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JAMA. 1997 Mar 12;277(10):822-4.

Apolipoprotein E epsilon4 and incidence of Alzheimer disease in a community population of older persons.

Author information

1
Rush Alzheimer's Disease Center, Chicago, IL 60612, USA.

Abstract

OBJECTIVE:

To examine the relation between apolipoprotein E status and risk of Alzheimer disease (AD) in a defined population and estimate the fraction of incident AD attributable to the epsilon4 allele.

DESIGN:

Community-based cohort study.

SETTING:

East Boston, Mass.

PARTICIPANTS:

A random sample of 578 community residents aged 65 years and older free of AD.

MAIN OUTCOME MEASURE:

Clinical diagnosis of AD by uniform, structured evaluation.

RESULTS:

The increased risk of AD associated with the presence of the epsilon4 allele was less than that found in most family and case-control studies. Persons with the epsilon4/epsilon4 or epsilon3/epsilon4 genotypes had 2.27 (95% confidence interval, 1.06-4.89) times the risk of incident disease compared with those with the epsilon3/epsilon3 genotype. The epsilon4 allele accounted for a fairly small fraction of the incidence of AD; if the allele did not exist or had no effect on disease risk, the incidence would be reduced by only 13.7%. The effect of the epsilon4 allele on risk of AD did not appear to vary with age.

CONCLUSIONS:

The apolipoprotein E epsilon4 allele is an important genetic risk factor for AD but accounts for a fairly small fraction of disease occurrence in this population-based study. Continued efforts to identify other environmental and genetic risk factors are warranted.

Comment in

  • ACP J Club. 1997 Sep-Oct;127(2):49.
PMID:
9052713
[Indexed for MEDLINE]

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