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[S3‐01‐04]: Cultural effect of Alzheimer's disease in the native American population
Author(s) -
Henderson J. Neil,
Henderson L. Carson
Publication year - 2005
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2005.06.370
Subject(s) - dementia , indigenous , population , disease , gerontology , medicine , allele , psychiatry , psychology , genetics , biology , gene , environmental health , ecology
Background: Multifactorial etiologic pathways leading to dementing diseases provoke the need to expand research horizons beyond conventional studies in majority population subjects. The bulk of dementia research in the U.S. has been done with majority population subjects. Corrective action requires that research in understudied populations must be accelerated. This is particularly true with indigenous people of the U.S. because of unique genetic loading relative to dementia, high prevalence of cardiovascular disease associated with dementia, and pluralistic health belief systems. Objective(s): Ascertainment of APO-E and tau allele frequency as a function of genetic loading of indigenous genes to non-indigenous genes (i.e., blood quantum), description of explanatory models of dementia, and development of a multifactorial model of dementia from these data derived from a large Federally recognized tribe. Methods: Subject recruitment was purposive (certified tribal membership, over age 21, tribal health care staff assisted in subject identification) and gained 172 subjects. Genotyping was done from blood samples. Cognitive status was screened using the “Screening for Memory Disorder Protocol” (MMSE, geriatric depression scale and the Short Portable Mental Status Questionnaire). Explanatory models were collected by personal interview done by an anthropologist who is also a member of this tribe. Conclusions: Compared to whites, APO-E4 and tau alleles are about one-half as frequent (6%), subjects with less than .5 genetic loading of indigenous genes have the same association of between the APO-E4 genotype and disease (P 0.05), APO-E4 appears to be less potent in contributing to AD in either homozygous or heterozygous conditions, and these factors vary inversely by degree of indigenous ancestry. Explanatory model investigation produced local indigenous cultural beliefs characterizing a range of attributional models, including a unique nonpathological schema. Additionally, a multifactorial, biocultural hypothesis for the etiology of dementia shows a chain of genetic, morbidity and behavioral factors each of which is postulated to contribute additively to dementia. The behavioral factors associated with management of diseases that increase risk for dementia constitute potential target areas for reducing the risk of late life dementia.