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Racial and Ethnic Differences in the Population-Attributable Fractions of Alzheimer Disease and Related Dementias
Open accessAbstract
BACKGROUND AND OBJECTIVES: Previous studies estimated that modifiable risk factors explain up to 40% of the dementia cases in the United States and that this population-attributable fraction (PAF) differs by race and ethnicity-estimates of future impact based on the risk factor prevalence in contemporary surveys. The aim of this study was to determine the race-specific and ethnicity-specific PAF of late-onset Alzheimer disease and related dementias (ADRDs) based on the risk factor prevalence and associations observed on the same individuals within a prospective cohort. METHODS: ε4 for a subset. RESULTS: ε4, which together with nongenetic risk factors accounted for 30.6% (25.8-35.1) of ADRD. DISCUSSION: Known risk factors explained about a third of the ADRD cases but with unequal distributions across racial and ethnic groups.
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“By contrast, reported estimates of the population attributable fraction of dementia for these modifiable risk factors, meaning the percentage of dementia cases that could be prevented if each factor was eliminated from the population, are higher in Black and Hispanic people than in white and Asian people, which points to complex genome × environment interactions34,35.”
From Multifaceted roles of APOE in Alzheimer disease (2024) · cites this paper as [34]
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1 retracted
Dementia prevention, intervention, and care: 2020 report of the Lancet Commission
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30367-6 · Cited by 10,430 · cited 2×
“7 They based their estimate on global risk factor data for the 2010s and risk factor associations with dementia (relative risks) derived from meta-analyses of published population-based cohort studies or trials. by relative risk estimates from meta-analyses of either ADRD or all-cause dementia,…”
RetractedInequalities in dementia incidence between six racial and ethnic groups over 14 years
Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., & Whitmer, R. A. (2016) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2015.12.007 · Cited by 883
Nianogo, R. A., Rosenwohl-Mack, A., Yaffe, K., Carrasco, A., Hoffmann, C. M., & Barnes, D. E. (2022) · JAMA Neurology · doi:10.1001/jamaneurol.2022.0976 · Cited by 269 · cited 4×
“8,9 fi Ha-waiian (29.3%), and African American (27.8”
InfluentialRajan, K. B., Weuve, J., Barnes, L. L., Wilson, R. S., & Evans, D. A. (2019) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2018.07.216 · Cited by 245
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Chen, Y., Tysinger, B., Crimmins, E., & Zissimopoulos, J. M. (2019) · Alzheimer's & Dementia: Translational Research & Clinical Interventions · doi:10.1016/j.trci.2019.04.003 · Cited by 129
Self-citationIncidence of Dementia and Alzheimer Disease Over Time: A Meta‐Analysis
Gao, S., Burney, H. N., Callahan, C. M., Purnell, C. E., & Hendrie, H. C. (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16027 · Cited by 104
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Cited by
Sorted by citations
Multifaceted roles of APOE in Alzheimer disease
Jackson, R. J., Hyman, B. T., & Serrano-Pozo, A. (2024) · Nature Reviews Neurology · doi:10.1038/s41582-024-00988-2 · Cited by 193
Metadata
- Authors
- Park, S.-Y., Setiawan, V. W., Crimmins, E. M., White, L. R., Wu, A. H., Cheng, I., Darst, B. F., Haiman, C. A., Wilkens, L. R., Le Marchand, L., & Lim, U.
- Affiliations
- University of Southern California (US)
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White),...
- ORCID
- Venue
- Neurology
- Published
- 2024-02-13
- Volume
- 102
- Issue
- 3
- Pages
- e208116-e208116
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC11097758
- OpenAlex
- W4390936560
- Cited by
- 33
- References
- 7
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 6
- FWCI
- 8.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (CA164973)
- National Institute on Aging (R01AG060110, P30AG017265)
- National Cancer Institute (CA164973, U01CA164973)
- 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
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- Alzheimer's disease and related dementias, late-onset dementia, population attributable fraction, racial and ethnic disparities, APOE ε4, modifiable risk factors
- MeSH terms
- Aged, Alzheimer Disease, Female, Medicare, Humans, Male, Middle Aged, Prospective Studies, United States, Cohort Studies, Apolipoprotein E4
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- Park, S.-Y., Setiawan, V. W., Crimmins, E. M., White, L. R., Wu, A. H., Cheng, I., Darst, B. F., Haiman, C. A., Wilkens, L. R., Le Marchand, L., & Lim, U. (2024). Racial and Ethnic Differences in the Population-Attributable Fractions of Alzheimer Disease and Related Dementias. Neurology. https://doi.org/10.1212/wnl.0000000000208116
