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Familial Alzheimer Disease Among Caribbean Hispanics
A Reexamination of Its Association With APOE
Stavra N. Romas, MD;
Vincent Santana, BA;
Jennifer Williamson, MS;
Alejandra Ciappa, BS;
Joseph H. Lee, PhD;
Haydee Z. Rondon, MD;
Pedro Estevez, MD;
Rafael Lantigua, MD;
Martin Medrano, MD;
Mayobanex Torres, MD;
Yaakov Stern, PhD;
Benjamin Tycko, MD, PhD;
Richard Mayeux, MD, MSc
Arch Neurol. 2002;59:87-91.
Objectives To reexamine the association between the apolipoprotein E  4 allele
(APOE 4) and familial Alzheimer disease (AD),
and to search for novel genes that may be associated with susceptibility in
Caribbean Hispanic families with a history of AD.
Methods Families were identified in Caribbean Hispanic communities in the greater
New York City area, the Dominican Republic, and Puerto Rico. Each family in
the study cohort included at least 2 living relatives with a history of dementia.
All family members underwent neuropsychological testing and medical and neurological
examinations to establish the presence or absence of dementia and to specify
the type of dementia.
Results Over a 2 -year period, 203 families were identified. Of these,
19 families had at least 1 family member with onset of dementia before age
55 years, with 8 of the 19 families showing an association with a previously
unreported presenilin mutation. Multiple cases of AD were identified in 29
families. Overall, there were 236 affected sibling pairs with AD available
for analysis. The average age at onset was 74 years. The presence of APOE 4 was strongly associated with AD.
Conclusions Both early-onset and late-onset familial AD occur in Caribbean Hispanics.
In contrast to sporadic AD, late-onset familial AD among Caribbean Hispanics
is strongly associated with APOE 4. Future
attempts to identify additional susceptibility genes should consider the effects
of APOE 4.
From the Taub Institute for Research on Alzheimer's Disease and the
Aging Brain (Drs Romas, Rondon, Estevez, Lantigua, Stern, and Mayeux, Mr Santana,
and Ms Williamson), the Gertrude H. Sergievsky Center (Drs Romas, Lee, Rondon,
Estevez, Lantigua, Stern, and Mayeux, Mr Santana, and Ms Williamson), the
Departments of Medicine (Dr Lantigua), Neurology (Drs Romas and Mayeux), Pathology
(Dr Tycko and Ms Ciappa), and Psychiatry (Dr Mayeux), College of Physicians
and Surgeons, and the Division of Epidemiology, Mailman School of Public Health
(Drs Lee and Mayeux), Columbia University, New York, NY; the Universidad Tecnologica
de Santiago, Santiago (Dr Medrano), and the Plaza de la Salud, Santo Domingo
(Dr Torres), Dominican Republic.
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