[Show abstract][Hide abstract] ABSTRACT: The ApoE gene is associated with the risk of Alzheimer or cardiovascular disease but its influence on exceptional longevity (EL) is uncertain. Our primary purpose was to determine, using a case-control design, if the ApoE gene is associated with EL. We compared ApoE allele/genotype frequencies among the following cohorts: cases (centenarians, most with 1 + major disease condition; n = 163, 100-111y) and healthy controls (n = 1039, 20-85y) from Spain; disease-free cases (centenarians; n = 79, 100-104y) and healthy controls (n = 597, age 27-81y) from Italy; and cases (centenarians and semi-supercentenarians, most with 1 + major disease condition; n = 729, 100-116) and healthy controls (n = 498, 23-59y) from Japan. Our main findings were two-fold. First, the ε4-allele was negatively associated with EL in the three cohorts, with the following odds ratio (OR) values (adjusted by sex) been found: 0.55 (95% confidence interval (CI): 0.33, 0.94), P = 0.030 (Spain); 0.41 (95%CI: 0.18, 0.99), P = 0.05 (Italy); and 0.35 (95%CI: 0.26, 0.57), P < 0.001 (Japan). Second, although no association was found in the Spanish cohort (OR = 1.42 (95%CI: 0.89, 2.26), P = 0.145), the ε2-allele was positively associated with EL in the Italian (OR = 2.14 (95%CI: 1.18, 3.45), P = 0.01) and Japanese subjects (OR = 1.81 (95%CI: 1.25, 2.63), P = 0.002). Notwithstanding the limitations of case-control designs, our data suggest that the ApoE might be a candidate to influence EL. The ε4-allele appears to decrease the likelihood of reaching EL among individuals of different ethnic/geographic origins. An additional, novel finding of our study was that the ε2-allele might favor EL, at least in the Italian and Japanese cohorts.
[Show abstract][Hide abstract] ABSTRACT: JUSTIFICATIVA E OBJETIVOS: A doença de Alzheimer é um problema de saúde pública em razão do envelhecimento populacional. Há diversos fatores de risco e proteção para a doença de Alzheimer com estudos recentes relevantes. A etapa principal do diagnóstico dessa forma de demência é o exame clínico associado a testes de rastreio cognitivo. Apesar disso, aproximadamente 50% dos clínicos não fazem diagnóstico de demência em estágio inicial. Esta revisão narrativa abrangente pretende atualizar a epidemiologia, fatores de risco e proteção para a doença e como fazer seu diagnóstico. CONTEÚDO: Foram revisadas as informações mais rele-vantes na epidemiologia e diagnóstico da doença de Alzhei-mer presentes em consensos e estudos originais encontra-dos nos bancos de dados da PubMed e LILACS. CONCLUSÃO: O diagnóstico clínico ainda é o ponto cha-ve para o diagnóstico dessa forma de demência, excluindo seus diagnósticos diferenciais. Testes de rastreio cognitivo como o Mini-Exame do Estado Mental e o Teste do dese-nho do relógio são muito importantes para o diagnóstico de pacientes em estado inicial. Descritores: diagnóstico, doença de Alzheimer, epidemiologia. SUMMARY BACKGROUND AND OBJECTIVES: Alzheimer´s disea-se is a public health problem because of population ageing.
[Show abstract][Hide abstract] ABSTRACT: The objective of this meta-analysis was to determine the association of the apolipoprotein E (ApoE) gene with exceptional longevity (EL, i.e. reaching 100+years), by identifying possible unequal distribution of alleles/genotypes in the common variants ε2, ε3 and ε4 among centenarians and younger population. The association of ApoE with EL was analysed in a total of 2,776 centenarians (cases) and 11,941 younger controls (from 13 case-control studies) using the chi-square test with the Yates correction. We conducted combined and separate analyses for all ethnic groups studied in the literature (Caucasian and Asian). The main result for all ethnic groups combined was that the likelihood of reaching EL was negatively associated with ε4-allele carriage [pooled odds ratio (OR)=0.43; 95% confidence interval (CI): 0.36, 0.50; P<0.001] and with ε4/ε4 (OR= 0.18; 95%CI: 0.08, 0.39; P<0.001), ε3/ε4 (OR=0.44; 95%CI: 0.37, 0.53; P<0.001) and ε2/ε4 genotypes (OR=0.48; 95%CI: 0.31, 0.74; P<0.001). In contrast, the ε2/ε3 genotype was positively associated with EL (OR=1.35; 95%CI: 1.06, 1.72; P=0.017). When compared with ε3-allele, the ε2-allele was not associated with increased odds of EL (OR=1.08; 95%CI: 0.77, 1.50, P=0.660). The present meta-analysis confirms that, besides its previously documented influence on Alzheimer's and cardiovascular disease risk, the ApoE gene is associated with the likelihood of reaching EL.
Rejuvenation Research 11/2014; 18(1). DOI:10.1089/rej.2014.1605 · 2.92 Impact Factor
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