and Disparities Professional Interest Area" dedicated to analyzing risks, diagnoses, and treatments among "individuals of diverse backgrounds on a global scale." The specialized interest area emphasizes "underlying cultural and cognitive differences and brain mechanisms," as well as "culturally responsible strategies" for dementia-related care across individuals of "diverse backgrounds on a global scale," according to the Alzheimer's Association's 2025 "Health Equity Impact Report."

Dr. Kurt Miceli, the medical director at the nonprofit organization Do No Harm, told National Review that cultural respect is not a substitute for evidence-based care and medicine. "Engaging with an individual's worldview may deepen and support a clinician's delivery of high-quality medical care but cannot take its place," he said.

One area where the Alzheimer's Association has endorsed a culturally sensitive approach to medicine is in its "Road Map for American Indian and Alaska Native Peoples" report, which was developed in conjunction with the Centers for Disease Control and Prevention and Healthy Brain Initiative to promote "health equity" by honoring native cultures and recognizing "indigenous determinants of health." The report suggests that treating dementia in American Indian and Alaska Native communities "requires a holistic life course approach that respects and integrates indigenous knowledge." It further states that "indigenous determinants of health" — meaning nonmedical factors that can affect health — include "historical mistreatment," "reclaiming traditional knowledge," and "recognizing and reaffirming that indigenous peoples are rooted in traditional understandings of specific places."

"For [American Indian and Alaska Native] peoples, it is essential to get input from Elders, trusted community members, leaders of tribal government and people with lived experience," says the report on Native communities.

The Alzheimer's Association has promoted increased racial diversity among participants in clinical trials. The organization and DEI Council launched the "Research Conversations" initiative with the aim to increase awareness about dementia and promote clinical trials in "underrepresented communities," specifically "Black/African American and Hispanic/Latino populations." According to a 2023-2024 fiscal report, the Alzheimer's Association provides leadership and support for the "New IDEAS: Imaging Dementia — Evidence for Amyloid Scanning Study" that prioritizes patients who identify as "Black/African American and Hispanic/Latinx," whom the organization describes as "populations that share the greatest burden of dementia."

The organization also supported the NAPA Reauthorization Act that passed in 2024. The bill amended the National Alzheimer's Project Act to require that the national Advisory Council on Alzheimer's Research, Care, and Services includes "at least one researcher with demonstrated experience in recruitment and retention of underrepresented groups into research or clinical trials related to dementia," as well as "[one] representative from a historically underserved population whose lifetime risk for developing Alzheimer's is markedly higher than that of other populations."

It isn't clear why the Alzheimer's Association encourages more diverse clinical trials because its "Inclusive Language Guide," last updated in 2023, states that "race and ethnicity are social, not biological, constructs." The linguistic manual further instructs readers to "avoid language or communication that implies biological significance of race, ethnicity or cultural/population background."

The Alzheimer's Association developed a free online course titled "Health Equity in Dementia — Using a Public Health Lens to Advance Health Equity in Alzheimer's and Other Dementia," which trains individuals to identify health inequities and describe the role of social determinants in health. The course suggests that "structural racism" may alter dementia risk, and it concludes by encouraging participants to promote DEI within their own organization. Participants in the course are told that "challenging racist, ageist, sexist, and classist policies and practices" may help remove "structural barriers" and thus improve public health.

"Historically, public health and other sectors of the health care system have not sufficiently addressed health equity and have, consciously or unconsciously, perpetuated health inequities," says the instructional course. "Policies and programs at the organizational, local, state, and federal levels have created structural barriers for historically marginalized people to achieve their highest level of health. Many people and communities have experienced generations of structural discrimination and exploitation, creating barriers to improving their health."

In a portion discussing individuals who self-identify as LGBTQ+, the course also emphasizes that "intersectionality" is "important."

When discussing health inequities, the course suggests that black individuals may be at higher risk of Alzheimer's because racism worsens cognitive ability: "Exposure to interpersonal and structural racism for Black adults is associated with lower memory scores. Experiences of racial micro-macroaggressions are associated with depression, anxiety and poorer sleep quality, all of which have been associated with cognitive decline," says the lesson.

Dr. Miceli of Do No Harm said that it is "inaccurate" to frame "structural racism" as a relevant risk factor and further diverts attention away evidenced-based medicine.

"Racism has not been established as an independent, clinically actionable risk factor for dementia," Miceli said. "Associations between discrimination and cognitive outcomes risk conflating correlation with causation, especially when other factors — such as smoking, physical inactivity, and well‑known medical risks like hypertension, diabetes, and cardiovascular disease — may be driving the relationship.”