Dementia risk scores, apolipoprotein E, and risk of Alzheimer's disease: One size does not fit all

痴呆风险评分、载脂蛋白 E 和阿尔茨海默病风险:没有统一的解决方案

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作者:Shea J Andrews, Ana I Boeriu, Michael E Belloy, Alan E Renton, Brian Fulton-Howard, Willa D Brenowitz, Kristine Yaffe; Alzheimer's Disease Neuroimaging Initiative

Discussion

Our findings underscore the importance of evaluating the validity of dementia risk scores in diverse populations for their use in personalized medicine approaches to promote brain health. Highlights: Dementia risk scores demonstrate race/ethnic-specific effects on dementia risk. Unfavorable modifiable risk profiles moderate the effect of APOE on dementia risk. Dementia risk scores need to be validated in diverse populations.

Methods

We analyzed the association of the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) and modified CAIDE (mCAIDE) scores with dementia risk using logistic regression models stratified by race/ethnicity in National Alzheimer's Coordinating Center (NACC) and Alzheimer's Disease Neuroimaging Initiative (ADNI), and assessed their interaction with apolipoprotein E (APOE).

Results

Higher CAIDE scores were associated with an increased risk of dementia in Asian, Latinx, and NLW participants but not in Black participants. In contrast, higher mCAIDE scores were also associated with an increased risk of dementia in Black participants. Unfavorable mCAIDE risk profiles exacerbated the apolipoprotein E*ε4 (APOE*ε4) risk effect and attenuated the APOE*ε2 protective effect.

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