Apolipoprotein E Phenotypes, Dementia and Mortality in a Prospective Population Sample

Tilvis, Reijo S.; Strandberg, Timo; Juva, Kati

doi:10.1111/j.1532-5415.1998.tb03805.x

Cited by 75 publications

(75 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third, we found that, among noncarriers of APOE ε4, borderline diabetes led to a higher risk of Alzheimer's disease, which is in accordance with a recent report that the association between diabetes and incident Alzheimer's disease was present only in APOE ε4 -negative individuals (41). One explanation is that the strength of association between APOE ε4 and Alzheimer's disease decreases with increasing age (42,43), and APOE ε4 is also associated with excess mortality (44). Thus, it is likely that those with ε4 allele have either died or been diagnosed with dementia in this elderly population, and the observed borderline diabetes-Alzheimer's disease association among APOE ε4 allele noncarriers might be due to selective survival (45).…”

Section: Discussionsupporting

confidence: 91%

The Effect of Borderline Diabetes on the Risk of Dementia and Alzheimer’s Disease

et al. 2007

View full text Add to dashboard Cite

To verify the hypothesis that borderline diabetes may increase the risk of dementia and Alzheimer's disease, a community-based cohort of 1,173 dementia-and diabetesfree individuals aged >75 years was longitudinally examined three times to detect patients with dementia and Alzheimer's disease (Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria). Borderline diabetes was defined as a random plasma glucose level of 7.8 -11.0 mmol/l. Data were analyzed using Cox proportional hazards models. During the 9-year follow-up, 397 subjects developed dementia, including 307 Alzheimer's cases. At baseline, 47 subjects were identified with borderline diabetes. Borderline diabetes was associated with adjusted hazard ratios (95% CIs) of 1.67 (1.04 -2.67) for dementia and 1.77 (1.06 -2.97) for Alzheimer's disease; the significant associations were present after additional adjustment for future development of diabetes. Stratified analysis suggested a significant association between borderline diabetes and Alzheimer's disease only among noncarriers of APOE 4 allele. There was an interaction between borderline diabetes and severe systolic hypertension on the risk of Alzheimer's disease (P ‫؍‬ 0.04). We conclude that borderline diabetes is associated with increased risks of dementia and Alzheimer's disease; the risk effect is independent of the future development of diabetes. Borderline diabetes may interact with severe systolic hypertension to multiply the risk of Alzheimer's disease.

show abstract

Section: Discussionsupporting

confidence: 91%

The Effect of Borderline Diabetes on the Risk of Dementia and Alzheimer’s Disease

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Dementia at baseline was diagnosed as described previously. 11 The individuals were classified as healthy elderly if their subjective or objective (according to the physician) health was good or moderate, if they did not suffer from any significant clinical disease, and if they had a normal reported exercise tolerance.…”

Section: Methodsmentioning

confidence: 99%

“…ApoE phenotype was determined as described previously. 11 Dehydroepiandrosterone (DHEA) was measured with a commercial kit (Coat-A-Count DHEA-soy, Diagnostics Products). 12 The census status (100%) was determined annually until December 1998.…”

Section: Methodsmentioning

confidence: 99%

C-Reactive Protein, Cardiovascular Risk Factors, and Mortality in a Prospective Study in the Elderly

Strandberg

Tilvis

2000

ATVB

205

127

View full text Add to dashboard Cite

Abstract-Serum C-reactive protein (CRP) reflects inflammation and predicts cardiovascular disease in middle-aged individuals. We investigated CRP, risk factors, and 10-year mortality in 3 elderly cohorts (aged 75, 80, and 85 years; nϭ455) of the population-based Helsinki Ageing Study. Clinical and laboratory examinations were performed at baseline, and in 1998, CRP was measured by a sensitive method (sensitivity 0.3 mg/L) from frozen serum samples. Mortality data were retrieved from national registers. Serum CRP ranged from 0.18 to 170.0 mg/L (interquartile range 0.68 to 4.10 mg/L, median 1.60 mg/L). CRP correlated significantly with body mass index and plasma insulin and was associated with smoking at baseline. An inverse correlation was found with albumin and total and HDL cholesterol. CRP was not associated with diabetes or cardiovascular disease but was significantly (Pϭ0.015) higher in persons with (nϭ70) than without (nϭ385) dementia. During the 10-year follow-up, 61% (nϭ278) of the cohort died; half of the deaths were due to cardiovascular diseases. Mean CRP in survivors and nonsurvivors was 3.16 and 5.22 mg/L (Pϭ0.017), respectively. After controlling for age and sex, baseline CRP (per 10 mg/L) significantly predicted the 10-year total mortality (risk ratio 1.20, 95% CI 1.08 to 1.32) and cardiovascular mortality (risk ratio 1.22, 95% CI 1.10 to 1.35). Predictive value was found in the 75-year-old cohort, but it was clearly attenuated in the 80-and 85-year-old cohorts. The results indicate that CRP is associated with several cardiovascular risk factors in the elderly. CRP alone predicts overall and cardiovascular mortality, but the prediction was significant in only the 75-year-old cohort. Key Words: C-reactive protein Ⅲ mortality Ⅲ elderly C ardiovascular diseases (CVDs) are the main causes of mortality in elderly populations. The basic process of most CVD, atherosclerosis, is now considered to be partly an inflammatory disorder, 1 and this may be 1 of several possible explanations for the findings that even slightly elevated concentrations of an acute-phase reactant, C-reactive protein (CRP), have predicted coronary events in middle-aged men and women in several studies. 2-6 CRP has also been associated with CVD events 7 and mortality 8 in healthy individuals aged Ն65 years. However, there are scant data about the epidemiology and predictive value of CRP, specifically in the elderly (aged Ͼ75 years), at the population level. Therefore, we measured baseline CRP in population-based cohorts aged 75, 80, and 85 years and related it to total and CVD mortality during a 10-year follow-up. Methods

