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.
"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). "
[Show abstract][Hide abstract] ABSTRACT: Native Hawaiian and other Pacific Islanders (NHOPI) experience significant health disparities compared with other racial groups
in the United States. Lower life expectancy has resulted in small proportions of elders in the population distribution of
NHOPI, yet the number of NHOPI elders is growing. This article presents data on NHOPI elders and discusses possible reasons
for continuing health disparities, including historical trauma, discrimination, changing lifestyle, and cultural values. We
outline promising interventions with NHOPI and make suggestions for future research.
The Gerontologist 07/2014; DOI:10.1093/geront/gnu072 · 3.21 Impact Factor
". 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. "
[Show abstract][Hide abstract] ABSTRACT: The evidence base on the prevalence of dementia is expanding rapidly, particularly in countries with low and middle incomes. A reappraisal of global prevalence and numbers is due, given the significant implications for social and public policy and planning.
In this study we provide a systematic review of the global literature on the prevalence of dementia (1980-2009) and metaanalysis to estimate the prevalence and numbers of those affected, aged ≥60 years in 21 Global Burden of Disease regions.
Age-standardized prevalence for those aged ≥60 years varied in a narrow band, 5%-7% in most world regions, with a higher prevalence in Latin America (8.5%), and a distinctively lower prevalence in the four sub-Saharan African regions (2%-4%). It was estimated that 35.6 million people lived with dementia worldwide in 2010, with numbers expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. In 2010, 58% of all people with dementia lived in countries with low or middle incomes, with this proportion anticipated to rise to 63% in 2030 and 71% in 2050.
The detailed estimates in this study constitute the best current basis for policymaking, planning, and allocation of health and welfare resources in dementia care. The age-specific prevalence of dementia varies little between world regions, and may converge further. Future projections of numbers of people with dementia may be modified substantially by preventive interventions (lowering incidence), improvements in treatment and care (prolonging survival), and disease-modifying interventions (preventing or slowing progression). All countries need to commission nationally representative surveys that are repeated regularly to monitor trends.
Alzheimer's & dementia: the journal of the Alzheimer's Association 01/2013; 9(1):63-75.e2. DOI:10.1016/j.jalz.2012.11.007 · 12.41 Impact Factor
"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. "
[Show abstract][Hide abstract] ABSTRACT: One of the first steps toward the correct diagnosis of dementia is to segregate out the nondegenerative dementias from possible degenerative dementias. Nondegenerative dementias could be due to traumatic, endocrine, metabolic, nutritional, toxic, infective, and immunological causes. They could also be caused by tumors, subdural hematomas, and normal pressure hydrocephalus. Many of the nondegenerative dementias occur at an earlier age and often progress quickly compared to Alzheimer's disease and other degenerative dementias. Many are treatable or preventable with simple measures. This review aims to give an overview of some of the more important endocrine, metabolic, nutritional, and toxic disorders that may lead to dementia.
Annals of Indian Academy of Neurology 12/2010; 13(Suppl 2):S63-8. DOI:10.4103/0972-2327.74247 · 0.60 Impact Factor
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