Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1989 Jun;81(6):644–652.

Racial differences in the etiology of dementia and frequency of Alzheimer lesions in the brain.

S M de la Monte, G M Hutchins, G W Moore
PMCID: PMC2625810  PMID: 2746686

Abstract

Empirical observations suggest a preponderance of cases of sporadic Alzheimer's disease among whites relative to blacks. If true, this might indicate a genetic basis for non-familial Alzheimer's disease. Among 6,000 consecutive autopsies performed at The Johns Hopkins Hospital, 242 adults with dementia were identified. The 98 consultation cases were excluded from the data analysis because of potential selection bias. Among the remaining 144 cases, the proportions of whites and blacks were similar, yet the frequency of Alzheimer's disease was 2.6 times higher among whites (P = 0.001), dementia due to Parkinson's disease was more frequent among whites (P = 0.05), and the frequencies of multi-infarct dementia and dementia due to chronic ethanol abuse were higher among blacks (P = 0.004 and P = 0.007, respectively). Moreover, in brains from neurologically intact controls, incidental histologic lesions of Alzheimer's disease were observed more frequently in whites than blacks (P = 0.01). These findings provide a strong argument in favor of genetic transmission of sporadic Alzheimer's disease.

Full text

PDF
652

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbeau A., Pourcher E. New data on the genetics of Parkinson's disease. Can J Neurol Sci. 1982 Feb;9(1):53–60. doi: 10.1017/s031716710004364x. [DOI] [PubMed] [Google Scholar]
  2. Barbeau A., Roy M., Boyer L. Genetic studies in Parkinson's disease. Adv Neurol. 1984;40:333–339. [PubMed] [Google Scholar]
  3. Barbeau A., Roy M. Familial subsets in idiopathic Parkinson's disease. Can J Neurol Sci. 1984 Feb;11(1 Suppl):144–150. doi: 10.1017/s0317167100046308. [DOI] [PubMed] [Google Scholar]
  4. Breitner J. C., Folstein M. F. Familial Alzheimer Dementia: a prevalent disorder with specific clinical features. Psychol Med. 1984 Feb;14(1):63–80. doi: 10.1017/s0033291700003081. [DOI] [PubMed] [Google Scholar]
  5. Buckton K. E., Whalley L. J., Lee M., Christie J. E. Chromosome aneuploidy in Alzheimer's disease. Exp Brain Res. 1982;Suppl 5:58–63. doi: 10.1007/978-3-642-68507-1_9. [DOI] [PubMed] [Google Scholar]
  6. Burger P. C., Vogel F. S. The development of the pathologic changes of Alzheimer's disease and senile dementia in patients with Down's syndrome. Am J Pathol. 1973 Nov;73(2):457–476. [PMC free article] [PubMed] [Google Scholar]
  7. Duvoisin R. C., Eldridge R., Williams A., Nutt J., Calne D. Twin study of Parkinson disease. Neurology. 1981 Jan;31(1):77–80. doi: 10.1212/wnl.31.1.77. [DOI] [PubMed] [Google Scholar]
  8. Ellis W. G., McCulloch J. R., Corley C. L. Presenile dementia in Down's syndrome. Ultrastructural identity with Alzheimer's disease. Neurology. 1974 Feb;24(2):101–106. doi: 10.1212/wnl.24.2.101. [DOI] [PubMed] [Google Scholar]
