Incidence of dementia and association with APOE genotype in older Cubans

Abstract

ObjectiveIn an admixed population of older Cubans, the incidence and association of APOE and sociodemographic risk factors with dementia incidence was estimated.MethodsA single-phase survey (baseline) of all over 65-year-olds residing in seven catchment areas in Cuba (n=2944) was conducted between 2003 and 2007. Dementia diagnosis was established according to DSM-IV and 10/66 criteria. APOE genotype was determined in 2520 participants. An incidence wave was conducted 4.5 years after cohort inception in order to estimate incidence and associations with sociodemographic risk factors of the APOE ε4 genotype.ResultsThe incidence rate of DSM IV dementia was 9.0 per 1000 person-years (95% CI 7.2-11.3) and of 10/66 dementia was 20.5 per 1000 person-years (95% CI, 17.6-23.5). Older age, a family history of dementia and APOE ε4 genotype were independent risk factors for incident 10/66 dementia. APOE genotype was associated cross-sectionally with dementia prevalence, but the effect on the incidence of dementia was attenuated, and only apparent among those in the youngest age group.ConclusionThe incidence of dementia in the older Cuban population is relatively high and similar to levels reported in Europe and North-America. The study showed that the relationship between APOE ε4 and incident dementia is stronger in the younger-old than the older-old and that this change must be taken into account in models of dementia.

Incidence of dementia in a population cohort of older people from São Paulo, Brazil

“…Similar to the other Brazilian study 18 and few international studies, [33][34][35][36] which showed low rates around the world, the total incidence rate, 11.2 per 1000 person-years, is not in concordance with the high dementia prevalence in the same study 13 and others in the same country 14,15 and continental region. 37 On the other hand, the high incidence rates among younger individuals corroborated the Latin American data on dementia prevalence 9 and were expressively higher than the rates observed in other worldwide incidence studies, 7,[38][39][40][41][42] including those from middle-income countries 43 and Brazil, 18 especially among women (Figure 2).…”

APOE alleles’ association with cognitive function differs across Hispanic/Latino groups and genetic ancestry in the study of Latinos‐investigation of neurocognitive aging (HCHS/SOL)

“…Cubans in our analytic dataset are also older (a risk factor for cognitive decline) and more educated (a protective factor for cognitive decline) compared to the other Latino backgrounds; however, our models controlled for age and education. A previous study conducted in Cubans from Cuba also reported an association between APOE ε4 and incident of dementia with a stronger effect in middle‐aged adults (<70 years) compared to older adults (>70 years) 38 …”

Genetics of dementia: insights from Latin America

“…The effects of ethnic identity, genetic admixture of APOE genotypes, and its association with dementia prevalence and incidence have been explored. In a 10/66 study report, Llibre-Rodriguez et al 51 described the APOE status in 2520 participants, with genetic admixture in 235 dementia cases and 349 controls. They concluded that APOE ( 4 allele carriage is associated with an increased prevalence and incidence of dementia in populations characterized by African/European admixture.…”