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Risk and protective effects of the APOE gene towards Alzheimer's disease in the Kungsholmen project: variation by age and sex
- Source :
- Journal of Neurology, Neurosurgery & Psychiatry. 75:828-833
- Publication Year :
- 2004
- Publisher :
- BMJ, 2004.
-
Abstract
- The risk effect of APOE epsilon 4 allele for Alzheimer's disease is acknowledged, whereas the putative protective effect of epsilon 2 allele remains in debate.To investigate whether those inconsistent findings may be attributable to differences in age and sex composition of the study populations.A community dementia free cohort (n = 985) agedor =75 years was followed up to detect Alzheimer's disease cases (DSM-III-R criteria). Data were analysed using Cox models with adjustment for major potential confounders.Over a median 5.6 year follow up, Alzheimer's disease was diagnosed in 206 subjects. Compared with APOE epsilon 3/epsilon 3 genotype, the relative risk (RR) of Alzheimer's disease was 1.4 (95% confidence interval (CI), 1.0 to 2.0; p = 0.03) for heterozygous epsilon 4 allele and 3.1 (95% CI, 1.6 to 5.9) for homozygous epsilon 4 allele. The association between epsilon 4 allele and Alzheimer's disease risk was stronger in men than in women (RR related to the interaction term epsilon 4 allele by sex, 0.4; 95% CI, 0.2 to 0.9). The epsilon 4 allele accounted for one third of Alzheimer's disease cases among men, but only one tenth among women. The epsilon 2 allele was related to a reduced Alzheimer's disease risk mainly in people aged85 years (RR, 0.4; 95% CI, 0.2 to 0.8). The RR of Alzheimer's disease related to the interaction term of epsilon 2 allele by age was 2.4 (95% CI, 1.0 to 6.0; p = 0.06).The APOE genotype specific effects on Alzheimer's disease vary by age and sex, in which the epsilon 4 allele has a stronger risk effect in men, and the epsilon 2 allele confers a protective effect only in younger-old people.
- Subjects :
- Male
Paper
Apolipoprotein E
Gerontology
medicine.medical_specialty
Genotype
Apolipoprotein E2
Cohort Studies
Apolipoproteins E
Sex Factors
Alzheimer Disease
Risk Factors
Internal medicine
medicine
Humans
Dementia
Genetic Predisposition to Disease
Genetic Testing
Risk factor
Allele
Aged
Proportional Hazards Models
Aged, 80 and over
Sweden
Age Factors
Genetic Variation
medicine.disease
Psychiatry and Mental health
Relative risk
Female
Surgery
Neurology (clinical)
Alzheimer's disease
Psychology
Follow-Up Studies
Cohort study
Subjects
Details
- ISSN :
- 00223050
- Volume :
- 75
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology, Neurosurgery & Psychiatry
- Accession number :
- edsair.doi.dedup.....27a540775032aaaa1659252bebcaaffc