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Apolipoprotein E 4 and Risk of Mortality in African American and White Older Community Residents

^a Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
^b Department of Psychiatry and Behavioral Sciences, Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
^c Division of Neurology, Department of Medicine, Duke University Medical Center, Durham, NC
^d Center for Health Policy/Law and Management, Duke University Medical Center, Durham, NC

Correspondence: Gerda G. Fillenbaum, PhD, Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3003, Durham, NC 27710. E-mail: ggf{at}geri.duke.edu.

Decision Editor: Laurence G. Branch, PhD

Purpose: The goal of this study was to determine whether the 4 allele of apolipoprotein E is predictive of mortality in a community-based sample. Design and Methods: Of the stratified random household sample of 4,162 participants age 65 years and older enrolled in the Duke site of the Established Populations for Epidemiologic Studies of the Elderly, those included in the present study were the 1,998 who were genotyped for apolipoprotein E (alleles 2, 3, and 4) six years after baseline, and for whom survival status eight years later was known by search of the National Death Index. Information on demographic characteristics, physical and mental health status, functional status, and health services use was determined by structured questionnaires administered in person in the home. Results: The 4 allele did not predict mortality for the group as a whole, or for those who were cognitively impaired. It did predict mortality for those who reported having had a heart attack or stroke. Implications: The apolipoprotein 4 allele—although a risk factor for Alzheimer's disease, heart disease, and stroke—was only found to be a risk factor for mortality for those community residents who had had a heart attack or stroke. Otherwise, for this community-based sample, 71 years of age and older, it did not predict time to death and was not a risk factor for mortality.

Key Words: Apolipoprotein E • Mortality • Race • African American • White

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