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Risk estimates of dementia by apolipoprotein E genotypes from a population-based incidence study: the Rotterdam Study.

Abstract

OBJECTIVES

To provide risk estimates of dementia and Alzheimer disease as a function of the apolipoprotein E (APOE) genotypes and to assess the proportion of dementia that is attributable to the APOE genotypes.

DESIGN

Case-control study nested in a population-based cohort study with a mean (SD) follow-up of 2.1 (0.9) years.

SETTING

General population in Rotterdam, the Netherlands.

PARTICIPANTS

A total of 134 patients with incident dementia and a random sample of 997 nondemented control subjects. No participant had dementia at baseline.

MAIN OUTCOME MEASURES

Odds ratios for dementia and Alzheimer disease, the fraction of dementia attributable to the APOE epsilon4 allele, and the proportion of the variance in age at the onset of dementia explained by the APOE genotypes.

RESULTS

Persons with the epsilon4/4 genotype had a more than 10-fold higher risk of dementia (odds ratio, 11.2; 95% confidence interval, 3.6-35.2), and subjects with the epsilon3/4 genotype had a 1.7-fold increased risk of dementia (95% confidence interval, 1.0-2.9) as compared with persons with the epsilon3/3 genotype. The proportion of patients with dementia that is attributable to the epsilon4 allele was estimated to be 20%. The APOE genotypes explained up to 10% of the variance in age at the onset of dementia. The association between the epsilon4 allele and dementia was strongest in the youngest age category and in those with a family history of dementia.

CONCLUSIONS

The APOE genotype is an important determinant of the risk of dementia. At a population level, however, other factors than the APOE genotype may play an important role in the cause of dementia.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands. slooter@epib.fgg.eur.nl

    , , , , ,

    Source

    Archives of neurology 55:7 1998 Jul pg 964-8

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Apolipoproteins E
    Case-Control Studies
    Dementia
    Female
    Genotype
    Humans
    Incidence
    Male
    Middle Aged
    Netherlands
    Odds Ratio
    Risk Assessment

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    9678314

    Citation

    Slooter, A J., et al. "Risk Estimates of Dementia By Apolipoprotein E Genotypes From a Population-based Incidence Study: the Rotterdam Study." Archives of Neurology, vol. 55, no. 7, 1998, pp. 964-8.
    Slooter AJ, Cruts M, Kalmijn S, et al. Risk estimates of dementia by apolipoprotein E genotypes from a population-based incidence study: the Rotterdam Study. Arch Neurol. 1998;55(7):964-8.
    Slooter, A. J., Cruts, M., Kalmijn, S., Hofman, A., Breteler, M. M., Van Broeckhoven, C., & van Duijn, C. M. (1998). Risk estimates of dementia by apolipoprotein E genotypes from a population-based incidence study: the Rotterdam Study. Archives of Neurology, 55(7), pp. 964-8.
    Slooter AJ, et al. Risk Estimates of Dementia By Apolipoprotein E Genotypes From a Population-based Incidence Study: the Rotterdam Study. Arch Neurol. 1998;55(7):964-8. PubMed PMID: 9678314.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Risk estimates of dementia by apolipoprotein E genotypes from a population-based incidence study: the Rotterdam Study. AU - Slooter,A J, AU - Cruts,M, AU - Kalmijn,S, AU - Hofman,A, AU - Breteler,M M, AU - Van Broeckhoven,C, AU - van Duijn,C M, PY - 1998/7/25/pubmed PY - 1998/7/25/medline PY - 1998/7/25/entrez SP - 964 EP - 8 JF - Archives of neurology JO - Arch. Neurol. VL - 55 IS - 7 N2 - OBJECTIVES: To provide risk estimates of dementia and Alzheimer disease as a function of the apolipoprotein E (APOE) genotypes and to assess the proportion of dementia that is attributable to the APOE genotypes. DESIGN: Case-control study nested in a population-based cohort study with a mean (SD) follow-up of 2.1 (0.9) years. SETTING: General population in Rotterdam, the Netherlands. PARTICIPANTS: A total of 134 patients with incident dementia and a random sample of 997 nondemented control subjects. No participant had dementia at baseline. MAIN OUTCOME MEASURES: Odds ratios for dementia and Alzheimer disease, the fraction of dementia attributable to the APOE epsilon4 allele, and the proportion of the variance in age at the onset of dementia explained by the APOE genotypes. RESULTS: Persons with the epsilon4/4 genotype had a more than 10-fold higher risk of dementia (odds ratio, 11.2; 95% confidence interval, 3.6-35.2), and subjects with the epsilon3/4 genotype had a 1.7-fold increased risk of dementia (95% confidence interval, 1.0-2.9) as compared with persons with the epsilon3/3 genotype. The proportion of patients with dementia that is attributable to the epsilon4 allele was estimated to be 20%. The APOE genotypes explained up to 10% of the variance in age at the onset of dementia. The association between the epsilon4 allele and dementia was strongest in the youngest age category and in those with a family history of dementia. CONCLUSIONS: The APOE genotype is an important determinant of the risk of dementia. At a population level, however, other factors than the APOE genotype may play an important role in the cause of dementia. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/9678314/Risk_estimates_of_dementia_by_apolipoprotein_E_genotypes_from_a_population_based_incidence_study:_the_Rotterdam_Study_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/vol/55/pg/964 DB - PRIME DP - Unbound Medicine ER -