  9. Endo H., Yamamoto T., Kuzuya F. HLA system in senile dementia of Alzheimer type and multi-infarct dementia in Japan. Arch Gerontol Geriatr. 1986 Apr;5(1):51–56. doi: 10.1016/0167-4943(86)90007-5. [DOI] [PubMed] [Google Scholar]
  10. French L. R., Schuman L. M., Mortimer J. A., Hutton J. T., Boatman R. A., Christians B. A case-control study of dementia of the Alzheimer type. Am J Epidemiol. 1985 Mar;121(3):414–421. doi: 10.1093/oxfordjournals.aje.a114013. [DOI] [PubMed] [Google Scholar]
  11. Gambetti P., Shecket G., Ghetti B., Hirano A., Dahl D. Neurofibrillary changes in human brain. An immunocytochemical study with a neurofilament antiserum. J Neuropathol Exp Neurol. 1983 Jan;42(1):69–79. doi: 10.1097/00005072-198301000-00006. [DOI] [PubMed] [Google Scholar]
  12. Gibbs C. J., Jr, Gajdusek D. C., Asher D. M., Alpers M. P., Beck E., Daniel P. M., Matthews W. B. Creutzfeldt-Jakob disease (spongiform encephalopathy): transmission to the chimpanzee. Science. 1968 Jul 26;161(3839):388–389. doi: 10.1126/science.161.3839.388. [DOI] [PubMed] [Google Scholar]
  13. Goldman J. E., Yen S. H. Cytoskeletal protein abnormalities in neurodegenerative diseases. Ann Neurol. 1986 Mar;19(3):209–223. doi: 10.1002/ana.410190302. [DOI] [PubMed] [Google Scholar]
  14. Goudsmit J., White B. J., Weitkamp L. R., Keats B. J., Morrow C. H., Gajdusek D. C. Familial Alzheimer's disease in two kindreds of the same geographic and ethnic origin. A clinical and genetic study. J Neurol Sci. 1981 Jan;49(1):79–89. doi: 10.1016/0022-510x(81)90190-8. [DOI] [PubMed] [Google Scholar]
  15. Groen J. J., Endtz L. J. Hereditary Pick's disease: second re-examination of the large family and discussion of other hereditary cases, with particular reference to electroencephalography, a computerized tomography. Brain. 1982 Sep;105(Pt 3):443–459. doi: 10.1093/brain/105.3.443. [DOI] [PubMed] [Google Scholar]
  16. Harada H., Nishikawa S., Takahashi K. Epidemiology of Parkinson's disease in a Japanese city. Arch Neurol. 1983 Mar;40(3):151–154. doi: 10.1001/archneur.1983.04050030045008. [DOI] [PubMed] [Google Scholar]
  17. Henderson A. S. The epidemiology of Alzheimer's disease. Br Med Bull. 1986 Jan;42(1):3–10. doi: 10.1093/oxfordjournals.bmb.a072095. [DOI] [PubMed] [Google Scholar]
  18. Heston L. L. Alzheimer's dementia and Down's syndrome: genetic evidence suggesting an association. Ann N Y Acad Sci. 1982;396:29–37. doi: 10.1111/j.1749-6632.1982.tb26841.x. [DOI] [PubMed] [Google Scholar]
  19. Heston L. L., Mastri A. R., Anderson V. E., White J. Dementia of the Alzheimer type. Clinical genetics, natural history, and associated conditions. Arch Gen Psychiatry. 1981 Oct;38(10):1085–1090. doi: 10.1001/archpsyc.1981.01780350019001. [DOI] [PubMed] [Google Scholar]
  20. Heston L. L., Mastri A. R., Anderson V. E., White J. Dementia of the Alzheimer type. Clinical genetics, natural history, and associated conditions. Arch Gen Psychiatry. 1981 Oct;38(10):1085–1090. doi: 10.1001/archpsyc.1981.01780350019001. [DOI] [PubMed] [Google Scholar]
