Alzheimer's disease (AD) is significantly more prevalent among African Americans than within the general population, but rates of early detection are lower in the African American community. Researchers have demonstrated that both pessimistic Alzheimer's-directed health beliefs, and negative perceptions of the effectiveness and the accessibility of medical care act as barriers to care seeking by African American family members of individuals with the disease. Recent research into causal judgments made by potential caregivers about individuals with undiagnosed AD suggests that gender bias and errors in attribution may constitute covert barriers to both lay and professional interpretations regarding the need for cognitive assessment. This study used grounded theory to investigate whether African American family caregivers hold integrated, gender-distinct beliefs about causal attributions of their family member's cognitive decline which may contribute to a delay in care-seeking behaviors. The health belief model was used in conjunction with the attribution theory as the conceptual framework for understanding the data. Purposive sampling of geriatric and memory clinics, and a church was used to recruit eight family caregivers who participated in in-depth interviews. The results indicated that there is a significant lack of caregivers' knowledge and understanding of AD regardless of gender, and that this lack is linked to delays in diagnosis. These results may be used to support the development of a new theory of family caregivers' knowledge and understanding of AD. The social change implications include decreasing delayed diagnosis through increased educational awareness, community outreach programs, and universal mandatory cognitive testing of AD for at-risk individuals.