TY - JOUR
T1 - Apolipoprotein E ε4 and the risk of dementia with stroke
T2 - A population- based investigation
AU - Slooter, Arjen J.C.
AU - Tang, Ming Xin
AU - Van Duijn, Cornelia M.
AU - Stern, Yaakov
AU - Ott, Alewijn
AU - Bell, Karen
AU - Breteler, Monique M.B.
AU - Van Broeckhoven, Christine
AU - Tatemichi, Thomas K.
AU - Tycko, Benjamin
AU - Hofman, Albert
AU - Mayeux, Richard
PY - 1997/3/12
Y1 - 1997/3/12
N2 - Objective.-To investigate the association between the apolipoprotein E (APOE) genotypes and dementia in patients with stroke, defined as either vascular dementia (VaD) or Alzheimer disease with cerebrovascular disease (AD with CVD). Design and Setting.-Population-based, case-control study from Rotterdam, the Netherlands, and New York City. Participants.-A total of 187 patients with dementia and stroke were compared with 507 controls similar in age and ethnic group. Main Outcome Measures.-The APOE allele frequencies in patients and controls; the odds ratio of dementia with stroke, VaD, and AD with CVD, adjusted for age, sex, residency, and education; and the percent attributable risk related to the APOE ε4 allele. Results.-Overall, patients with dementia and stroke had a higher APOEε4 allele frequency than controls. Compared with APOE ε3 homozygote individuals, APOEε4 homozygotes had a 7- fold increased risk of dementia with stroke (OR=6.9; 95% CI, 1.6-29.4), while APOε4 heterozygotes had nearly a 2-fold increase in risk (OR=1.8; 95% CI, 1.2-2.7). Risks associated with APOEε4 were elevated regardless of the subtype of dementia with stroke or age or sex. The percent attributable risk related to the APOE ε4 allele among demented patients with stroke was 41% overall, 33% among those with VaD, and 44% among those with AD with CVD. Conclusion.-The APOE ε4 allele is a genetic risk factor for dementia with stroke, including VaD and AD with CVD. This may imply shared genetic susceptibility to dementia associated with stroke and AD. Alternatively, the category of patients with dementia and stroke, including VaD as currently defined, may include patients with AD.
AB - Objective.-To investigate the association between the apolipoprotein E (APOE) genotypes and dementia in patients with stroke, defined as either vascular dementia (VaD) or Alzheimer disease with cerebrovascular disease (AD with CVD). Design and Setting.-Population-based, case-control study from Rotterdam, the Netherlands, and New York City. Participants.-A total of 187 patients with dementia and stroke were compared with 507 controls similar in age and ethnic group. Main Outcome Measures.-The APOE allele frequencies in patients and controls; the odds ratio of dementia with stroke, VaD, and AD with CVD, adjusted for age, sex, residency, and education; and the percent attributable risk related to the APOE ε4 allele. Results.-Overall, patients with dementia and stroke had a higher APOEε4 allele frequency than controls. Compared with APOE ε3 homozygote individuals, APOEε4 homozygotes had a 7- fold increased risk of dementia with stroke (OR=6.9; 95% CI, 1.6-29.4), while APOε4 heterozygotes had nearly a 2-fold increase in risk (OR=1.8; 95% CI, 1.2-2.7). Risks associated with APOEε4 were elevated regardless of the subtype of dementia with stroke or age or sex. The percent attributable risk related to the APOE ε4 allele among demented patients with stroke was 41% overall, 33% among those with VaD, and 44% among those with AD with CVD. Conclusion.-The APOE ε4 allele is a genetic risk factor for dementia with stroke, including VaD and AD with CVD. This may imply shared genetic susceptibility to dementia associated with stroke and AD. Alternatively, the category of patients with dementia and stroke, including VaD as currently defined, may include patients with AD.
UR - http://www.scopus.com/inward/record.url?scp=0030614814&partnerID=8YFLogxK
M3 - Article
C2 - 9052712
AN - SCOPUS:0030614814
SN - 0098-7484
VL - 277
SP - 818
EP - 821
JO - Journal of the American Medical Association
JF - Journal of the American Medical Association
IS - 10
ER -