Prevalence of dementia and mild cognitive impairment in indigenous Bolivian forager‐horticulturalists

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.

Prevalence of dementia in Latin America and Caribbean countries: Systematic review and meta-analyses exploring age, sex, rurality, and education as possible determinants

“… Two-phase study ≥ 65 None (n = 25, %) 1–4 years (n = 108, %) 5–8 years (n = 139, %) 9 − 12 (n = 213, %) 13 + (n = 195, %) DSM-IV, ICD-10, NINCDS-ADRDA, NINDS-AIREN AVLT, VFT, MDRS, Matrix reasoning, digit span digit symbol-coding, comprehension, and vocabulary (WAIS-III) MMSE and FAQ 115 (16.9%) Custodio et al (2008) 2005 Peru (Lima) Urban 1532 Randomly selected from the region Three-phase study ≥ 65 Illiterates (n = 269, 17,5%) 1–3 years (n = 312, 20,4%) 4–7 years (n = 417,27,2%) 8 + (n = 534, 34,9%) DSM IV, NINCDS-ADRDA, NINDS-AIREN MMSE, CDT, AVLT, Logical Memory Subtest and Letter-Number (WAIS), TMT A and B, ROCF, BNT, WCST, DS, and CDR MMSE, CDT, PFAQ 103 (6.72%) Davis et al (2018) 2011 Trinidad Urban 1832 Randomly selected from electoral districts One-phase study ≥ 70 None (n = 139, %) Primary (n = 1231, %) Secondary (n = 253, %) Tertiary (n = 124, %) 10/66 dementia diagnosis algorithm/ DSM-IV CSI-D, CERAD 10-word list learning task, and Euro-D scale – 442 (23.4%) Eldemire- Shearer et al (2018) 2012 Jamaica Unclear 301 Randomly selected from a national sample. One-phase study ≥ 60 – DSM-IV MMSE and medical consensus – 34 (11.41%) Gatz et al (2022) 2017 Bolivia (Tsimane and Moseten villages) Rural 604 ≥ 60 No formal education - Tsimane (80.6%) and Moseten (38.3%) DSM-V and NIA VS, DS, W R , VFT, SS, and SDT – 6 (0.99%) Gooding et al (2006) 2003–2005 Colombia (Neiva) Urban 643 …”

“…Regarding rurality, most of the studies included participants in urban areas ( n = 23), while two studies from Brazil ( Brucki and Nitrini, 2014 , Magalhães et al, 2008 ) and one from Bolivia ( Gatz et al, 2022 ) comprised individuals from rural populations, and eight studies had individuals recruited in both, rural and urban areas. In one article ( Soto-Añari et al, 2021 ), the rurality of the samples was unclear for the samples from all nine countries.…”

“…A total of ten articles specified the types of dementia, such as Alzheimer’s disease and vascular dementia ( Bottino et al, 2008 , Correa Ribeiro et al, 2013 , Custodio et al, 2008 ; Gatz et al, 2022 ; Herrera et al, 2002 ; Llibre Rodríguez et al, 1999 ; Maestre et al, 2018 ; Martínez Querol et al, 2005 ; Scazufca et al, 2008 ; Villarreal et al, 2016 ).…”

The emerging neuroprotective roles of exerkines in Alzheimer’s disease

“…In this context, a recent study observed that the prevalence of dementia in the indigenous population of Tsimane and Moseten Amerindian of the Bolivian Amazon, who live a subsistence lifestyle, hunting, gathering food from the forest, and fishing, was one of the lowest compared with the majority population of the world. These observations evidence that a physically active lifestyle may be a critical factor in establishing improved body and brain health ( Gatz et al, 2022 ).…”

Ellagic Acid: A Dietary-Derived Phenolic Compound for Drug Discovery in Mild Cognitive Impairment

“…Mild cognitive impairment (MCI) is usually associated with cognitive impairment, which is seen with general age-related cognitive decline, but is not severe enough to lead to considerably impaired daily function (Stevens et al, 2022). Furthermore, the GRAPHICAL ABSTRACT | principal cognitive domain that could be afflicted refers to a decline in the capability to acquire raw information or recall stored information (Gatz et al, 2022;Kuroda et al, 2022). Clinically, age-related cognitive impairment represents the preclinical, transitional stage between healthy aging and dementia (Levey et al, 2021).…”