Comparison of Alzheimer's Disease in Native Americans and Whites

Abstract

Objective: This study compared medical history and findings on initial clinical examination in Native Americans diagnosed with possible or probable Alzheimer's disease (AD) at Native American satellite clinics of the University of Texas (UT) Southwestern Medical Center's Alzheimer's Disease Center with those of Whites diagnosed with probable AD at the UT Southwestern Medical Center's Alzheimer's Disease Clinic. Methods: The information reviewed was contained in the database of the UT Southwestern Alzheimer's Disease Center. Results: In relation to Whites, Native Americans had slightly but significantly greater age at onset of symptoms (71.7 vs. 69.6 years, t = -2.08, p = .04) and equivalent cognitive scores at evaluation (Mini-Mental State Exam score = 17.4 vs. 18.5, t = 0.98, p = .33), despite significantly lower educational level (1 1.4 vs. 13.4 years, t = 5.63, p < .OOl). Native Americans were more frequently depressed on examination (22.8% vs. 9.5%, x2 = 12, p = .OOl) andreported diabetes, hypertension, and heart disease significantly more often than did Whites @ < .01 for all), but their survival time after AD diagnosis was similar to that of Whites despite these comorbidities. Conclusions: With the exception of a greater prevalence of depression and cardiovascular risk factors in Native Americans than in Whites, Native Americans had a course of illness similar to that of Whites.

Atherosclerosis Risk Factors in American Indians With Alzheimer Disease

“…26 History of high cholesterol or use of cholesterol-lowering agents was used instead of determining actual cholesterol values because of differences in the use of hypolipidemic agents among both Indians and whites in the populations studied. 17 Differences in education between groups are similar to our previous findings, 23 and partially explain differences in MMSE scores between white and Indian AD subjects. BMI findings suggesting loss of body fat in Indian AD subjects is consistent with the literature showing a tendency to weight loss with onset and progression of AD.…”

“…17 Among subjects with >50% American Indian heritage, history of diabetes was 50% versus 10% among those with <50% heritage; history of hypertension was 76% versus 46%. The prevalence of diabetes, hypertension, and cardiovascular disease has been increasing rapidly among American Indians; 18–20 these in turn seem partly related to lifestyle factors such as diet and exercise in a vulnerable population.…”

Interethnic Differences in Dementia Epidemiology: Global and Asia-Pacific Perspectives

“…The disproportionate risks among the 3 ethnic groups were not entirely explained by differences in number of years of education, illiteracy or history of stroke, hypertension, heart disease or diabetes. Another study has reported that Native Americans may have a later age of onset compared to Whites [29]. …”

Perspective on race and ethnicity in Alzheimer's disease research

“…In comparing 26 age-matched Cherokee Indians with and without AD, a significantly larger portion of the AD than the control group had American Indian heritage ≤ 50%, suggesting a possible protective effect of American Indian heritage against AD; the percentages were unchanged by the Eε4 allele (Rosenberg et al, 1996). Weiner et al (2003) found no difference in time from diagnosis to death between American Indians and Whites, but the modal American Indian in the study had only 25% American Indian heritage.…”

“…The availability of such information can make it easier to quantify the effects of racial heritage on susceptibility to certain diseases. Within our group of American Indian AD subjects, we have shown that persons with American Indian heritage ≥ 50% vs. those with American Indian heritage < 50% had significantly more frequent history of hypertension (76% vs. 46%, χ 2 = 7.138, p = .008) and diabetes (50% vs. 10%, χ 2 = 15.142, p < .001) (Weiner et al, 2003). It is probably no longer possible to study the interaction of race and cultural factors in Choctaws because their religion and diet is largely that of rural Whites, but it would be possible if more remote and less acculturated tribes of known blood quantum could be studied.…”