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Apolipoprotein E element 4 association with dementia in a population-based study: The Framingham Study
Abstract
Apolipoprotein E type 4 allele (apoE epsilon4) is associated with Alzheimer's disease (AD) in the late-onset familial form and in sporadic cases, but the age-associated risk in a randomly sampled elderly population is not established. We examined the association of apoE epsilon4 with AD and other dementias (mainly multi-infarct or dementia following stroke) in 1,030 persons aged 71 to 100 years in the population-based Framingham Study cohort. Kaplan-Meier survival analysis revealed that 55% of the apoE epsilon4/epsilon4 homozygotes developed AD by age 80, whereas 27% of apoE epsilon3/epsilon4 heterozygotes developed AD by age 85, and 9% of those without a 4 allele developed AD by age 85 years. In comparison with persons without a 4 allele, the risk ration for AD was 3.7 (95% CI = 1.9 to 7.5) for apoE epsilon3/epsilon4 heterozygotes and 30.1 (95% CI = 10.7 to 84.4) for apoE epsilon4 homozygotes. ApoE epsilon2 (2/2, 2/3, or 2/4 genotypes) was associated with an absence of AD. One-half (n=21) of the 43 AD patients were either homozygous or heterozygous for apoE epsilon4. We found evidence for an association of apoE epsilon4 with other dementia, primarily multi-infarct dementia and stroke. The risk ratio was 2.3 (95% CI = 0.9 to 6.1) for non-AD dementias among persons with apoE epsilon3/epsilon4. Although the apoE epsilon4 allele is a potent risk factor for AD and may be associated with other forms of dementia, most apoE epsilon4 carriers do not develop dementia, and about one-ha…
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“Being homozygous or heterozygous for the ⑀4 allele increases the risk of LOAD 4-fold and lowers the age of onset of the disease (4,5).”
From Molecular Basis for Increased Risk for Late-onset Alzheimer Disease Due to the Naturally Occurring L28P Mutation in Apolipoprotein E4 (2014) · cites this paper as [5]
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Domoto‐Reilly, K., Flanagan, M. E., & Grabowski, T. J. (2019) · Springer eBooks · doi:10.1007/978-3-030-03283-8_6 · Cited by 3
Richens, J. L., Bramble, J. P., Spencer, H. L., Cantlay, F., Butler, M., & O’Shea, P. (2016) · Global Medical Genetics · doi:10.3934/genet.2016.1.25 · Cited by 3
Parkinsonism-Plus Syndromes and Secondary Parkinsonian Disorders
Fahn, S., Jankovic, J. J., Hallett, M., & Jenner, P. G. (2007) · Elsevier eBooks · doi:10.1016/b978-0-443-07941-2.50013-9 · Cited by 3
Critical Intersections and Engagements
Parker, R. (2012) · Duke University Press eBooks · doi:10.1215/9780822395478-013 · Cited by 3
Cognitive Impairment and Rehabilitation in Alzheimer’s Disease
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Genetic Testing in the Early Diagnosis of Alzheimer’s Disease
Blacker, D., & Tanzi, R. E. (2000) · Humana Press eBooks · doi:10.1007/978-1-59259-005-6_5 · Cited by 3
Genomic insights into the etiology of Alzheimer's disease: a review
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de León‐González, E. D., Hermosillo, H. G., Rodrígez, J. A. C., Romero, M. A. R., Camacho‐Luis, A., Corona, R. P., Nava, J. A. B., Valles, J. A. R., & Pérez, H. E. T. (2013) · Medicina Clínica · doi:10.1016/j.medcli.2013.07.031 · Cited by 2
Atypical parkinsonism, parkinsonism-plus syndromes, and secondary parkinsonian disorders
Fahn, S., Jankovic, J. J., & Hallett, M. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4377-2369-4.00009-3 · Cited by 2
An AS‐qPCR‐based method for the detection of Alzheimer's disease‐related SNPs
Chen, J., Shi, B., Li, Y., Feng, Y., Ni, J., Shi, J., Luo, C., Wang, J., & Tian, J. (2022) · Journal of Cellular Biochemistry · doi:10.1002/jcb.30350 · Cited by 2
Xiong, C., Gao, F., Yan, Y., Luo, J. R., Sung, Y., & Shi, G. (2008) · Journal of Modern Applied Statistical Methods · doi:10.22237/jmasm/1209615780 · Cited by 2
Lee, E.-G., Leong, L., Chen, S., Tulloch, J., & Yu, C. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms27010302 · Cited by 1
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Getting at Anthropology through Medical History
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Risk Assessment for Complications of Diabetes Mellitus
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Metadata
- Authors
- Myers, R. H., Schaefer, E. J., Wilson, P. W. F., D'Agostino, R., Ordovas, J. M., Espino, A., Au, R., White, R. F., Knoefel, J. E., Cobb, J. L., McNulty, K. A., Beiser, A., & Wolf, P. A.
- Affiliations
- Boston University (US)
- Venue
- Neurology
- Published
- 1996-03
- Volume
- 46
- Issue
- 3
- Pages
- 673-677
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W1972509050
- Cited by
- 346
- References
- 30
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 1 · 2023: 4 · 2022: 10 · 2021: 12 · 2020: 5 · 2019: 10 · 2018: 8 · 2017: 6 · 2016: 6 · 2015: 13 · 2014: 11 · 2013: 16 · 2012: 24
- FWCI
- 16.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc038038-022)
- National Institute on Aging (2-R01-AG08122-06, R01AG008122)
- National Heart, Lung, and Blood Institute (N01-HC-38038)
- 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 › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- APOE ε4, Alzheimer's disease, dementia, multi-infarct dementia, stroke, genetic risk factors, APOE genotype, Framingham Heart Study, older adults, positive predictive value, genetic screening
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alleles, Alzheimer Disease, Apolipoproteins E, Base Sequence, Dementia, Female, Humans, Longitudinal Studies, Male, Middle Aged, Molecular Sequence Data, Sensitivity and Specificity, Cohort Studies, Molecular Probes, Incidence, Odds Ratio, Apolipoprotein E4
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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