  21. Heyman A., Wilkinson W. E., Hurwitz B. J., Schmechel D., Sigmon A. H., Weinberg T., Helms M. J., Swift M. Alzheimer's disease: genetic aspects and associated clinical disorders. Ann Neurol. 1983 Nov;14(5):507–515. doi: 10.1002/ana.410140503. [DOI] [PubMed] [Google Scholar]
  22. Heyman A., Wilkinson W. E., Stafford J. A., Helms M. J., Sigmon A. H., Weinberg T. Alzheimer's disease: a study of epidemiological aspects. Ann Neurol. 1984 Apr;15(4):335–341. doi: 10.1002/ana.410150406. [DOI] [PubMed] [Google Scholar]
  23. Hudson A. J. Amyotrophic lateral sclerosis and its association with dementia, parkinsonism and other neurological disorders: a review. Brain. 1981 Jun;104(2):217–247. doi: 10.1093/brain/104.2.217. [DOI] [PubMed] [Google Scholar]
  24. Khachaturian Z. S. Diagnosis of Alzheimer's disease. Arch Neurol. 1985 Nov;42(11):1097–1105. doi: 10.1001/archneur.1985.04060100083029. [DOI] [PubMed] [Google Scholar]
  25. Koller W., O'Hara R., Nutt J., Young J., Rubino F. Monozygotic twins with Parkinson's disease. Ann Neurol. 1986 Apr;19(4):402–405. doi: 10.1002/ana.410190420. [DOI] [PubMed] [Google Scholar]
  26. Kurtzke J. F. Epidemiology of amyotrophic lateral sclerosis. Adv Neurol. 1982;36:281–302. [PubMed] [Google Scholar]
  27. Li J. C., Kaminskas E. Deficient repair of DNA lesions in Alzheimer's disease fibroblasts. Biochem Biophys Res Commun. 1985 Jun 28;129(3):733–738. doi: 10.1016/0006-291x(85)91953-9. [DOI] [PubMed] [Google Scholar]
  28. Li S. C., Schoenberg B. S., Wang C. C., Cheng X. M., Rui D. Y., Bolis C. L., Schoenberg D. G. A prevalence survey of Parkinson's disease and other movement disorders in the People's Republic of China. Arch Neurol. 1985 Jul;42(7):655–657. doi: 10.1001/archneur.1985.04060070045013. [DOI] [PubMed] [Google Scholar]
  29. Marttila R. J., Rinne U. K. Epidemiology of Parkinson's disease--an overview. J Neural Transm. 1981;51(1-2):135–148. doi: 10.1007/BF01664011. [DOI] [PubMed] [Google Scholar]
  30. Masters C. L., Gajdusek D. C., Gibbs C. J., Jr The familial occurrence of Creutzfeldt-Jakob disease and Alzheimer's disease. Brain. 1981 Sep;104(3):535–558. doi: 10.1093/brain/104.3.535. [DOI] [PubMed] [Google Scholar]
  31. Moorhead P. S., Heyman A. Chromosome studies of patients with Alzheimer disease. Am J Med Genet. 1983 Mar;14(3):545–556. doi: 10.1002/ajmg.1320140319. [DOI] [PubMed] [Google Scholar]
  32. Májský A., Vojtechovský M. Non-relationship between the HLA system and the senile form of Alzheimer's disease. Arch Psychiatr Nervenkr (1970) 1983;233(5):381–383. doi: 10.1007/BF00346088. [DOI] [PubMed] [Google Scholar]
  33. Nakazato Y., Sasaki A., Hirato J., Ishida Y. Immunohistochemical localization of neurofilament protein in neuronal degenerations. Acta Neuropathol. 1984;64(1):30–36. doi: 10.1007/BF00695603. [DOI] [PubMed] [Google Scholar]
  34. Owens D., Dawson J. C., Losin S. Alzheimer's disease in Down's syndrome. Am J Ment Defic. 1971 Mar;75(5):606–612. [PubMed] [Google Scholar]
  35. Price D. L., Whitehouse P. J., Struble R. G., Coyle J. T., Clark A. W., Delong M. R., Cork L. C., Hedreen J. C. Alzheimer's disease and Down's syndrome. Ann N Y Acad Sci. 1982;396:145–164. doi: 10.1111/j.1749-6632.1982.tb26850.x. [DOI] [PubMed] [Google Scholar]
