• JAMA · Mar 1998

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

    • M X Tang, Y Stern, K Marder, K Bell, B Gurland, R Lantigua, H Andrews, L Feng, B Tycko, and R Mayeux.
    • Gertrude H. Sergievsky Center, Division of Biostatistics, Columbia University College of Physicians and Surgeons and Columbia-Presbyterian Medical Center, New York, NY 10032, USA.
    • JAMA. 1998 Mar 11; 279 (10): 751755751-5.

    ContextAlthough 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.ObjectiveTo investigate the association between the APOE-epsilon4 allele and AD in elderly African Americans, Hispanics, and whites.DesignProspective, population-based, longitudinal study over a 5-year period (1991-1996).SettingThe Washington Heights-Inwood community of New York City.ParticipantsA total of 1079 Medicare recipients without AD or a related disorder at baseline.Main Outcome MeasuresRisk of clinically diagnosed AD in the 3 ethnic groups and among individuals with and without an APOE-epsilon4 allele.ResultsCompared 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.ConclusionThe 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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