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Risk Estimates of Dementia by Apolipoprotein E Genotypes From a Population-Based Incidence Study: The Rotterdam Study
Open accessAbstract
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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“To date, APOE remains the only locus repeatedly associated with AAO8,9, but PICALM and BIN1 have also been reported to affect AAO6,10,11.”
From A common haplotype lowers PU.1 expression in myeloid cells and delays onset of Alzheimer's disease (2017) · cites this paper as [9]
Experimental — accuracy not yet measuredIn the citing paper
“Genetic studies show that a number of genes that have been linked to early-onset AD risk are expressed primarily in microglia.”
From Microglial signatures and their role in health and disease (2018) · cites this paper as [130]
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Sepulveda-Diaz, J. E. (2013) · theses.fr (ABES) · doi:10.70675/56c42bcbz41dfz432bzbb78z77110b373285
The Association Between APOE Genotype, Race, and Dementia
Lakomski, N., Giorgio, K., Stephen, J. J., Mansolf, M. A., Soumaré, A., Gross, A. L., Aiello, A. E., Singh‐Manoux, A., Ikram, M. A., Helmer, C., et al. (2026) · Neurology Genetics · doi:10.1212/nxg.0000000000200417
“10,11,14 Furthermore, previous studies with results on all APOE genotypes were case-control studies 6,8,31-33 or used a mixture of study designs which included participants recruited from clinics/hospitals and autopsies/brain banks.”
Family History of Dementia in an Essential Tremor Cohort
Louis, E. D., & Stephanie, C. (2026) · Tremor and Other Hyperkinetic Movements · doi:10.5334/tohm.1289
Newman, S. F. (2009) · UKnowledge (University of Kentucky)
Liquormarker Aß 1-42, T-Tau und P-Tau in der Differenzialdiagnostik der Demenzen
Kaerst, L. (2014) · eDiss (Georg-August-Universität Göttingen) · doi:10.53846/goediss-4595
Die Alzheimer-Krankheit: Molekulare Grundlagen und Therapieansätze
Finckh, U., Höck, C., & Nitsch, R. M. (2004) · Springer eBooks · doi:10.1007/978-3-642-18741-4_6
Older Adults With Limited Literacy Are at Increased Risk for Likely Dementia
Kaup, A. R., Simonsick, E. M., Harris, T. B., Satterfield, S., Metti, A. L., Ayonayon, H. N., Rubin, S. M., & Yaffe, K. (2014) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/glt176 · Cited by 59
“Possession of at least one APOE ε4 allele is a well-established risk factor for the development of dementia, with possession of two ε4 alleles placing individuals at even greater risk (28,29).”
BackgroundA unifying hypothesis of alzheimer’s disease: III—Risk factors
Heininger, K. (2000) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/(sici)1099-1077(200001)15:1
Metadata
- Authors
- Slooter, A. J. C., Cruts, M., Kalmijn, S., Hofman, A., Breteler, M. M. B., Van Broeckhoven, C., & van Duijn, C. M.
- Affiliations
- Erasmus MC (NL)
- University of Antwerp (BE)
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 1998-07-01
- Volume
- 55
- Issue
- 7
- Pages
- 964
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2134448489
- Cited by
- 399
- References
- 31
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 7 · 2023: 8 · 2022: 14 · 2021: 10 · 2020: 16 · 2019: 9 · 2018: 9 · 2017: 15 · 2016: 10 · 2015: 18 · 2014: 18 · 2013: 25 · 2012: 15
- FWCI
- 8.48
- Type
- journal article
- Language
- en
- Open access
- green
- pure.eur.nl
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
- Keywords
- dementia, Alzheimer's disease, apolipoprotein E, APOE ε4, genetic risk factors, dementia incidence, attributable fraction, family history of dementia, Rotterdam Study
- MeSH terms
- Aged, Aged, 80 and over, Alzheimer Disease, Apolipoproteins E, Dementia, Female, Genotype, Humans, Male, Middle Aged, Netherlands, Incidence, Odds Ratio, Case-Control Studies, Risk Assessment
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