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Jill R. Murrell, PhD; Brandon Price, MS; Kathleen A. Lane, MS; Olusegun Baiyewu, MBBS; Oye Gureje, MBBS, PhD, DSc; Adesola Ogunniyi, MB, ChB; Frederick W. Unverzagt, PhD; Valerie Smith-Gamble, MD; Sujuan Gao, PhD; Hugh C. Hendrie, MB, ChB; Kathleen S. Hall, PhD

Arch Neurol. 2006;63:431-434.

Background  Alzheimer disease (AD) is the most frequent cause of dementia. Even though the incidence of AD in the African American population is similar to or higher than that in persons of European descent, AD in African Americans is understudied. Identification of genetic risk factors in African Americans is essential for understanding the etiology of AD.

Objective  To determine the effect of apolipoprotein E (APOE) genotype on the risk of AD in elderly African Americans.

Design  Population-based longitudinal study of AD.

Setting  Indianapolis, Ind.

Participants  African Americans 65 years and older.

Main Outcome Measures  APOE genotype and diagnosis of AD.

Results  The APOE genotype was determined in 1822 samples. Of these, 690 were clinically evaluated: 318 were normal, and 162 had a diagnosis of AD. The presence of APOE 4 was significantly associated with increased risk of AD (3/4: OR, 2.32; 95% confidence interval [CI], 1.41-3.82; and 4/4: OR, 7.19; 95% CI, 3.00-17.29, compared with the 3/3 genotype). There was also a significant protective effect with APOE 2 (2/2 and 2/3: OR, 0.42; 95% CI, 0.20-0.89).

Conclusions  These findings are in marked contrast to the lack of association between APOE and AD in the Ibadan, Nigeria, sample of this project. These results suggest that other genetic factors and different environmental influences may play a role in the risk for AD in individuals of African ancestry.

Author Affiliations: Departments of Pathology and Laboratory Medicine (Dr Murrell and Mr Price), Medicine (Ms Lane and Dr Gao), and Psychiatry (Drs Unverzagt, Smith-Gamble, Hendrie, and Hall), Indiana University School of Medicine, Indianapolis; and Departments of Psychiatry (Drs Baiyewu and Gureje) and Medicine (Dr Ogunniyi), University of Ibadan, Ibadan, Nigeria.

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