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g., demented vs. nondemented) were evaluated using the Pearson ?2 test. Levels of tHcy, vitamin B12, and folate were log-transformed to fit normal distributions. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated using two logistic regression models."
Chance: Low, given the long-term screening of subjects for AD in larger Maracaibo Aging Study
Generalizability
Eligible population: Patients with a strong genetic predisposition for AD
Source population: Uncertain, given the diverse range of factors that could still affect the health of the source population, although many common risk factors were accounted for in the statistical analyses performed
Other population: Generalizability between the Maracaibo population and the AD population as a whole is still being determined.
Study 3:
Bowirrat A; R.P. Friedland; L. Farrer, C. Baldwin, A. Korczyn. (2002). Genetic and environmental risk factors for Alzheimer's disease in Israeli Arabs.
Journal of Molecular Neuroscience, 19(1-2):239-45.
Causality Criteria
Description: An assessment of genetic and environmental risk factors and prevalence, and incidence of dementia of the Alzheimer type (DAT) among the elderly in an Arab community in Israel.
Exposure, Intervention: All persons aged 60 years or older who were residents of the rural area of Wadi Ara were examined for identification of dementia associated with Alzheimer's disease (DAT), vascular dementia (VaD) and age related cognitive decline (ARCD) due to AD. DSM-IV criteria and a semi-structured questionnaire were used. "ApoE genotype...
Total plasma homocysteine (tHcy) was determined using HPLC with fluorescence detection. Vitamins B12 and plasma folate were determined using a commercial radioisotope dilution kit assay (ICN)."
Study design: Descriptive
Study Population: Residents of remote Arab village
Main Result: DAT (dementia of the Alzheimer's type) was diagnosed in 20.5% of this population. Illiteracy, old age, and female strongly correlated with development of AD. "The ApoE epsilon4 allele is relatively uncommon in this population and it cannot explain the high DAT prevalence." But it was similarly found that vascular-related dementia and age related-dementia were also correlated.
Internal Validity
Observation bias: Possible observational bias given open-ended nature of questionnaires and difficulty of determining cause of dementia
Recall bias: Questionnaires described as semi-structured, leading to possible bias
Confounding: "ApoE genotype was also determined. Total plasma homocysteine (tHcy) was determined using HPLC with fluorescence detection. Vitamins B12 and plasma folate were determined using a commercial radioisotope dilution kit assay (ICN)."
Chance: High, given singularity of test population.
Generalizability
Eligible population: All residents of remote Israeli Arab village
Source population: Uncertain, particularly given the subjective nature of the causality of the different dementias studied
Other population: Points to need for further examination of relationship of illiteracy to dementia of different kinds
This intervention is also primary in nature, given that it underlines the need for social changes, such as improved diet and education amongst the poor, to reduce the prevalence of the disorder. Source: Israeli-Korn, S.D.; M. Masarwa; E. Schechtman; A. Abuful; R. Strugatsky; S. Avni; L.A. Farrer; R.P. Friedland; R. Inzelberg. (2010). Hypertension increases the probability of Alzheimer's disease and of mild cognitive impairment in an Arab community in northern Israel. Neuroepidemiology,
In light of the knowledge provided by these case studies, it is important to note certain flaws in the methodology of each cases study. The study in the case of midlife neuroticism, the researchers do not take into account pre- existing conditions such the brain structure and function associated with greater neuroticism. Failure to proper diagnosis might lead to early presentation of Alzheimer's disease in response to pathology. As for
A. Harvard Women's Health Watch (2010) Preserving and improving memory as we age. Feb 1: NA B. This is an article that is written directly to consumers who are over the age of 50 and are starting to notice changes in the ability to remember things. It addresses the fact that this wrongly causes fear in some people that they are prone toward Alzheimer's disease. Studies have shown that cognitive decline
) Researcher believe that when Alzheimer's begins to attack, it hits the "factory" of cell groups that otherwise are functioning perfectly. There are breakdowns in the communications that the cell groups hitherto provided, and although scientists don't know precisely where the attack is first launched by Alzheimer's, but they do understand that "as the damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes
Huntington's disease (HD) was the first autonomic dominant disorder for which genetic prediction became possible" (Harper, et al., 2000, Journal of Medical Genetics, p. 567). HD is a disease that occurs due to an inherited disorder leading to the death of brain cells. A diagnosis of HD is accomplished through genetic testing which can be implemented at any age regardless of whether the symptoms manifest or not. Although, the specific
94). The modern legal definition of disease provides a useful starting point for an examination of the concept of disease and how it is regarded by various disciplines. According to Black's Law Dictionary (1990), disease is a "deviation from the healthy or normal condition of any of the functions or tissues of the body. An alternation in the state of the body or some of its organs, interrupting or disturbing