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The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics.

Abstract

CONTEXT

Although the association between Alzheimer disease (AD) and the apolipoprotein E epsilon4 (APOE-epsilon4) allele has been confirmed worldwide, it appears to be inconsistent among African Americans, Hispanics, and Nigerians.

OBJECTIVE

To investigate the association between the APOE-epsilon4 allele and AD in elderly African Americans, Hispanics, and whites.

DESIGN

Prospective, population-based, longitudinal study over a 5-year period (1991-1996).

SETTING

The Washington Heights-Inwood community of New York City.

PARTICIPANTS

A total of 1079 Medicare recipients without AD or a related disorder at baseline.

MAIN OUTCOME MEASURES

Risk of clinically diagnosed AD in the 3 ethnic groups and among individuals with and without an APOE-epsilon4 allele.

RESULTS

Compared with individuals with the APOE-epsilon3/epsilon3 genotype, the relative risk (RR) of AD associated with 1 or more copies of the APOE-epsilon4 allele was significantly increased among whites (RR, 2.5; 95% confidence interval [CI], 1.1-6.4), but not among African Americans (RR, 1.0; 95% CI, 0.6-1.6) or Hispanics (RR, 1.1; 95% CI, 0.7-1.6). In the absence of the APOE-epsilon4 allele, the cumulative risks of AD to age 90 years, adjusted for education and sex, were 4 times higher for African Americans (RR, 4.4; 95% CI, 2.3-8.6) and 2 times higher for Hispanics (RR, 2.3; 95% CI, 1.2-4.3) than for whites. In the presence of an APOE-epsilon4 allele, the cumulative risk of AD to age 90 years was similar for individuals in all 3 ethnic groups.

CONCLUSION

The presence of an APOE-epsilon4 allele is a determinant of AD risk in whites, but African Americans and Hispanics have an increased frequency of AD regardless of their APOE genotype. These results suggest that other genes or risk factors may contribute to the increased risk of AD in African Americans and Hispanics.

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  • Authors+Show Affiliations

    ,

    Gertrude H. Sergievsky Center, Division of Biostatistics, Columbia University College of Physicians and Surgeons and Columbia-Presbyterian Medical Center, New York, NY 10032, USA.

    , , , , , , , ,

    Source

    JAMA 279:10 1998 Mar 11 pg 751-5

    MeSH

    African Continental Ancestry Group
    Aged
    Aged, 80 and over
    Alleles
    Alzheimer Disease
    Apolipoproteins E
    European Continental Ancestry Group
    Female
    Gene Frequency
    Hispanic Americans
    Humans
    Longitudinal Studies
    Male
    Proportional Hazards Models
    Prospective Studies
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    9508150

    Citation

    Tang, M X., et al. "The APOE-epsilon4 Allele and the Risk of Alzheimer Disease Among African Americans, Whites, and Hispanics." JAMA, vol. 279, no. 10, 1998, pp. 751-5.
    Tang MX, Stern Y, Marder K, et al. The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics. JAMA. 1998;279(10):751-5.
    Tang, M. X., Stern, Y., Marder, K., Bell, K., Gurland, B., Lantigua, R., ... Mayeux, R. (1998). The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics. JAMA, 279(10), pp. 751-5.
    Tang MX, et al. The APOE-epsilon4 Allele and the Risk of Alzheimer Disease Among African Americans, Whites, and Hispanics. JAMA. 1998 Mar 11;279(10):751-5. PubMed PMID: 9508150.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The APOE-epsilon4 allele and the risk of Alzheimer disease among African Americans, whites, and Hispanics. AU - Tang,M X, AU - Stern,Y, AU - Marder,K, AU - Bell,K, AU - Gurland,B, AU - Lantigua,R, AU - Andrews,H, AU - Feng,L, AU - Tycko,B, AU - Mayeux,R, PY - 1998/3/21/pubmed PY - 2001/8/14/medline PY - 1998/3/21/entrez SP - 751 EP - 5 JF - JAMA JO - JAMA VL - 279 IS - 10 N2 - CONTEXT: Although the association between Alzheimer disease (AD) and the apolipoprotein E epsilon4 (APOE-epsilon4) allele has been confirmed worldwide, it appears to be inconsistent among African Americans, Hispanics, and Nigerians. OBJECTIVE: To investigate the association between the APOE-epsilon4 allele and AD in elderly African Americans, Hispanics, and whites. DESIGN: Prospective, population-based, longitudinal study over a 5-year period (1991-1996). SETTING: The Washington Heights-Inwood community of New York City. PARTICIPANTS: A total of 1079 Medicare recipients without AD or a related disorder at baseline. MAIN OUTCOME MEASURES: Risk of clinically diagnosed AD in the 3 ethnic groups and among individuals with and without an APOE-epsilon4 allele. RESULTS: Compared with individuals with the APOE-epsilon3/epsilon3 genotype, the relative risk (RR) of AD associated with 1 or more copies of the APOE-epsilon4 allele was significantly increased among whites (RR, 2.5; 95% confidence interval [CI], 1.1-6.4), but not among African Americans (RR, 1.0; 95% CI, 0.6-1.6) or Hispanics (RR, 1.1; 95% CI, 0.7-1.6). In the absence of the APOE-epsilon4 allele, the cumulative risks of AD to age 90 years, adjusted for education and sex, were 4 times higher for African Americans (RR, 4.4; 95% CI, 2.3-8.6) and 2 times higher for Hispanics (RR, 2.3; 95% CI, 1.2-4.3) than for whites. In the presence of an APOE-epsilon4 allele, the cumulative risk of AD to age 90 years was similar for individuals in all 3 ethnic groups. CONCLUSION: The presence of an APOE-epsilon4 allele is a determinant of AD risk in whites, but African Americans and Hispanics have an increased frequency of AD regardless of their APOE genotype. These results suggest that other genes or risk factors may contribute to the increased risk of AD in African Americans and Hispanics. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/9508150/The_APOE_epsilon4_allele_and_the_risk_of_Alzheimer_disease_among_African_Americans_whites_and_Hispanics_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/279/pg/751 DB - PRIME DP - Unbound Medicine ER -