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Friday, June 17, 2011

Recent study on the prevalence of Alzheimer's Disease in India. (extracts).

Profiles of Alzheimer's Disease-Related Pathology in an Aging Urban Population Sample.(Mumbai sample, India).

Dushyant P. Purohit,ab* Nirmala O. Batheja,a Mary Sano,bc Kusum D. Jashnani,d Rajesh N. Kalaria,e Arivarasan Karunamurthy,f Shalinder Kaur,gAsha S. Shenoy,d Kathleen Van Dyk,b James Schmeidler,b and Daniel P. Perl

J Alzheimers Dis. Author manuscript; available in PMC 2011 March 31.
Published in final edited form as:

"Aging is the main risk factor for dementia and thus the number of elderly people suffering from dementia in India will rise in tandem with rising elderly population. Initial epidemiological studies in India suggested low estimates for the prevalence of dementia and Alzheimer's disease (AD),
with some showing about one-third of the prevalence [47] compared to the United States and other developed countries [811]. This was followed by several recent studies based on updated clinical and neuropsychological methodologies [1221]. Nevertheless, among the present vast elderly population and its projections for exponential growth in the coming few decades, even with these lower prevalence rates, AD and other age-related dementias would affect very large portion of the elderly population."


"In appraising the extent of AD and other forms of dementia, neuropathological assessment of brain tissue for AD-related changes represents a valuable biologic means to investigate the tendency of this population to develop this disease process. Accordingly, we sought to estimate the burden of AD-pathology prevailing in India and carried out a study on postmortem brain specimens from three large teaching hospitals associated with medical schools in Mumbai, the largest city in India. Here, we present a report on AD-related pathology on 91 autopsy-cases and compared these changes with pathology data of an equal number of age-matched cases from New York, NY."


"Epidemiological and neuropsychological investigations in India, similar to other LMICs, face several barriers, including lower literacy levels, sociological factors of stigma of a diagnosis of dementia, and a prevailing notion that memory problems and cognitive loss are natural manifestations of senescence and not due to a disease which might require intervention. Additionally, most elderly people in India live in extended families where they do not need to independently carry out routine, day-to-day functions such as shopping, getting out and about using any modes of transportation, handling financial matters, and maintaining household and its associated responsibilities For these reasons, epidemiological studies investigating cognitive status may not provide precise estimates of prevalence and incidence of dementia. In contrast, the appearance of pathological lesions of amyloid-β (Aβ) plaque deposits and neurofibrillary tangles (NFT) in brain specimens is an outcome of neurobiological mechanisms, therefore pathological studies can offer additional perspectives regarding occurrence of AD. However, there have been very few autopsy confirmations or pathological studies of brain aging and AD in LMICs."


"In a recent review, Kalaria et al. [2] observe that the existing retrospective and prospective clinical studies reporting that prevalence estimates of dementia and AD vary widely between and within individual countries, possibly due to subjective, cultural and contextual factors operating within clinical and epidemiological methodology. This may lead to an underestimate of the dementia burden [2]. However, neuropathological studies on autopsy brain specimens can provide culture-independent insights into the extent of dementing diseases, since the pathological lesions are the outcome of biological phenomena. Further, neuropathology can help identify or confirm specific diagnostic types of dementia."


"Therefore, we do not attempt to offer precise estimates of AD-related pathology in the urban population of Mumbai, or of the country at large, but our study indicates that AD-related pathology is apparent in a pattern similar to that in the urban population of NY."


"Such investigations in India (and other LMICs) could provide better indication of the true extent of dementia burden, help plan for future health care needs and also offer neurobiological perspectives that underlie lifestyle and environmental risk/protective factors for AD affecting these cultures."

link to the full article :

Journal of Alzheimer's Disease
PublisherIOS Press
ISSN1387-2877 (Print)
1875-8908 (Online)
SubjectMedicine, Clinical Neurology and Internal Medicine
IssueVolume 24, Number 1 / 2011
Subject GroupNeurosciences
Online DateMonday, December 27, 2010


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