Dataset Information

Race, APOE?4, and Long-Term Cognitive Trajectories in a Biracial Population Sample.

ABSTRACT: BACKGROUND:The association of the APOE?4 allele with incident Alzheimer's dementia is higher among European Americans (EAs) than African Americans (AAs), but similar for the rate of cognitive decline. OBJECTIVE:To examine the racial differences in the association of the APOE?4 allele with incident Alzheimer's dementia and cognitive decline. METHODS:Using a population-based sample of 5,117 older adults (66% AAs and 63% females), we identified cognitive trajectory groups from a latent class mixed model and examined the association of the APOE?4 allele with these groups. RESULTS:The frequency of the APOE?4 allele was higher among AAs than EAs (37% versus 26%). Four cognitive trajectories were identified: slow, mild, moderate, and rapid. Overall, AAs had a lower baseline global cognition than EAs, and a higher proportion had rapid (7% versus 5%) and moderate (20% versus 15%) decline, but similar mild (44% versus 46%), and lesser slow (29% versus 34%) decline compared to EAs. Additionally, 25% of AAs (13% of EAs) with mild and 5% (<1% of EAs) with slow decline were diagnosed with incident Alzheimer's dementia. The APOE?4 allele was associated with higher odds of rapid and moderate decline compared to slow decline among AAs and EAs, but not with mild decline. CONCLUSIONS:AAs had lower cognitive levels and were more likely to meet the cognitive threshold for Alzheimer's dementia among mild and slow decliners, explaining the attenuated association of the ?4 allele with incident Alzheimer's dementia among AAs.

SUBMITTER: Rajan KB

PROVIDER: S-EPMC6914259 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Race, APOEɛ4, and Long-Term Cognitive Trajectories in a Biracial Population Sample.

Rajan Kumar B KB McAninch Elizabeth A EA Wilson Robert S RS Weuve Jennifer J Barnes Lisa L LL Evans Denis A DA

Journal of Alzheimer's disease : JAD 20190101 1

<h4>Background</h4>The association of the APOEɛ4 allele with incident Alzheimer's dementia is higher among European Americans (EAs) than African Americans (AAs), but similar for the rate of cognitive decline.<h4>Objective</h4>To examine the racial differences in the association of the APOEɛ4 allele with incident Alzheimer's dementia and cognitive decline.<h4>Methods</h4>Using a population-based sample of 5,117 older adults (66% AAs and 63% females), we identified cognitive trajectory groups from ...[more]

PMID: 31561363

Similar Datasets

Project description:BackgroundImproved understanding of the quality of survival of patients is crucial in evaluating trauma care, understanding recovery patterns and timeframes, and informing healthcare, social, and disability service provision. We aimed to describe the longer-term health status of seriously injured patients, identify predictors of outcome, and establish recovery trajectories by population characteristics.Methods and findingsA population-based, prospective cohort study using the Victorian State Trauma Registry (VSTR) was undertaken. We followed up 2,757 adult patients, injured between July 2011 and June 2012, through deaths registry linkage and telephone interview at 6-, 12-, 24-, and 36-months postinjury. The 3-level EuroQol 5 dimensions questionnaire (EQ-5D-3L) was collected, and mixed-effects regression modelling was used to identify predictors of outcome, and recovery trajectories, for the EQ-5D-3L items and summary score. Mean (SD) age of participants was 50.8 (21.6) years, and 72% were male. Twelve percent (n = 333) died during their hospital stay, 8.1% (n = 222) of patients died postdischarge, and 155 (7.0%) were known to have survived to 36-months postinjury but were lost to follow-up at all time points. The prevalence of reporting problems at 36-months postinjury was 37% for mobility, 21% for self-care, 47% for usual activities, 50% for pain/discomfort, and 41% for anxiety/depression. Continued improvement to 36-months postinjury was only present for the usual activities item; the adjusted relative risk (ARR) of reporting problems decreased from 6 to 12 (ARR 0.87, 95% CI: 0.83-0.90), 12 to 24 (ARR 0.94, 95% CI: 0.90-0.98), and 24 to 36 months (ARR 0.95, 95% CI: 0.95-0.99). The risk of reporting problems with pain or discomfort increased from 24- to 36-months postinjury (ARR 1.06, 95% CI: 1.01, 1.12). While loss to follow-up was low, there was responder bias with patients injured in intentional events, younger, and less seriously injured patients less likely to participate; therefore, these patient subgroups were underrepresented in the study findings.ConclusionsThe prevalence of ongoing problems at 3-years postinjury is high, confirming that serious injury is frequently a chronic disorder. These findings have implications for trauma system design. Investment in interventions to reduce the longer-term impact of injuries is needed, and greater investment in primary prevention is needed.

Dataset Information

Race, APOE?4, and Long-Term Cognitive Trajectories in a Biracial Population Sample.

Publications

Race, APOEɛ4, and Long-Term Cognitive Trajectories in a Biracial Population Sample.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure