Risk of dementia among white and African American relatives of patients with Alzheimer disease

Robert C. Green, L. Adrienne Cupples, Rodney Go, Kelly S. Benke, Timi Edeki, Patrick A. Griffith, Mary Williams, Yvonne Hipps, Neill R Graff Radford, David Bachman, Lindsay A. Farrer

Research output: Contribution to journalArticle

235 Citations (Scopus)

Abstract

Context: Evidence exists that the incidence of Alzheimer disease (AD), as well as risk attributable to specific genetic factors such as apolipoprotein E (APOE) genotype, may vary considerably among ethnic groups. Family studies of probands with AD offer an opportunity to evaluate lifetime risk of dementia among relatives of these probands. Objective: To compare lifetime dementia risk estimates among relatives of white and African American probands with probable or definite AD. Design and Setting: Risk analysis using data collected by questionnaire and supplemental records between May 1991 and March 2001 at 17 medical centers contributing to the Multi-Institutional Research in Alzheimer's Genetic Epidemiology Study. Participants: A total of 17639 first-degree biological relatives and 2474 spouses of 2339 white AD probands, and 2281 first-degree biological relatives and 257 spouses of 255 African American AD probands. Main Outcome Measures: Cumulative risk of dementia by age 85 years, stratified by ethnicity and sex of relatives and by APOE genotype of probands. Results: Cumulative risk of dementia in first-degree biological relatives of African American AD probands by age 85 years was 43.7% (SE, 3.1%), and the corresponding risk in first-degree biological relatives of white AD probands was 26.9% (SE, 0.8%), yielding a relative risk (RR) of 1.6 (95% confidence interval [Cl], 1.4-1.9; P<.001). The risk in spouses of African American AD probands of 18.5% (SE, 8.4%) was also higher than the risk in white spouses of 10.4% (SE, 1.7%) but did not reach statistical significance (RR, 1.8; 95% Cl, 0.5-6.0; P=.34), likely due to the smaller sample size of African Americans. The proportional increase in risk of dementia among white first-degree biological relatives compared with white spouses of 2.6 (95% Cl, 2.1-3.2) was similar to that of 2.4 (95% Cl, 1.3-4.4) in African American first-degree biological relatives compared with African American spouses. Female first-degree biological relatives of probands had a higher risk of developing dementia than did their male counterparts, among whites (31.2% vs 20.4%; RR, 1.5; 95% Cl, 1.3-1.7; P<.001) as well as among African Americans, although this was not significant among African Americans (46.7% vs 40.1%; RR, 1.2; 95% Cl, 0.9-1.7, P=.30). The patterns of risk among first-degree biological relatives stratified by APOE genotype of the probands were similar in white families and African American families. Conclusion: First-degree relatives of African Americans with AD have a higher cumulative risk of dementia than do those of whites with AD. However, in this study, the additional risk of dementia conferred by being a first-degree relative, by being female, or by the probability of having an APOE ε4 allele appeared similar in African American and white families. These data provide estimates of dementia risk that can be used to offer counseling to family members of patients with AD.

Original languageEnglish (US)
Pages (from-to)329-336
Number of pages8
JournalJournal of the American Medical Association
Volume287
Issue number3
StatePublished - Jan 16 2002

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African Americans
Dementia
Alzheimer Disease
Spouses
Apolipoproteins E
Genotype
Apolipoprotein E4
Molecular Epidemiology
Ethnic Groups
Sample Size

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Green, R. C., Cupples, L. A., Go, R., Benke, K. S., Edeki, T., Griffith, P. A., ... Farrer, L. A. (2002). Risk of dementia among white and African American relatives of patients with Alzheimer disease. Journal of the American Medical Association, 287(3), 329-336.

Risk of dementia among white and African American relatives of patients with Alzheimer disease. / Green, Robert C.; Cupples, L. Adrienne; Go, Rodney; Benke, Kelly S.; Edeki, Timi; Griffith, Patrick A.; Williams, Mary; Hipps, Yvonne; Graff Radford, Neill R; Bachman, David; Farrer, Lindsay A.

In: Journal of the American Medical Association, Vol. 287, No. 3, 16.01.2002, p. 329-336.

