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Hygiene and the world distribution of Alzheimer's disease : epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden
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Fox, Molly, Knapp, Leslie Ann, Andrews, Paul W. and Fincher, Corey L. (2013) Hygiene and the world distribution of Alzheimer's disease : epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden. Evolution, Medicine, and Public Health, Volume 2013 (Number 1). pp. 173-186. doi:10.1093/emph/eot015
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Official URL: http://dx.doi.org/10.1093/emph/eot015
Abstract
Background and objectives:
Alzheimer’s disease (AD) shares certain etiological features with autoimmunity. Prevalence of autoimmunity varies between populations in accordance with variation in environmental microbial diversity. Exposure to microorganisms may improve individuals’ immunoregulation in ways that protect against autoimmunity, and we suggest that this may also be the case for AD. Here, we investigate whether differences in microbial diversity can explain patterns of age-adjusted AD rates between countries.
Methodology:
We use regression models to test whether pathogen prevalence, as a proxy for microbial diversity, across 192 countries can explain a significant amount of the variation in age-standardized AD disability-adjusted life-year (DALY) rates. We also review and assess the relationship between pathogen prevalence and AD rates in different world populations.
Results:
Based on our analyses, it appears that hygiene is positively associated with AD risk. Countries with greater degree of sanitation and lower degree of pathogen prevalence have higher age-adjusted AD DALY rates. Countries with greater degree of urbanization and wealth exhibit higher age-adjusted AD DALY rates.
Conclusions and implications:
Variation in hygiene may partly explain global patterns in AD rates. Microorganism exposure may be inversely related to AD risk. These results may help predict AD burden in developing countries where microbial diversity is rapidly diminishing. Epidemiological forecasting is important for preparing for future healthcare needs and research prioritization.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine | ||||
| Divisions: | Faculty of Science > Psychology | ||||
| Library of Congress Subject Headings (LCSH): | Alzheimer's disease, Hygiene -- Health aspects | ||||
| Journal or Publication Title: | Evolution, Medicine, and Public Health | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 2050-6201 | ||||
| Official Date: | 11 August 2013 | ||||
| Dates: |
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| Volume: | Volume 2013 | ||||
| Number: | Number 1 | ||||
| Number of Pages: | 14 | ||||
| Page Range: | pp. 173-186 | ||||
| DOI: | 10.1093/emph/eot015 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Funder: | Gonville and Caius College, Engineering and Physical Sciences Research Council (EPSRC) | ||||
| Grant number: | ES/I031022/1 (EPSRC) |
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