This document proposes a cross-cultural study to gather data on risk factors for Alzheimer's disease by comparing populations. It will build on previous research that explored genetic and environmental risks for AD between populations in Nigeria and the US. The study will combine neurological, anthropological, and sociological methods to compare populations and add to current knowledge about AD. It will pilot collaboration with international organizations to study factors like diet, genetics, pollution exposure, and their relationships to AD risk.

1. Cross Cultural Study Informing Alzheimer’s Disease Prevention
Agnes Ezekwesili, MD, PhD
Alzheimer’s Association International Conference and Alzheimer’s Disease International
International rates of dementia are
increasing at an alarming rate, the
number almost doubling worldwide,
every 20 years.
Alzheimer’s Disease (AD) is the
most common form of dementia and
is also a world wide problem.
Between 60 and 80 percent of
dementia cases are caused by
Alzheimer’s disease. Alzheimer’s
disease is caused by a combination of
factors not comprehensively
understood today by neurologists.
Hugh Hendrie (2001) explored the environmental and genetic
risks of AD, emphasizing the worth of cross-cultural studies. This
investigation creates genetic-environmental models to explain
variations in disease rates between the Yoruba in Nigeria and an
African-American population in Indianapolis. Differences in diet,
education, genetics, and the prevalence of other diseases were
compared (Hendrie, 2001).
In this international pilot study we will build off of Hendrie’s work
to gather data to reinforce other risk factors identified by other
Alzheimer's research. This study combines neurology with
anthropological and sociological methods of study. Through
collaboration with international organizations, we will compare
populations to add to the current body of neurological knowledge.
This study will pilot through collaboration with a handful of
associations but can be added to and grown continually.
PROPOSAL
PURPOSE
APOE
SEQUENCING
ORGANIZATIONAL COLLABORATION
REFERENCES
The most commonly accepted contributor to increased AD risk
is the presence of two alleles of the APOE4 allele. It is still unknown
if/how other alleles of APOE contribute to changes in AD risk. APOE
sequencing can create connections between specific AD risk factors
and the genome.
A few other factors such as BMI, residential altitude,
smoking, alcohol consumption, and degree of socialization have
also been suggested as factors that may affect risk for AD
(Imtiaz, 2014). Additional questions addressing these factors
will be included in the survey.
OTHER
POSSIBLE
CONTRIBUTING
FACTORS
Grant W., Campbell A., & Itzhaki R. (2002). The significance of environmental factors in the etiology of Alzheimer’s disease. Journal of Alzheimer’s Disease 4(3), 179-189. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/12226537
Hendrie H. (2001). Exploration of Environmental and Genetic Risk Factors for Alzheimer’s Disease: The Value of Cross-Cultural Studies. Current Directions in Psychological Science 10(3), 98-101. Retrieved from:
https://www.researchgate.net/publication/247781189_Exploration_of_Environmental_and_Genetic_Risk_Factors_for_Alzheimer's_Disease_The_Value_of_Cross-Cultural_Studies
Heusinkveld H., Wahle T., & Campbell A. (2016). Neurodegenerative and neurological disorders by small inhaled particles. Neurotoxicology 56, 94-106. doi:10.1016/j.neuro.2016.07.007
Imtiaz B., Tolppanen A., & Kivipelto M. (2014). Future directions in Alzheimer’s disease from risk factors to prevention. Biochemical Pharmacology,88 (4), 661-670. http://dx.doi.org/10.1016/j.bcp.2014.01.003
Setting and Reviewing Standards to Control Particulate Matter (PM) Pollution. (2016). US Environmental Protection Agency. Retrieved from: https://www.epa.gov/pm-pollution/setting-and-reviewing-standards-control-particulate-matter-pm-
pollution#standards
CONCLUSION: INTERNATIONAL ENVIRONMENTAL AND GENETIC SURVEY
https://stanfordhealthcare.org/content/dam/SHC/conditions/brains-nerves/images/alzhemers-diagram-
brain2.jpg
http://www.worldalzreport2015.org/downloads/global-impact-of-dementia-
infographic.pdf
Many studies have shown possible connections between diets high in
cholesterol and fatty acids with higher risk for AD. (Grant, 2002; Hendrie, 2001)
Other studies correlate higher glucose levels with APOE4 genetic frequency.
Other studies showed that specific foods, like fish, may decrease risk and
Hendrie’s study gave support for these possibilities and this new study will add to
this body of knowledge.
In the survey portion of this study questions of diet will be proposed
including: commonly consumed vitamins and nutrients, staples in diet, and fat,
cholesterol and glucose consumption.
DIET
http://assets.motherjones.com/environment/2015/06/pollution_graphics_960x230-
01.png
Studies in the neurological community have
associated the inhalation of fine and ultra fine
particulate matter (PM) with expedited onset of AD
(Heusinkveld, 2016).
As a part of the study, the implementing AD research
association will test for the amount of PM in the air
inhaled by the community. The numbers will then be
compared to the US EPA and National Ambient Air
Quality Standards (NAAQS).
POLLUTIO
N
http://curealz.org/sites/default/files/AboutAlz_InheritAPOE4_0.jpg
http://www.pcrm.org/sites/default/files/images/media/releases/alzheimers-graphic.jpg
http://assets.motherjones.com/environment/2015/06/pollution_graphics_960x230-
02.png