title: Lower Prevalence of Alzheimer's Disease among Tibetans: Association with Religious and Genetic Factors.
abstract: BACKGROUND
  The prevalence of dementia differs among racial groups, the highest prevalence being in Latin America (8.5%) compared to sub-Saharan African regions (2-4%). The most common type of dementia is Alzheimer's disease (AD).
  
  
  OBJECTIVE
  To estimate the prevalence of AD in the Qinghai-Tibet plateau and to investigate the related factors.
  
  
  METHODS
  This was a cross-sectional, multistage cluster sampling design survey. Data was collected from May 2014 to September 2014 from 4,060 Tibetan aged >60 years. Participants underwent clinical examinations and neuropsychological evaluations. MALDI-TOF was used to test the genotypes of CLU, TFAM, TP53INP1, IGHV1-67, CR1, ApoE, and BIN1. Logistic regression models were used to ascertain the associations with AD.
  
  
  RESULTS
  The prevalence of AD among Tibetan individuals aged >60 years was 1.33% (95% CI: 0.98-1.69). The CLU haplotypes AA+GA (odds ratio (OR) = 4.483; 95% CI: 1.069-18.792) of rs2279590 was correlated with AD. The CLU haplotypes GG+GC (OR = 0.184; 95% CI: 0.038-0.888) of rs9331888 and kowtow (OR = 0.203; 95% CI 0.046-0.896) were negatively correlated with AD.
  
  
  CONCLUSIONS
  A low prevalence of AD was found in Tibetans from the Qinghai-Tibet plateau. Multivariate analysis might suggest that regular "mind-body" religious meditative activities may be negatively associated with AD in this population, as well as the CLU genotype at rs9331888.
authors.affiliation: Beijing Tibetan Hospital, China Tibet-ology Research Center, Beijing, P.R. China.
authors.forename: Fukai
authors.initials: F
authors.lastname: Huang
authors.affiliation: Beijing Mentougou Hospital of Traditional Chinese Medicine, Beijing, P.R. China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Beijing Tibetan Hospital, China Tibet-ology Research Center, Beijing, P.R. China.
authors.forename: Yuandai
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Southern Medical University, Guangzhou, P.R. China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wu
authors.affiliation: Southern Medical University, Guangzhou, P.R. China.
authors.forename: Xue
authors.initials: X
authors.lastname: Huang
authors.affiliation: Southern Medical University, Guangzhou, P.R. China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Tan
authors.affiliation: Beijing Tibetan Hospital, China Tibet-ology Research Center, Beijing, P.R. China.
authors.forename: Xingyi
authors.initials: X
authors.lastname: Lu
authors.affiliation: Beijing Tibetan Hospital, China Tibet-ology Research Center, Beijing, P.R. China.
authors.forename: Lifang
authors.initials: L
authors.lastname: Zhen
authors.affiliation: Beijing Tibetan Hospital, China Tibet-ology Research Center, Beijing, P.R. China.
authors.forename: Xianda
authors.initials: X
authors.lastname: Hu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D051152:Clusterin / Q000235:genetics*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D011569:Psychiatric Status Rating Scales; D012067:Religion; D012307:Risk Factors; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D018609:Tibet / Q000453:epidemiology / Q000208:ethnology
chemical_list: C495242:CLU protein, human; D051152:Clusterin
keywords: Alzheimer’s disease; Qinghai-Tibet Plateau; Tibetan; gene polymorphisms; religion