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Risk in Children When Both Parents Have Alzheimer Disease

Suman Jayadev, MD; Ellen J. Steinbart, RN, MA; Yueh-Yun Chi, PhD; Walter A. Kukull, PhD; Gerard D. Schellenberg, PhD; Thomas D. Bird, MD

Arch Neurol. 2008;65(3):373-378.

Background  There is limited information regarding children's risk of Alzheimer disease (AD) if both parents are affected.

Objective  To determine the risk of AD in families in which both parents have AD.

Design  Retrospective study.

Setting  University research center.

Participants  A total of 111 families in which both parents had a clinical diagnosis of AD.

Main Outcome Measure  Frequency of AD in the children of spouses with AD.

Results  The 111 couples with AD had 297 children surviving to adulthood; 22.6% of these adult children have developed AD. The risk of AD in these children increases with age, being 31.0% (58 of 187) in those older than 60 years and 41.8% (41 of 98) in those older than 70 years. Many children (79.0%) at risk in these families are still younger than 70 years, meaning that the occurrence of AD will increase in the coming years. A family history of AD beyond the parents did not change the risk of AD in the children but did reduce the median age at onset in affected children. The apolipoprotein E 4 allele played an important part in this phenomenon but did not explain all cases of AD in the children.

Conclusions  When both parents have AD, there is an increased risk of AD in their children beyond that of the general population. The role of family history and the specific genes involved in this phenomenon require a better definition.

Author Affiliations: Departments of Neurology (Drs Jayadev, Schellenberg, and Bird and Ms Steinbart), Epidemiology (Drs Chi and Kukull), and Biostatistics (Drs Chi and Kukull), University of Washington, Seattle; Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (Drs Schellenberg and Bird); and Departments of Epidemiology and Health Policy Research, University of Florida, Gainesville (Dr Chi).

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