Margaret Gatz1, Wendy J Mack2, Helena C Chui3, E Meng Law4, Giuseppe Barisano5, M Linda Sutherland6, James D Sutherland6, Daniel Eid Rodriguez7, Raul Quispe Gutierrez8, Juan Copajira Adrian8, Jesus Bani Cuata8, Amy R Borenstein9, Ellen E Walters1, Andrei Irimia10,11, Christopher J Rowan12, L Samuel Wann13, Adel H Allam14, Randall C Thompson15, Michael I Miyamoto16, David E Michalik17, Daniel K Cummings18, Edmond Seabright19, Angela R Garcia20, Paul L Hooper19, Thomas S Kraft21, Caleb E Finch10, Gregory S Thomas22,23, Jonathan Stieglitz24, Benjamin C Trumble20, Michael D Gurven21, Hillard Kaplan18. 1. Center for Economic and Social Research, University of Southern California, Los Angeles, California, USA. 2. Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 3. Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. 4. Department of Neuroscience, Monash University, Melbourne, Victoria, Australia. 5. Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA. 6. MemorialCare Health Systems, Fountain Valley, California, USA. 7. Institute of Biomedical Research, Faculty of Medicine, San Simon University, Cochabamba, Bolivia. 8. Tsimane Health and Life History Project, San Borja, Beni, Bolivia. 9. Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego School of Medicine, La Jolla, California, USA. 10. Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA. 11. Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA. 12. Renown Institute for Heart and Vascular Health, Reno, Nevada, USA. 13. Division of Cardiology, University of New Mexico, Albuquerque, New Mexico, USA. 14. Department of Cardiology, School of Medicine, Al-Azhar University, Cairo, Egypt. 15. Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA. 16. Providence Health, Mission Viejo, California, USA. 17. Memorial Care Miller Women's and Children's Hospital, Long Beach, California, USA. 18. Economic Science Institute, Argyos School of Business and Economics, Chapman University, Orange, California, USA. 19. Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA. 20. School of Human Evolution and Social Change, and Center for Evolution and Medicine, Arizona State University, Tempe, Arizona, USA. 21. Department of Anthropology, University of California Santa Barbara, Santa Barbara, California, USA. 22. MemorialCare Heart & Vascular Institute, Fountain Valley, California, USA. 23. Division of Cardiology, University of California, Irvine, Orange, California, USA. 24. Institute for Advanced Study in Toulouse, Toulouse, France.
Abstract
INTRODUCTION: We evaluated the prevalence of dementia and mild cognitive impairment (MCI) in indigenous Tsimane and Moseten, who lead a subsistence lifestyle. METHODS: Participants from population-based samples ≥ 60 years of age (n = 623) were assessed using adapted versions of the Modified Mini-Mental State Examination, informant interview, longitudinal cognitive testing and brain computed tomography (CT) scans. RESULTS: Tsimane exhibited five cases of dementia (among n = 435; crude prevalence = 1.2%, 95% confidence interval [CI]: 0.4, 2.7); Moseten exhibited one case (among n = 169; crude prevalence = 0.6%, 95% CI: 0.0, 3.2), all age ≥ 80 years. Age-standardized MCI prevalence was 7.7% (95% CI: 5.2, 10.3) in Tsimane and 9.8% (95% CI: 4.9, 14.6) in Moseten. Cognitive impairment was associated with visuospatial impairments, parkinsonian symptoms, and vascular calcification in the basal ganglia. DISCUSSION: The prevalence of dementia in this cohort is among the lowest in the world. Widespread intracranial medial arterial calcifications suggest a previously unrecognized, non-Alzheimer's disease (AD) dementia phenotype.
INTRODUCTION: We evaluated the prevalence of dementia and mild cognitive impairment (MCI) in indigenous Tsimane and Moseten, who lead a subsistence lifestyle. METHODS: Participants from population-based samples ≥ 60 years of age (n = 623) were assessed using adapted versions of the Modified Mini-Mental State Examination, informant interview, longitudinal cognitive testing and brain computed tomography (CT) scans. RESULTS: Tsimane exhibited five cases of dementia (among n = 435; crude prevalence = 1.2%, 95% confidence interval [CI]: 0.4, 2.7); Moseten exhibited one case (among n = 169; crude prevalence = 0.6%, 95% CI: 0.0, 3.2), all age ≥ 80 years. Age-standardized MCI prevalence was 7.7% (95% CI: 5.2, 10.3) in Tsimane and 9.8% (95% CI: 4.9, 14.6) in Moseten. Cognitive impairment was associated with visuospatial impairments, parkinsonian symptoms, and vascular calcification in the basal ganglia. DISCUSSION: The prevalence of dementia in this cohort is among the lowest in the world. Widespread intracranial medial arterial calcifications suggest a previously unrecognized, non-Alzheimer's disease (AD) dementia phenotype.
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