show abstract

“…For example, a population-based prospective study of individuals over age 75, revealed a relative risk for developing AD of 3.24 (95% CI, 1.67-6.25) in those possessing ApoE4. 52 However, the sensitivity (approximately 50%) and specificity (approximately 75%) for the presence of the ApoE4 genotype in diagnosing AD is insufficiently high to guide diagnosis or accurately quantify genetic risk. 52,53 …”

Section: Genetics Of Dementiamentioning

confidence: 99%

The Recognition, Assessment and Management of Dementing Disorders: Conclusions from the Canadian Consensus Conference on Dementia

Patterson

Grek

Gauthier

et al. 2001

Can. J. Neurol. Sci.

122

119

View full text Add to dashboard Cite

To develop evidence based consensus statements on which to build clinical practice guidelines for primary care physicians towards the recognition, assessment and management of dementing disorders; ii) to disseminate and evaluate the impact of these statements and guidelines built on these statements. O p t i o n s : Structured approach to assessment, including recommended laboratory tests, choices for neuroimaging and referral; management of complications (especially behaviour problems and depression) and use of cognitive enhancing agents. Potential outcomes: Consistent and improved clinical care of persons with dementia; cost containment by more selective use of laboratory investigations, neuroimaging and referrals; appropriate use of cognitive enhancing agents. E v i d e n c e : Authors of each background paper were entrusted to: perform a literature search, discover additional relevant material including references cited in retrieved articles; consult with other experts in the field and then synthesize information. Standard rules of evidence were applied. Based upon this evidence, consensus statements were developed by a group of experts, guided by a steering committee of eight individuals from the areas of Neurology, Geriatric Medicine, Psychiatry, Family Développer des énoncés consensuels basés sur les données actuelles de la science sur lesquels on puisse construire des lignes directrices cliniques pour les médecins de première ligne pour l'identification, l'évaluation et la prise en charge des patients déments; ii) diffuser et évaluer l'impact de ces énoncés et des lignes directrices basées sur ces énoncés. O p t i o n s : Une approche structurée pour l'évaluation, incluant les épreuves de laboratoire recommandées, les choix d'examens de neuroimagerie et de référence en spécialité; la prise en charge des complications (spécialement des problèmes de comportement et de dépression) et l'utilisation d'agents qui améliorent la fonction cognitive. Bénéfices potentiels: Des soins améliorés et fiables aux personnes démentes; un contrôle des coûts par une utilisation plus judicieuse des examens de laboratoire, de la neuroimagerie et de la référence en spécialité; une utilisation appropriée des agents qui améliorent la fonction cognitive. É v i d e n c e : Les auteurs de chaque article de fond ont reçu le mandat de faire une recherche de la littérature pour ajouter des informations pertinentes incluant les références citées dans ces articles; consulter d'autres experts dans ce domaine et faire une synthèse de l'information. Ces tâches ont été effectuées conformément aux normes de la preuve. Sur la foi de cette évidence, les énoncés consensuels ont été développés par un groupe d'experts, guidé par un comité de direction de huit individus des domaines de la neurologie, de la gériatrie, de la psychiatrie, de la médecine familiale, de la médecine préventive et des systèmes de santé. Va l e u r s : Des recommandations ont été développées en portant une attention particulière sur le contexte des soins de première ligne ...

show abstract

Apolipoprotein E Phenotypes, Dementia and Mortality in a Prospective Population Sample

Abstract: In a population aged 75 to 85 years, the presence of an apoE e4 allele is associated with impaired cognitive function, clinical dementia, AD, and excess 5-year mortality resulting from dementia and all causes.

Cited by 75 publications

References 23 publications

The Effect of Borderline Diabetes on the Risk of Dementia and Alzheimer’s Disease

The Effect of Borderline Diabetes on the Risk of Dementia and Alzheimer’s Disease

C-Reactive Protein, Cardiovascular Risk Factors, and Mortality in a Prospective Study in the Elderly

The Recognition, Assessment and Management of Dementing Disorders: Conclusions from the Canadian Consensus Conference on Dementia

Contact Info

Product

Resources

About