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February 25, 1998

Effects of Age and Ethnicity on the Link Between APOE ∊4 and Alzheimer Disease

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(8):580-582. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-8-jbk0225

To the Editor.—Dr Farrer and colleagues1 provide evidence for a strong association between APOE polymorphisms and Alzheimer disease (AD) risk in Caucasian and Japanese populations. In contrast, the combined ORs for AD in African Americans with all genotypes (other than 2 ∊4 alleles) were not significantly different from 1.0. The authors attributed the weak APOE∊4–AD association in African Americans to differences in study design with variable demographic characteristics, sampling strategies, and degrees of diagnostic consistency. Another possible explanation is that the presence of a single ∊4 allele was an AD risk factor in some African Americans and not in others. Such a variable pattern of association can be obscured when studied with small samples that are combined in a meta-analysis.

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