Prevalence of dementia in Chamorros on Guam - Relationship to age, gender, education, and APOE
ABSTRACT To estimate the prevalence of dementia and its clinical subtypes among Chamorros on Guam aged 65 years or older and to examine associations with age, gender, education, and APOE genotype.
Chamorros, the indigenous people of Guam, had a high incidence of ALS and parkinsonism-dementia complex (PDC), in the 1950s. Over the next 50 years, ALS incidence declined markedly, but PDC only slightly. The prevalence of late life dementia in Chamorros and its relationship to ALS/PDC are unknown.
Island-wide population-based survey of Chamorros aged 65 years or older as of January 1, 2003. Two-stage assessment: cognitive and motor screening, followed by neurologic and psychometric evaluation. Data were reviewed at consensus conference to make clinical diagnoses.
Of 2,789 Chamorros aged 65 years or older, 73% were enrolled; 27% declined participation, died before contact or screening, or moved off Guam. The point prevalence of all-cause dementia on February 1, 2004, was 12.2%. Prevalence data for subtypes were as follows: Guam dementia (clinically equivalent to AD), 8.8%; PDC, 1.5%; pure vascular dementia, 1.3%; other, 0.6%. The prevalence of dementia rose exponentially with age. Low education was significantly associated with dementia, but gender was not. There was a trend toward higher PDC prevalence among men. The APOE epsilon4 allele was not associated with dementia.
The prevalence of dementia among elderly Chamorros is relatively high. Guam dementia is the most common diagnosis and exceeds parkinsonism-dementia complex. Age and low education are strongly associated with dementia, but gender and APOE epsilon4 are not. Incidence studies will allow risk factors for dementia to be clarified.
- SourceAvailable from: Kathryn L Braun
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- "A population-based survey of Chamorros aged 65+ on Guam suggested a point prevalence of all-cause dementia on February 1, 2004 of 12.2%, including 8.8% Guam dementia (clinically equivalent to AD), 1.5% PDC, 1.3% pure vascular dementia, and 0.6% other. As in other communities, dementia prevalence rose exponentially with age (Galasko et al., 2007). "
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- ". By this time, the global evidence base had expanded considerably with more studies from low-and middle-income countries (defined according to the World Bank classification), based on gross national income per capita, and other regions and groups previously underrepresented in the literature. These included prevalence studies conducted by the 10/66 Dementia Research Group in Brazil, Cuba, Dominican Republic, Peru, Mexico, Venezuela, India, and China  , and further new prevalence studies from Brazil , Peru , Cuba , Venezuela , China , Korea , India , Thailand , Australia (indigenous people ), Guam , Poland , and Turkey . Enhancements from the previous exercise included: a fully systematic review of the world literature on the prevalence of dementia; a critical appraisal of study quality; and an attempt, where possible, to generate regional estimates from quantitative metaanalyses. "
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- "Furthermore, a late-life dementia without early parkinsonism has been described in the Chamorro elderly. Although clinically akin to AD, the neuropathological and genetic findings bear a closer relation to ALS/PDC. "
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