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. 2008 Jan;65(1):89-93.
doi: 10.1001/archneurol.2007.29.

Enhanced risk for Alzheimer disease in persons with type 2 diabetes and APOE epsilon4: the Cardiovascular Health Study Cognition Study

Fumiko Irie  1 , Annette L Fitzpatrick, Oscar L Lopez, Lewis H Kuller, Rita Peila, Anne B Newman, Lenore J Launer
Affiliations

Enhanced risk for Alzheimer disease in persons with type 2 diabetes and APOE epsilon4: the Cardiovascular Health Study Cognition Study

Fumiko Irie et al. Arch Neurol. 2008 Jan.

Abstract

Background: Diabetes and the apolipoprotein E epsilon4 allele (APOE epsilon4) increase the risk for Alzheimer disease (AD). We hypothesize that APOE epsilon4 may modify the risk for AD in individuals with diabetes.

Objective: To examine the joint effect of type 2 diabetes and APOE epsilon4 on the risk of AD, AD with vascular dementia (mixed AD), and vascular dementia without AD.

Design: The Cardiovascular Health Study (CHS) Cognition Study (1992-2000) is a prospective study designed to identify all existing and new cases of dementia among study participants. Diagnoses were made according to international criteria for dementia and subtypes. There were 2547 dementia-free participants in the CHS Cognition Study cohort with complete information on APOE epsilon4 and type 2 diabetes status; among these, 411 new cases of dementia developed. Risk of dementia was estimated with a Cox proportional hazard model adjusted for age and other demographic and cardiovascular risk factors.

Results: Compared with those who had neither type 2 diabetes nor APOE epsilon4, those with both factors had a significantly higher risk of AD (hazard ratio, 4.58; 95% confidence interval, 2.18-9.65) and mixed AD (hazard ratio, 3.89; 95% confidence interval, 1.46-10.40).

Conclusion: These data suggest that having both diabetes and APOE epsilon4 increases the risk of dementia, especially for AD and mixed AD.

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Figures

Figure.
Figure.
Kaplan-Meier log-rank test for equality of developing dementia, stratified by diabetes mellitus (DM) and the ε4 allele of the apolipoprotein E genotype (APOE ε4): χ32=64.9 (P< .001 ). Sixty-five years is the start age for dementia risk.
See this image and copyright information in PMC

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