Factors predisposing to and associated with atherosclerosis may impact the onset and progression of Alzheimer disease (AD). The high prevalence of atherosclerosis and associated risk factors in American Indians makes them ideal subjects to test this association. We compared frequency of history of hypertension, myocardial infarction, stroke, diabetes, and high cholesterol in 34 American Indians with AD with 34 age-matched American Indian controls, and 34 age-matched whites with probable AD. We also measured waist size, height, and weight, and acquired blood for determination of plasma homocysteine and apolipoprotein E genotype. The 3 groups did not differ significantly in age or sex. History of hypertension and diabetes was significantly more common among American Indian AD patients than Indian controls or whites with AD. The 3 groups did not differ in history of stroke or myocardial infarction. Body mass index was significantly greater in both Indian groups than the white AD group. Plasma homocysteine levels were greater, but not significantly so, in the Indian AD than the Indian control group. Thus, there is preliminary evidence of a modest association between history of hypertension and diabetes and AD in a small sample of American Indians. This suggests that changes in lifestyle factors could influence the expression of AD in American Indians.

Alzheimer's & DementiaVolume 2, Issue 4 p. 327-329 Research News Dementia diagnosis, treatment, and research with American Indians Myron F. Weiner, Corresponding Author Myron F. Weiner myron.weiner@utsouthwestern.edu Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Corresponding author. Tel.: 214-648-9353; fax: 214-648-2031. E-mail address: myron.weiner@utsouthwestern.eduSearch for more papers by this authorRoger N. Rosenberg, Roger N. Rosenberg Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorDoris Svetlik, Doris Svetlik Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorMargaret Higgins, Margaret Higgins Health Care Sciences, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorKyle Womack, Kyle Womack Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorCarey Fuller, Carey Fuller Choctaw Nation Healthcare Center, Talihina, OK, 74571 USASearch for more papers by this authorLaura H. Lacritz, Laura H. Lacritz Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorC. Munro Cullum, C. Munro Cullum Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this author Myron F. Weiner, Corresponding Author Myron F. Weiner myron.weiner@utsouthwestern.edu Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Corresponding author. Tel.: 214-648-9353; fax: 214-648-2031. E-mail address: myron.weiner@utsouthwestern.eduSearch for more papers by this authorRoger N. Rosenberg, Roger N. Rosenberg Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorDoris Svetlik, Doris Svetlik Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorMargaret Higgins, Margaret Higgins Health Care Sciences, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorKyle Womack, Kyle Womack Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorCarey Fuller, Carey Fuller Choctaw Nation Healthcare Center, Talihina, OK, 74571 USASearch for more papers by this authorLaura H. Lacritz, Laura H. Lacritz Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this authorC. Munro Cullum, C. Munro Cullum Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USA Department of Neurology, UT Southwestern Medical Center, Dallas, TX, 75390-9129 USASearch for more papers by this author First published: 01 October 2006 https://doi.org/10.1016/j.jalz.2006.08.002Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue4October 2006Pages 327-329 RelatedInformation

The UT Southwestern Alzheimer's Disease Center in Dallas, Texas has had a satellite operation with the Chocatw Nation in Oklahoma since 2001. The primary problem of the satellite's function is the physical remoteness of the 60,000 Choctaw Indians spread over 15,000 square miles in southeastern Oklahoma. To more effectively reach Choctaw Indians and retain them in long-term followup. We have begun to employ a telemedicine link to follow persons whom we have diagnosed by direct evaluation. Cognitive testing is performed prior to the visit by our staff in Oklahoma and sent by fax to Dallas. Caregivers are interviewed on screen, and patients are evaluated in a structured manner for psychiatric and neurological symptyoms. The procedure has been well accepted by patients, caregivers and staff in Oklahoma. Telemedicine linkage is an effective means to maintain followup of American Indians in remote locations.

Objective: This study compared medical history and findings on initial clinical examination in Native Americans diagnosed with possible or probable Alzheimer's disease (AD) at Native American satellite clinics of the University of Texas (UT) Southwestern Medical Center's Alzheimer's Disease Center with those of Whites diagnosed with probable AD at the UT Southwestern Medical Center's Alzheimer's Disease Clinic. Methods: The information reviewed was contained in the database of the UT Southwestern Alzheimer's Disease Center. Results: In relation to Whites, Native Americans had slightly but significantly greater age at onset of symptoms (71.7 vs. 69.6 years, t = -2.08, p = .04) and equivalent cognitive scores at evaluation (Mini-Mental State Exam score = 17.4 vs. 18.5, t = 0.98, p = .33), despite significantly lower educational level (11.4 vs. 13.4 years, t = 5.63, p < .001). Native Americans were more frequently depressed on examination (22.8% vs. 9.5%, chi(2) = 12, p =.001) and reported diabetes, hypertension, and heart disease significantly more often than did Whites (p < .01 for all), but their survival time after AD diagnosis was similar to that of Whites despite these comorbidities. Conclusions: With the exception of a greater prevalence of depression and cardiovascular risk factors in Native Americans than in Whites, Native Americans had a course of illness similar to that of Whites.