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

Margaret Gatz; Wendy J Mack; Helena C Chui; E Meng Law; Giuseppe Barisano; M Linda Sutherland; James D Sutherland; Daniel Eid Rodriguez; Raul Quispe Gutierrez; Juan Copajira Adrian; Jesus Bani Cuata; Amy R Borenstein; Ellen E Walters; Andrei Irimia; Christopher J Rowan; L Samuel Wann; Adel H Allam; Randall C Thompson; Michael I Miyamoto; David E Michalik; Daniel K Cummings; Edmond Seabright; Angela R Garcia; Paul L Hooper; Thomas S Kraft; Caleb E Finch; Gregory S Thomas; Jonathan Stieglitz; Benjamin C Trumble; Michael D Gurven; Hillard Kaplan

doi:10.1002/alz.12626

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

Alzheimers Dement. 2023 Jan;19(1):44-55. doi: 10.1002/alz.12626. Epub 2022 Mar 9.

Authors

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 Irimia^{10

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 Thomas^{22

23}, Jonathan Stieglitz²⁴, Benjamin C Trumble²⁰, Michael D Gurven²¹, Hillard Kaplan¹⁸

Affiliations

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.

Keywords: Moseten; Tsimane; cognitive dysfunction; dementia; mental status and dementia tests.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Alzheimer Disease* / epidemiology
Bolivia / epidemiology
Cognitive Dysfunction* / complications
Cognitive Dysfunction* / diagnostic imaging
Cognitive Dysfunction* / epidemiology
Dementia* / complications
Dementia* / diagnostic imaging
Dementia* / epidemiology
Disease Progression
Humans
Neuroimaging
Prevalence

Abstract

Publication types

MeSH terms

Grants and funding