ボリビア低地のティマネ族・モセテン族の認知症について新たな知見(New study adds nuance to our understanding of dementia in the Tsimané and Mosetén of lowland Bolivia)

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2026-09-22 カリフォルニア大学サンタバーバラ校(UCSB)

ボリビア低地の先住民TsimanéとMoseténを対象に、認知症の発症率を約5年間追跡した研究が報告された。認知症のない成人730人を追跡した結果、22人が新たに認知症を発症し、発症率は1,000人年当たり7.40例で、米国や北欧の集団と大きく異ならなかった。一方、追跡時点での有病率は2%未満と低かった。研究者は、低い有病率の背景として、認知症発症後の生存期間が短い可能性を指摘する。さらに、認知症例では典型的なアルツハイマー病とは異なる脳萎縮パターンが多く、血管性要因の関与が示唆された。血中ニューロフィラメント軽鎖との関連や、APOE ε4との関連も確認されたが、症例数が22例と少なく、生活様式・遺伝・血管・感染などの影響を区別するにはさらなる研究が必要である。

ボリビア低地のティマネ族・モセテン族の認知症について新たな知見(New study adds nuance to our understanding of dementia in the Tsimané and Mosetén of lowland Bolivia)
Photo Credit:Michael Gurven
Compared to industrialized counterparts Tsimané people of lowland Bolivia have less food availability and must expend more effort to get it

<関連情報>

ボリビア先住民2集団における認知症および軽度認知障害の発症率 Incidence of dementia and mild cognitive impairment in two Indigenous Bolivian cohorts

Margaret Gatz, Wendy J. Mack, Daniel Eid Rodriguez, Raul Quispe Gutierrez, Jesus Bani Cuata, Helena C. Chui, Ellen E. Walters, Daniel K. Cummings, …
Alzheimer’s & Dementia  Published: 15 September 2026
DOI:https://doi.org/10.1002/alz.71750

Abstract

INTRODUCTION
We studied dementia incidence and risk factors in Indigenous Tsimane and Moseten Amerindian populations in Amazonian Bolivia with largely subsistence lifestyles.

METHODS
A median of 4.7 years after baseline dementia assessment, 730 participants (52% male; mean age 67.3 years) were re-visited at two follow-up phases to determine new cases among non-demented at baseline. Clinical evaluation was adapted to culture, language, and illiteracy.

RESULTS
There were 22 incident dementia cases (7.40/1000 person years; 95% confidence interval = 4.87–11.24). Prevalence rates remained < 2%. Mortality among dementia cases at baseline was significantly greater versus cognitively normal participants. In exploratory analyses, apolipoprotein E ε4 genotype, thoracic aortic calcium, and plasma neurofilament light chain were associated with incident dementia; other risk factors, amyloid, and phosphorylated tau were non-significant.

DISCUSSION
In these populations, dementia prevalence is strikingly low, reflecting modestly low incidence and shortened life expectancy after diagnosis. Next steps include delineating vascular contributions versus Alzheimer’s disease pathology in dementia cases.

Highlights

  • Incidence and especially prevalence of dementia are low in Indigenous Bolivians.
  • Dementia cases have shortened life expectancy, contributing to lower prevalence.
  • Apolipoprotein E ε4 is a risk factor for incident dementia.
  • A subsistence lifestyle with low vascular risk factors may be protective.
  • Results may shed light on the evolution of dementia and its risk factors.
医療・健康
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