  36. Rogers M. S. Racial variations in the incidence of Trisomy 21. Br J Obstet Gynaecol. 1986 Jun;93(6):597–599. doi: 10.1111/j.1471-0528.1986.tb07961.x. [DOI] [PubMed] [Google Scholar]
  37. Schoenberg B. S., Anderson D. W., Haerer A. F. Prevalence of Parkinson's disease in the biracial population of Copiah County, Mississippi. Neurology. 1985 Jun;35(6):841–845. doi: 10.1212/wnl.35.6.841. [DOI] [PubMed] [Google Scholar]
  38. Smith A., Broe G. A., Williamson M. Chromosome aneuploidy in Alzheimer's disease. Clin Genet. 1983 Jul;24(1):54–57. doi: 10.1111/j.1399-0004.1983.tb00070.x. [DOI] [PubMed] [Google Scholar]
  39. Smith A., Broe G. A., Williamson M. Chromosome fragility in Alzheimer's disease. Clin Genet. 1984 May;25(5):416–421. doi: 10.1111/j.1399-0004.1984.tb02010.x. [DOI] [PubMed] [Google Scholar]
  40. St George-Hyslop P. H., Tanzi R. E., Polinsky R. J., Haines J. L., Nee L., Watkins P. C., Myers R. H., Feldman R. G., Pollen D., Drachman D. The genetic defect causing familial Alzheimer's disease maps on chromosome 21. Science. 1987 Feb 20;235(4791):885–890. doi: 10.1126/science.2880399. [DOI] [PubMed] [Google Scholar]
  41. Tanzi R. E., Gusella J. F., Watkins P. C., Bruns G. A., St George-Hyslop P., Van Keuren M. L., Patterson D., Pagan S., Kurnit D. M., Neve R. L. Amyloid beta protein gene: cDNA, mRNA distribution, and genetic linkage near the Alzheimer locus. Science. 1987 Feb 20;235(4791):880–884. doi: 10.1126/science.2949367. [DOI] [PubMed] [Google Scholar]
  42. Terry R. D., Katzman R. Senile dementia of the Alzheimer type. Ann Neurol. 1983 Nov;14(5):497–506. doi: 10.1002/ana.410140502. [DOI] [PubMed] [Google Scholar]
  43. Tomlinson B. E., Blessed G., Roth M. Observations on the brains of demented old people. J Neurol Sci. 1970 Sep;11(3):205–242. doi: 10.1016/0022-510x(70)90063-8. [DOI] [PubMed] [Google Scholar]
  44. Treves T., Korczyn A. D., Zilber N., Kahana E., Leibowitz Y., Alter M., Schoenberg B. S. Presenile dementia in Israel. Arch Neurol. 1986 Jan;43(1):26–29. doi: 10.1001/archneur.1986.00520010022014. [DOI] [PubMed] [Google Scholar]
  45. Ward C. D., Duvoisin R. C., Ince S. E., Nutt J. D., Eldridge R., Calne D. B. Parkinson's disease in 65 pairs of twins and in a set of quadruplets. Neurology. 1983 Jul;33(7):815–824. doi: 10.1212/wnl.33.7.815. [DOI] [PubMed] [Google Scholar]
  46. White B. J., Crandall C., Goudsmit J., Morrow C. H., Alling D. W., Gajdusek D. C., Tijio J. H. Cytogenetic studies of familial and sporadic Alzheimer disease. Am J Med Genet. 1981;10(1):77–89. doi: 10.1002/ajmg.1320100110. [DOI] [PubMed] [Google Scholar]
  47. Wiśniewski H. M., Coblentz J. M., Terry R. D. Pick's disease. A clinical and ultrastructural study. Arch Neurol. 1972 Feb;26(2):97–108. doi: 10.1001/archneur.1972.00490080015001. [DOI] [PubMed] [Google Scholar]
  48. Wright A. F., Whalley L. J. Genetics, ageing and dementia. Br J Psychiatry. 1984 Jul;145:20–38. doi: 10.1192/bjp.145.1.20. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES