Apolipoprotein E epsilon4 and the risk of dementia with stroke. A population-based investigation
Slooter AJ, Tang MX, van Duijn CM, Stern Y, Ott A, Bell K, Breteler MM, Van Broeckhoven C et al.. JAMA, 1997-03-01
Topic: Amyloid, tau and blood-test diagnosis
Plain-language summary
Objective To investigate the association between the apolipoprotein E (APOE) genotypes and dementia in patients with stroke, defined as either vascular dementia (VaD) or Alzheimer disease with cerebrovascular disease (AD with CVD). Design and setting Population-based, case-control study from Rotterdam, the Netherlands, and New York City. Participants A total of 187 patients with dementia and stroke were compared with 507 controls similar in age and ethnic group. Main outcome measures The APOE allele frequencies in patients and controls; the odds ratio of dementia with stroke, VaD, and AD with CVD, adjusted for age, sex, residency, and education; and the percent attributable risk related to the APOE epsilon4 allele. Results Overall, patients with dementia and stroke had a higher APOE epsilon4 allele frequency than controls. Compared with APOE epsilon3 homozygote individuals, APOE epsilon4 homozygotes had a 7-fold increased risk of dementia with stroke (OR=6.9; 95% CI, 1.6-29.4), while APOE epsilon4 heterozygotes had nearly a 2-fold increase in risk (OR=1.8; 95% CI, 1.2-2.7). Risks associated with APOE epsilon4 were elevated regardless of the subtype of dementia with stroke or age or sex. The percent attributable risk related to the APOE epsilon4 allele among demented patients with stroke was 41% overall, 33% among those with VaD, and 44% among those with AD with CVD. Conclusion The APOE epsilon4 allele is a genetic risk factor for dementia with stroke, including VaD and AD with CVD. This may imply shared genetic susceptibility to dementia associated with stroke and AD. Alternatively, the category of patients with dementia and stroke, including VaD as currently defined, may include patients with AD.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Slooter, A. J., Tang, M. X., van Duijn, C. M., Stern, Y., Ott, A., Bell, K., et al. (1997). Apolipoprotein E epsilon4 and the risk of dementia with stroke. A population-based investigation. JAMA. https://doi.org/10.1001/jama.277.10.818
Vancouver
Slooter AJ, Tang MX, van Duijn CM, Stern Y, Ott A, Bell K, et al. Apolipoprotein E epsilon4 and the risk of dementia with stroke. A population-based investigation. JAMA. 1997. doi:10.1001/jama.277.10.818. PMID: 9052712.
BibTeX
@article{slooter1997-9052712,
author = {Slooter, A. J. and Tang, M. X. and van Duijn, C. M. and Stern, Y. and Ott, A. and Bell, K. and Breteler, M. M. and Van Broeckhoven, C. and others},
title = {{Apolipoprotein E epsilon4 and the risk of dementia with stroke. A population-based investigation}},
journal = {JAMA},
year = {1997},
doi = {10.1001/jama.277.10.818},
pmid = {9052712},
url = {https://doi.org/10.1001/jama.277.10.818}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Participants A total of 187 patients with dementia and stroke were compared with 507 controls similar in age and ethnic group.
- Results Overall, patients with dementia and stroke had a higher APOE epsilon4 allele frequency than controls.
- Compared with APOE epsilon3 homozygote individuals, APOE epsilon4 homozygotes had a 7-fold increased risk of dementia with stroke (OR=6.9; 95% CI, 1.6-29.4), while APOE epsilon4 heterozygotes had nearly a 2-fold increase in risk (OR=1.8; 95% CI, 1.2-2.7).
- Risks associated with APOE epsilon4 were elevated regardless of the subtype of dementia with stroke or age or sex.
- The percent attributable risk related to the APOE epsilon4 allele among demented patients with stroke was 41% overall, 33% among those with VaD, and 44% among those with AD with CVD.
Why it matters
In this population-based case-control study, people with dementia and stroke were more likely to carry the APOE epsilon4 allele, with homozygotes having about a 7-fold increased risk. This describes a risk factor for dementia with stroke, not a treatment, cure or prevention.
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Study details
- Study designcase-control study
- Participants187
- Effect sizeOR=6.9; OR=1.8
- Evidence strengthModerate
How this study scored 66/100
Published in a top-tier journal, and it is a case-control study. Scored zero for randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 6 / 12 | A case-control study |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1997 — older than 20 years, still counted |
| Sample size | 2 / 4 | 187 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 287 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.3 citations a year over 31 year(s) since 1997 |
| Impact for its field and year | 5 / 6 | Cited 21.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 17 other studies in this library |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Arjen J. C. Slooter: h-index 64 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Columbia University: institution h-index 1,824 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 9052712) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 66 / 100 | — |
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