Research output: Contribution to journalArticle

Green, RC, Cupples, LA, Go, R, Benke, KS, Edeki, T, Griffith, PA, Williams, M, Hipps, Y, Graff Radford, NR, Bachman, D & Farrer, LA 2002, 'Risk of dementia among white and African American relatives of patients with Alzheimer disease', Journal of the American Medical Association, vol. 287, no. 3, pp. 329-336.
Green RC, Cupples LA, Go R, Benke KS, Edeki T, Griffith PA et al. Risk of dementia among white and African American relatives of patients with Alzheimer disease. Journal of the American Medical Association. 2002 Jan 16;287(3):329-336.
Green, Robert C. ; Cupples, L. Adrienne ; Go, Rodney ; Benke, Kelly S. ; Edeki, Timi ; Griffith, Patrick A. ; Williams, Mary ; Hipps, Yvonne ; Graff Radford, Neill R ; Bachman, David ; Farrer, Lindsay A. / Risk of dementia among white and African American relatives of patients with Alzheimer disease. In: Journal of the American Medical Association. 2002 ; Vol. 287, No. 3. pp. 329-336.
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title = "Risk of dementia among white and African American relatives of patients with Alzheimer disease",
abstract = "Context: Evidence exists that the incidence of Alzheimer disease (AD), as well as risk attributable to specific genetic factors such as apolipoprotein E (APOE) genotype, may vary considerably among ethnic groups. Family studies of probands with AD offer an opportunity to evaluate lifetime risk of dementia among relatives of these probands. Objective: To compare lifetime dementia risk estimates among relatives of white and African American probands with probable or definite AD. Design and Setting: Risk analysis using data collected by questionnaire and supplemental records between May 1991 and March 2001 at 17 medical centers contributing to the Multi-Institutional Research in Alzheimer's Genetic Epidemiology Study. Participants: A total of 17639 first-degree biological relatives and 2474 spouses of 2339 white AD probands, and 2281 first-degree biological relatives and 257 spouses of 255 African American AD probands. Main Outcome Measures: Cumulative risk of dementia by age 85 years, stratified by ethnicity and sex of relatives and by APOE genotype of probands. Results: Cumulative risk of dementia in first-degree biological relatives of African American AD probands by age 85 years was 43.7{\%} (SE, 3.1{\%}), and the corresponding risk in first-degree biological relatives of white AD probands was 26.9{\%} (SE, 0.8{\%}), yielding a relative risk (RR) of 1.6 (95{\%} confidence interval [Cl], 1.4-1.9; P<.001). The risk in spouses of African American AD probands of 18.5{\%} (SE, 8.4{\%}) was also higher than the risk in white spouses of 10.4{\%} (SE, 1.7{\%}) but did not reach statistical significance (RR, 1.8; 95{\%} Cl, 0.5-6.0; P=.34), likely due to the smaller sample size of African Americans. The proportional increase in risk of dementia among white first-degree biological relatives compared with white spouses of 2.6 (95{\%} Cl, 2.1-3.2) was similar to that of 2.4 (95{\%} Cl, 1.3-4.4) in African American first-degree biological relatives compared with African American spouses. Female first-degree biological relatives of probands had a higher risk of developing dementia than did their male counterparts, among whites (31.2{\%} vs 20.4{\%}; RR, 1.5; 95{\%} Cl, 1.3-1.7; P<.001) as well as among African Americans, although this was not significant among African Americans (46.7{\%} vs 40.1{\%}; RR, 1.2; 95{\%} Cl, 0.9-1.7, P=.30). The patterns of risk among first-degree biological relatives stratified by APOE genotype of the probands were similar in white families and African American families. Conclusion: First-degree relatives of African Americans with AD have a higher cumulative risk of dementia than do those of whites with AD. However, in this study, the additional risk of dementia conferred by being a first-degree relative, by being female, or by the probability of having an APOE ε4 allele appeared similar in African American and white families. These data provide estimates of dementia risk that can be used to offer counseling to family members of patients with AD.",
author = "Green, {Robert C.} and Cupples, {L. Adrienne} and Rodney Go and Benke, {Kelly S.} and Timi Edeki and Griffith, {Patrick A.} and Mary Williams and Yvonne Hipps and {Graff Radford}, {Neill R} and David Bachman and Farrer, {Lindsay A.}",
year = "2002",
month = "1",
day = "16",
language = "English (US)",
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pages = "329--336",
journal = "JAMA - Journal of the American Medical Association",
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TY - JOUR

T1 - Risk of dementia among white and African American relatives of patients with Alzheimer disease

AU - Green, Robert C.

AU - Cupples, L. Adrienne

AU - Go, Rodney

AU - Benke, Kelly S.

AU - Edeki, Timi

AU - Griffith, Patrick A.

AU - Williams, Mary

AU - Hipps, Yvonne

AU - Graff Radford, Neill R

AU - Bachman, David

AU - Farrer, Lindsay A.

