TY - JOUR
T1 - Incidence of Alzheimer disease in a biracial urban community
T2 - Relation to apolipoprotein E allele status
AU - Evans, Denis A.
AU - Bennett, David A.
AU - Wilson, Robert S.
AU - Bienias, Julia L.
AU - Morris, Martha Clare
AU - Scherr, Paul A.
AU - Hebert, Liesi E.
AU - Aggarwal, Neelum
AU - Beckett, Laurel A
AU - Joglekar, Rajiv
AU - Berry-Kravis, Elizabeth
AU - Schneider, Julie
PY - 2003/2/1
Y1 - 2003/2/1
N2 - Context: Few studies compare Alzheimer disease (AD) incidence among black and white subjects. Objective: To estimate incidence and the effect of the apolipoprotein E (APOE) ε4 allele in these races. Design: Population-based study of disease incidence using a random, stratified sample. Setting: A geographically defined community of 3 adjacent neighborhoods in Chicago, Ill. Participants: A total of 6158 persons (78.7% overall; 80.5% of the black subjects and 74.6% of the white subjects) participated; 4.1 years later, persons initially free of AD were sampled for clinical evaluation for disease incidence (overall 842 persons [74.8%] participated; 67.6% of the black subjects and 81.9% of the white subjects). Interventions: None. Main Outcome Measure: Incident, clinically diagnosed AD. Results: The effect of the APOE ε4 allele on the risk of AD differed strongly for black and white subjects. Among white subjects, the presence of the APOE ε4 allele was associated with a 2.73-fold (95% confidence interval [CI], 1.40-5.32) increase in risk while among black subjects there was no increase in risk (odds ratio, 1.02; 95% confidence interval, 0.39-2.68). Black race was associated with a nonsignificantly increased risk of AD with an odds ratio of 1.84 (95% CI, 0.734.66) if APOE and its interaction with race are considered, and an odds ratio of 1.28 (95% CI, 0.54-2.98) if they are not. The incidence of AD was 1.45% (95% CI, 0.89%-2.01%) per year among persons 65 to 74 years old, 4.73% (95% CI, 3.83%-5.64%) among those 75 to 84 years old, and 9.11% (95% CI, 7.36%-10.9%) among those 85 years and older. Conclusion: Apolipoprotein E ε4 led to increased risk of AD among white subjects but not black subjects.
AB - Context: Few studies compare Alzheimer disease (AD) incidence among black and white subjects. Objective: To estimate incidence and the effect of the apolipoprotein E (APOE) ε4 allele in these races. Design: Population-based study of disease incidence using a random, stratified sample. Setting: A geographically defined community of 3 adjacent neighborhoods in Chicago, Ill. Participants: A total of 6158 persons (78.7% overall; 80.5% of the black subjects and 74.6% of the white subjects) participated; 4.1 years later, persons initially free of AD were sampled for clinical evaluation for disease incidence (overall 842 persons [74.8%] participated; 67.6% of the black subjects and 81.9% of the white subjects). Interventions: None. Main Outcome Measure: Incident, clinically diagnosed AD. Results: The effect of the APOE ε4 allele on the risk of AD differed strongly for black and white subjects. Among white subjects, the presence of the APOE ε4 allele was associated with a 2.73-fold (95% confidence interval [CI], 1.40-5.32) increase in risk while among black subjects there was no increase in risk (odds ratio, 1.02; 95% confidence interval, 0.39-2.68). Black race was associated with a nonsignificantly increased risk of AD with an odds ratio of 1.84 (95% CI, 0.734.66) if APOE and its interaction with race are considered, and an odds ratio of 1.28 (95% CI, 0.54-2.98) if they are not. The incidence of AD was 1.45% (95% CI, 0.89%-2.01%) per year among persons 65 to 74 years old, 4.73% (95% CI, 3.83%-5.64%) among those 75 to 84 years old, and 9.11% (95% CI, 7.36%-10.9%) among those 85 years and older. Conclusion: Apolipoprotein E ε4 led to increased risk of AD among white subjects but not black subjects.
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U2 - 10.1001/archneur.60.2.185
DO - 10.1001/archneur.60.2.185
M3 - Article
C2 - 12580702
AN - SCOPUS:0037318496
VL - 60
SP - 185
EP - 189
JO - Archives of Neurology
JF - Archives of Neurology
SN - 0003-9942
IS - 2
ER -