Atherosclerosis Risk Factors in American Indians With Alzheimer Disease

Abstract

Factors predisposing to and associated with atherosclerosis may impact the onset and progression of Alzheimer disease (AD). The high prevalence of atherosclerosis and associated risk factors in American Indians makes them ideal subjects to test this association. We compared frequency of history of hypertension, myocardial infarction, stroke, diabetes, and high cholesterol in 34 American Indians with AD with 34 age-matched American Indian controls, and 34 age-matched whites with probable AD. We also measured waist size, height, and weight, and acquired blood for determination of plasma homocysteine and apolipoprotein E genotype. The 3 groups did not differ significantly in age or sex. History of hypertension and diabetes was significantly more common among American Indian AD patients than Indian controls or whites with AD. The 3 groups did not differ in history of stroke or myocardial infarction. Body mass index was significantly greater in both Indian groups than the white AD group. Plasma homocysteine levels were greater, but not significantly so, in the Indian AD than the Indian control group. Thus, there is preliminary evidence of a modest association between history of hypertension and diabetes and AD in a small sample of American Indians. This suggests that changes in lifestyle factors could influence the expression of AD in American Indians.

Heart disease as a risk factor for dementia

“…Ettorre and colleagues reported that in a group of MCI patients, 60% of them eventually developed dementia, and all subgroups with cardiovascular risk factors had a higher conversion rate to AD 102. In addition, many cardiovascular risk factors occur in conjunction with each other, compounding the risk of subtle gray matter changes and subclinical cerebrovascular abnormalities in the brain, as well as dementia 103–106. When combined with the presence of the APOE ɛ4 allele and stroke, vascular risk factors lead to both vascular and AD pathology 107,108…”

Role of cardiovascular risk factors (CRF) in the patients with mild cognitive impairment (MCI)

“…Research has been especially focusing on the study of preclinical forms of dementia, including MCI, which is an intermediate clinical condition between normal aging and dementia. MCI is defined by an impairment of memory and other cognitive functions, not so serious as dementia (Weiner et al, 2008). More and more evidence suggests that the control of CRF may change the progression of the disease, in preclinical stages of cognitive impairment (Goldstein et al, 2008).…”

Brain MRI, Apoliprotein E Genotype, and Plasma Homocysteine in American Indian Alzheimer Disease Patients and Indian Controls

“…In a small study of American Indians, we found an association between diabetes and hypertension and the clinical diagnosis of probable AD [17]. The present report compares findings in American Indians with a diagnosis of probable AD with age-matched, cognitively intact American Indians and assesses the relationship of plasma homocysteine to WMH volume (WMHV), whole brain volume (WBV), and WMHV/WBV and the frequency of the apolipoprotein E4 allele in both groups.…”