PY - 2002/1/16

Y1 - 2002/1/16

N2 - Context: Evidence exists that the incidence of Alzheimer disease (AD), as well as risk attributable to specific genetic factors such as apolipoprotein E (APOE) genotype, may vary considerably among ethnic groups. Family studies of probands with AD offer an opportunity to evaluate lifetime risk of dementia among relatives of these probands. Objective: To compare lifetime dementia risk estimates among relatives of white and African American probands with probable or definite AD. Design and Setting: Risk analysis using data collected by questionnaire and supplemental records between May 1991 and March 2001 at 17 medical centers contributing to the Multi-Institutional Research in Alzheimer's Genetic Epidemiology Study. Participants: A total of 17639 first-degree biological relatives and 2474 spouses of 2339 white AD probands, and 2281 first-degree biological relatives and 257 spouses of 255 African American AD probands. Main Outcome Measures: Cumulative risk of dementia by age 85 years, stratified by ethnicity and sex of relatives and by APOE genotype of probands. Results: Cumulative risk of dementia in first-degree biological relatives of African American AD probands by age 85 years was 43.7% (SE, 3.1%), and the corresponding risk in first-degree biological relatives of white AD probands was 26.9% (SE, 0.8%), yielding a relative risk (RR) of 1.6 (95% confidence interval [Cl], 1.4-1.9; P<.001). The risk in spouses of African American AD probands of 18.5% (SE, 8.4%) was also higher than the risk in white spouses of 10.4% (SE, 1.7%) but did not reach statistical significance (RR, 1.8; 95% Cl, 0.5-6.0; P=.34), likely due to the smaller sample size of African Americans. The proportional increase in risk of dementia among white first-degree biological relatives compared with white spouses of 2.6 (95% Cl, 2.1-3.2) was similar to that of 2.4 (95% Cl, 1.3-4.4) in African American first-degree biological relatives compared with African American spouses. Female first-degree biological relatives of probands had a higher risk of developing dementia than did their male counterparts, among whites (31.2% vs 20.4%; RR, 1.5; 95% Cl, 1.3-1.7; P<.001) as well as among African Americans, although this was not significant among African Americans (46.7% vs 40.1%; RR, 1.2; 95% Cl, 0.9-1.7, P=.30). The patterns of risk among first-degree biological relatives stratified by APOE genotype of the probands were similar in white families and African American families. Conclusion: First-degree relatives of African Americans with AD have a higher cumulative risk of dementia than do those of whites with AD. However, in this study, the additional risk of dementia conferred by being a first-degree relative, by being female, or by the probability of having an APOE ε4 allele appeared similar in African American and white families. These data provide estimates of dementia risk that can be used to offer counseling to family members of patients with AD.

AB - Context: Evidence exists that the incidence of Alzheimer disease (AD), as well as risk attributable to specific genetic factors such as apolipoprotein E (APOE) genotype, may vary considerably among ethnic groups. Family studies of probands with AD offer an opportunity to evaluate lifetime risk of dementia among relatives of these probands. Objective: To compare lifetime dementia risk estimates among relatives of white and African American probands with probable or definite AD. Design and Setting: Risk analysis using data collected by questionnaire and supplemental records between May 1991 and March 2001 at 17 medical centers contributing to the Multi-Institutional Research in Alzheimer's Genetic Epidemiology Study. Participants: A total of 17639 first-degree biological relatives and 2474 spouses of 2339 white AD probands, and 2281 first-degree biological relatives and 257 spouses of 255 African American AD probands. Main Outcome Measures: Cumulative risk of dementia by age 85 years, stratified by ethnicity and sex of relatives and by APOE genotype of probands. Results: Cumulative risk of dementia in first-degree biological relatives of African American AD probands by age 85 years was 43.7% (SE, 3.1%), and the corresponding risk in first-degree biological relatives of white AD probands was 26.9% (SE, 0.8%), yielding a relative risk (RR) of 1.6 (95% confidence interval [Cl], 1.4-1.9; P<.001). The risk in spouses of African American AD probands of 18.5% (SE, 8.4%) was also higher than the risk in white spouses of 10.4% (SE, 1.7%) but did not reach statistical significance (RR, 1.8; 95% Cl, 0.5-6.0; P=.34), likely due to the smaller sample size of African Americans. The proportional increase in risk of dementia among white first-degree biological relatives compared with white spouses of 2.6 (95% Cl, 2.1-3.2) was similar to that of 2.4 (95% Cl, 1.3-4.4) in African American first-degree biological relatives compared with African American spouses. Female first-degree biological relatives of probands had a higher risk of developing dementia than did their male counterparts, among whites (31.2% vs 20.4%; RR, 1.5; 95% Cl, 1.3-1.7; P<.001) as well as among African Americans, although this was not significant among African Americans (46.7% vs 40.1%; RR, 1.2; 95% Cl, 0.9-1.7, P=.30). The patterns of risk among first-degree biological relatives stratified by APOE genotype of the probands were similar in white families and African American families. Conclusion: First-degree relatives of African Americans with AD have a higher cumulative risk of dementia than do those of whites with AD. However, in this study, the additional risk of dementia conferred by being a first-degree relative, by being female, or by the probability of having an APOE ε4 allele appeared similar in African American and white families. These data provide estimates of dementia risk that can be used to offer counseling to family members of patients with AD.

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