Profiles of Alzheimer's Disease-Related Pathology in an Aging Urban Population Sample in India

Article type: Research Article

Authors: Purohit, Dushyant P.^{a; b; *} | Batheja, Nirmala O.^a | Sano, Mary^{b; c} | Jashnani, Kusum D.^d | Kalaria, Rajesh N.^e | Karunamurthy, Arivarasan^f | Kaur, Shalinder^g | Shenoy, Asha S.^d | Van Dyk, Kathleen^b | Schmeidler, James^b | Perl, Daniel P.^h

Affiliations: [a] Department of Pathology, Mount Sinai School of Medicine, New York, NY, USA | [b] Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA | [c] JJP VA Medical Center, Bronx, NY, USA | [d] Pathology Department, TN. Medical College/BYL Nair Ch. Hospital, Mumbai, India | [e] Institute for Ageing and Health, Newcastle University, Newcastle Upon Tyne, UK | [f] Pathology Department, SGS Medical College and KEM Hospital, Mumbai, India | [g] Pathology Department, LTM Medical College/LTM General Hospital, Mumbai India | [h] Uniformed Services University of the Health Sciences, Bethesda, MD, USA

Correspondence: [*] Correspondence to: Dushyant P. Purohit, MD, Neuropathology Division, Box 1134, Department of Pathology, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029, USA. Tel.: + 1 212 241 7371; Fax: +1 212 996 1343; E-mail: dushyant.purohit@mssm.edu.

Abstract: Systematic studies on Alzheimer's disease (AD)-related pathology that complement clinical and epidemiological data on dementia from low and middle income countries are rare. We report the first large study on AD-related pathology in autopsy service-derived brains from an urban center in India, a low/middle income country, and compare findings with a similar sample from New York. Amyloid-β plaques and neurofibrillary tangles were assessed in 91 brain specimens derived from hospital autopsy cases from Mumbai, India (age 60+ years; mean age 71.1 years, ±8.3 SD; range 60–107 years) and compared with identically examined age-matched sample obtained in New York. These cases had no known clinical history of dementia. Our study showed that in comparison with the New York sample, the mean brain weight of the Mumbai sample was lower (p = 0.013) and mean diffuse plaque density was higher (p = 0.019), while differences in mean density and counts of neurofibrillary tangles and neuritic plaques were not statistically significant (p > 0.05). Our findings indicate that the burden of AD-related pathology was approximately equivalent in Mumbai and New York samples, which is at variance with expected lower AD-related lesion burden based on the clinical/epidemiological studies suggesting lower prevalence of AD in India.

Keywords: AD-related pathology, Alzheimer's disease, amyloid-β plaques, developing countries, LMIC, neurofibrillary tangles, senile plaques

DOI: 10.3233/JAD-2010-101698

Journal: Journal of Alzheimer's Disease, vol. 24, no. 1, pp. 187-196, 2011