Alzheimer's disease risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Overview

The most potent risk factors for the development of Alzheimer's disease (AD) are age and genetic mutations. Females are more prone to development of Alzheimer's disease. Inhabitants of Central African Republic, East Africa, Southern Africa, Malaysia, Australia, and Papua New Guinea are more predisposed to the development of Alzheimer's disease. Stroke increases the risk of Alzheimer's dementia.

Risk Factors

The following risk factors may lead to the development of Alzheimer's dementia (AD):[1][2][3]

  • Increasing age
  • Genetic mutations
  • Gender (females > males)
  • Early-life negative events and physical attributes
  • Literacy and education (low literacy and education increases the chances of developing AD)
  • Geographical location (Central African Republic, East Africa, Southern Africa, Malaysia, Australia, and Papua New Guinea, APOE4 is a risk factor for AD among women but not men in Venezuela)
  • Stroke
  • Vascular disease
  • Diet (fruits, vegetables, and fibre decrease risk; Tofu, cycad fruit, salivary phytooestrogens e.g. genistein and daidizein are associated with increased risk)

Comparison of risk factors among developed and developing countries for Alzheimer's dementia

The following table outlines the comparison of different risk factors among various geographic regions:[4][5][6][7][8][9][10][11][12][13][14][15][16][3][17][18]

Risk Factor Developed regions (North America, Europe, Japan) Asia (China, Guam, India, South Korea, Taiwan) Africa (Egypt, Nigeria, Kenya, South Africa) Latin America (Argentina, Brazil, Venezuela)
Increasing age + + + +
Female sex + + Not reported Not reported
Family history + + Not reported +
Head injury + Not reported Not reported +
Genes (APOE4 allele) + + No risk Not reported
Illiteracy or lack of education + + + +
Mild cognitive impairment or cognitive impairment without dementia + + Not reported +
Urban living Not reported Not reported - +
Low socioeconomic status or poverty Not reported + Not reported +
Occupation as housewife - + Not reported +
Depression + + Positive +
Vascular disease + + + Not reported
Low fibre diet Not reported + + -
Smoking + + Not reported Not reported

Legend:

+ : Positive correlation

- : Negative correlation

References

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  2. Dong MJ, Peng B, Lin XT, Zhao J, Zhou YR, Wang RH (2007). "The prevalence of dementia in the People's Republic of China: a systematic analysis of 1980-2004 studies". Age Ageing. 36 (6): 619–24. doi:10.1093/ageing/afm128. PMID 17965036.
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  5. Hendrie HC, Murrell J, Gao S, Unverzagt FW, Ogunniyi A, Hall KS (2006). "International studies in dementia with particular emphasis on populations of African origin". Alzheimer Dis Assoc Disord. 20 (3 Suppl 2): S42–6. PMC 3212027. PMID 16917194.
  6. Brayne C (1991). "The EURODEM collaborative re-analysis of case-control studies of Alzheimer's disease: implications for public health". Int J Epidemiol. 20 Suppl 2: S68–71. PMID 1917271.
  7. Chen CH, Mizuno T, Elston R, Kariuki MM, Hall K, Unverzagt F, Hendrie H, Gatere S, Kioy P, Patel NB, Friedland RP, Kalaria RN (2010). "A comparative study to screen dementia and APOE genotypes in an ageing East African population". Neurobiol. Aging. 31 (5): 732–40. doi:10.1016/j.neurobiolaging.2008.06.014. PMC 2857314. PMID 18703255.
  8. Zhang ZX, Zahner GE, Román GC, Liu J, Hong Z, Qu QM, Liu XH, Zhang XJ, Zhou B, Wu CB, Tang MN, Hong X, Li H (2005). "Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu". Arch. Neurol. 62 (3): 447–53. doi:10.1001/archneur.62.3.447. PMID 15767510.
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  11. Scazufca M, Menezes PR, Vallada HP, Crepaldi AL, Pastor-Valero M, Coutinho LM, Di Rienzo VD, Almeida OP (2008). "High prevalence of dementia among older adults from poor socioeconomic backgrounds in São Paulo, Brazil". Int Psychogeriatr. 20 (2): 394–405. doi:10.1017/S1041610207005625. PMID 17559708.
  12. Hendrie HC, Osuntokun BO, Hall KS, Ogunniyi AO, Hui SL, Unverzagt FW, Gureje O, Rodenberg CA, Baiyewu O, Musick BS (1995). "Prevalence of Alzheimer's disease and dementia in two communities: Nigerian Africans and African Americans". Am J Psychiatry. 152 (10): 1485–92. doi:10.1176/ajp.152.10.1485. PMID 7573588.
  13. Llibre JJ, Guerra MA, Pérez-Cruz H, Bayarre H, Fernández-Ramírez S, González-Rodríguez M, Samper JA (1999). "[Dementia syndrome and risk factors in adults older than 60 years old residing in Habana]". Rev Neurol (in Spanish; Castilian). 29 (10): 908–11. PMID 10637837.
  14. Quiroga P, Calvo C, Albala C, Urquidi J, Santos JL, Pérez H, Klaassen G (1999). "Apolipoprotein E polymorphism in elderly Chilean people with Alzheimer's disease". Neuroepidemiology. 18 (1): 48–52. PMID 9831815.
  15. Ochayi B, Thacher TD (2006). "Risk factors for dementia in central Nigeria". Aging Ment Health. 10 (6): 616–20. doi:10.1080/13607860600736182. PMID 17050090.
  16. Suhanov AV, Pilipenko PI, Korczyn AD, Hofman A, Voevoda MI, Shishkin SV, Simonova GI, Nikitin YP, Feigin VL (2006). "Risk factors for Alzheimer's disease in Russia: a case-control study". Eur. J. Neurol. 13 (9): 990–5. doi:10.1111/j.1468-1331.2006.01391.x. PMID 16930366.
  17. Romas SN, Santana V, Williamson J, Ciappa A, Lee JH, Rondon HZ, Estevez P, Lantigua R, Medrano M, Torres M, Stern Y, Tycko B, Mayeux R (2002). "Familial Alzheimer disease among Caribbean Hispanics: a reexamination of its association with APOE". Arch. Neurol. 59 (1): 87–91. PMID 11790235.
  18. Baiyewu O, Smith-Gamble V, Lane KA, Gureje O, Gao S, Ogunniyi A, Unverzagt FW, Hall KS, Hendrie HC (2007). "Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria". Int Psychogeriatr. 19 (4): 679–89. doi:10.1017/S1041610207005480. PMC 2855127. PMID 17506912.

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