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P3‐068: Serum hsCRP predicts 3‐year change in attention function in cognitively intact older women: The cognitive change in women ancillary study to the women's health initiative
Author(s) -
Dunn Julie E.,
Harty Brian,
Stoddard Anne M.,
Weintraub Sandra
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1562
Subject(s) - cognition , medicine , effects of sleep deprivation on cognitive performance , cognitive decline , dementia , depression (economics) , cognitive test , gerontology , clinical psychology , psychiatry , disease , economics , macroeconomics
Background: The e4 allele of Apolipoprotein E (APOE) is associated with late-onset familial and sporadic Alzheimer’s disease (AD). Attributable risk due to APOE e4 is not globally constant, partly because of variation in the frequency of this allele by region and race/ethnicity. Methods: To estimate the prevalence of APOE e4 carrier proportions by geographical area among AD patients, we conducted a literature review of the published literature and meta-analysis. Publications using autopsy or randomized clinical trial study designs were searched from 1993, while community-based studies were restricted to those published from 2003. Results: In spite of highly heterogeneous results, e4 proportions appear to vary by region for the community-based studies with Asian (37%, 31-43% mean and 95% confidence interval) and Southern European/Mediterranean studies (43%, 40-46%), appearing to have significantly lower e4 carrier status proportions than North American (58%, 51-64%) or Northern European (64%, 60-68%) studies. Attempts to explain variance further by study design and case definition revealed differences upon stratification. Community-based studies had a lower carrier proportion (47%, 44-50%) when compared with autopsy-based studies (59%, 54-63) and randomized clinical trials (63%, 58-69%). Studies using the NINCDS-ADRDA of ‘‘probable/definite’’ AD were observed to have e4 carriers in 52% (49-55%) of subjects, while including ‘‘possible’’ AD had e4 carrier proportion of 48% (44-53%). Conclusions: This literature review reveals that APOE e4 genotype frequency varies among AD patients in regional patterns similar to that of the general population. Study level data such as study design and case definition may also contribute to the heterogeneity of published estimates of APOE e4 carrier proportions among AD cases.