Evidence map›Paper›PMID 24481197›Full record

ArticleEvolution, medicine, and public health2013

Hygiene and the world distribution of Alzheimer's disease: Epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden.

Molly Fox, Leslie A Knapp, Paul W Andrews, Corey L Fincher

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Evolution, medicine, and public health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 51 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Article
  6. Role of environmental pollutants in Alzheimer's disease: a review.Environmental science and pollution research international · 2020
    Review
  7. How do Rural Second Homes Affect Human Health and Well-being? Review of Potential Impacts.International journal of environmental research and public health · 2020
    Review
  8. Article
  9. Gut Microbiota in Neurological Disorders.Archivum immunologiae et therapiae experimentalis · 2019
    Review
  10. Review
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Glove wearing: an assessment of the evidence.British dental journal · 2015
    Article
  18. Review
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Molly FoxDivision of Biological Anthropology, Department of Anthropology and Archaeology, University of Cambridge, Pembroke Street, Cambridge CB2 3QY, UK, Department of Anthropology, University of Utah, 270 S 1400 E, Salt Lake City, UT 84112, USA, Department of Psychology, Neuroscience & Behaviour, McMaster University, 1280 Main Street W, Hamilton, ON L8S 4K1, Canada and Institute of Neuroscience and Psychology, University of Glasgow, 58 Hillhead Street, Glasgow G12 8QB, UK.
Leslie A Knapp
Paul W Andrews
Corey L Fincher
University of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAlzheimer'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.

resultsBased 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.

Indexed as

Alzheimer’s diseaseDarwinian medicinedementiahygiene hypothesisinflammationpathogen prevalence

Identifiers

PMID24481197
PMCPMC3868447
OpenAlexW2063236656

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.