ABSTRACT
A number of autoimmune diseases and immune-related conditions were investigated in a series of 100 Alzheimer patients and their families. The group was divided into those who had familial dementia of the Alzheimer type and non-familial dementia of the Alzheimer type. HLA DR3 was associated with the familial dementia of the Alzheimer type patients. Adult exposure to tuberculosis appeared to be a risk factor for familial dementia of the Alzheimer type patients. Autoimmune diseases clustered among the non-familial dementia of the Alzheimer type patients, and also among their relatives. Asthma and infertility were also significantly increased among non-familial dementia of the Alzheimer type relatives. The analysis showed that (1) autoimmunity may be important in the sporadic form of Alzheimer disease; (2) it may be possible to confer a decreased risk for Alzheimer disease among relatives when many autoimmune diseases occur in the family; (3) it may be important to assess environmental risk factors for Alzheimer disease separately in patients with familial and sporadic disease; and (4) the efficacy of drug therapies may be dependent on whether the patients have a familial or sporadic form of Alzheimer disease.
Subject(s)
Alzheimer Disease/genetics , Alzheimer Disease/immunology , Autoimmune Diseases/immunology , Age of Onset , Aged , Alzheimer Disease/epidemiology , Asthma/epidemiology , Autoimmune Diseases/genetics , Female , HLA-DR3 Antigen/analysis , Humans , Infertility/epidemiology , Male , Risk Factors , Tuberculosis, PulmonaryABSTRACT
The history of civil commitment procedures is reviewed, with an analysis of the origins of commitment authority. Views contrary to involuntary hospitalization are presented. The author argues for the retention of these procedures, with an emphasis upon the parens patriae approach.