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Objectives: Lack of awareness of Alzheimer's disease (AD) among Black Americans may undermine their ability to identify potential AD risk. We examined Black Americans' perceptions and knowledge of AD, and views of a healthy brain, which may contribute to the development of effective and culturally sensitive strategies to address racial disparities in AD. Methods: We conducted a mixed-methods study, integrating a cross-sectional survey of 258 older (>55 years) Black participants and qualitative interviews with a sub-sample of N = 29. Both data sets were integrated to inform the results. Results: Participants endorsed having little knowledge of AD. While most participants reported practicing a healthy lifestyle to promote a healthy brain, the range of activities listed were limited. Participants made several suggestions to increase AD awareness, which includes using AD educational materials containing information that would benefit the whole family, not only older adults. Outreach approaches that address both individual behaviors and structural factors were also encouraged. Conclusion: Our findings identify ongoing needs to improve AD awareness among traditionally under-represented groups. Innovation: The study utilized novel approaches to examine participants' perspectives of AD that included a diverse sample of research naïve participants, and integrated exploration of participants' views of AD and brain health.

Objectives: Lack of awareness of Alzheimer's disease (AD) among Black Americans may undermine their ability to identify potential AD risk. We examined Black Americans' perceptions and knowledge of AD, and views of a healthy brain, which may contribute to the development of effective and culturally sensitive strategies to address racial disparities in AD., Methods: We conducted a mixed-methods study, integrating a cross-sectional survey of 258 older (>55 years) Black participants and qualitative interviews with a sub-sample of N  = 29. Both data sets were integrated to inform the results., Results: Participants endorsed having little knowledge of AD. While most participants reported practicing a healthy lifestyle to promote a healthy brain, the range of activities listed were limited. Participants made several suggestions to increase AD awareness, which includes using AD educational materials containing information that would benefit the whole family, not only older adults. Outreach approaches that address both individual behaviors and structural factors were also encouraged., Conclusion: Our findings identify ongoing needs to improve AD awareness among traditionally under-represented groups., Innovation: The study utilized novel approaches to examine participants' perspectives of AD that included a diverse sample of research naïve participants, and integrated exploration of participants' views of AD and brain health., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Andrew Saykin reports financial support was provided by National Institute on Aging. Johanne Eliacin reports financial support and administrative support were provided by US DEPARTMENT OF VETERANS AFFAIRS (VETERANS HEALTH ADMINISTRATION). Andrew Saykin reports a relationship with Avid Radiopharmaceuticals Inc. that includes: board membership and consulting or advisory. Sophia Wang reports a relationship with APPI and DSMB that includes: consulting or advisory. Kenzie Cameron reports a relationship with EPI-Q, Inc. that includes: consulting or advisory. Andrew Saykin reports a relationship with Bayer Oncology (Scientific Advisory Board) that includes: board membership. Andrew Saykin reports a relationship with Eisai (Scientific Advisory Board) that includes: board membership. Andrew Saykin reports a relationship with Siemens Medical Solutions USA, Inc. (Dementia Advisory Board) that includes: board membership. Andrew Saykin reports a relationship with Springer-Nature Publishing that includes: board membership. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.