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Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study
Kivipelto M, Rovio S, Ngandu T, Kåreholt I, Eskelinen M, Winblad B, Hachinski V, Cedazo-Minguez A et al.. Journal of cellular and molecular medicine, 2008-02-08
Topic: Amyloid, tau and blood-test diagnosis
The risk of dementia and Alzheimer's disease (AD) probably results from an interaction between genetic and environmental factors. The aim of this study was to investigate the effects and putative interactions between the apoE epsilon4 allele and lifestyle related risk factors for dementia and AD. Participants of the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study were derived from random, population-based samples previously studied in 1972, 1977, 1982 or 1987. After an average follow-up of 21 years, 1449 individuals (72.5%) aged 65-79 years were re-examined in 1998. The apoE epsilon4 allele was an independent risk factor for dementia/AD even after adjustments for sociodemographic, lifestyle and vascular factors (odds ratio [OR]=2.83, 95% confidence interval [CI]=1.61-4.97). Physical inactivity, alcohol drinking and smoking increased the risk of dementia/AD particularly among the apoE epsilon4 carriers. Furthermore, low-moderate intake of polyunsaturated, and moderate-high intake of saturated fats were associated with an increased risk of dementia/AD more pronouncedly among apoE epsilon4 carriers. Composite effect of the lifestyle factors was particularly seen among the epsilon4 carriers (OR=11.42, 95% CI=1.94-67.07 in the 4th quartile). Physical inactivity, dietary fat intake, alcohol drinking and smoking at midlife are associated with the risk of dementia and AD, especially among the apoE epsilon4 carriers. The apoE epsilon4 carriers may be more vulnerable to environmental factors, and thus, lifestyle interventions may greatly modify dementia risk particularly among the genetically susceptible individuals.
Key findings
- The risk of dementia and Alzheimer's disease (AD) probably results from an interaction between genetic and environmental factors.
- Furthermore, low-moderate intake of polyunsaturated, and moderate-high intake of saturated fats were associated with an increased risk of dementia/AD more pronouncedly among apoE epsilon4 carriers.
- Physical inactivity, dietary fat intake, alcohol drinking and smoking at midlife are associated with the risk of dementia and AD, especially among the apoE epsilon4 carriers.
Why it matters
Carrying the APOE epsilon4 allele was an independent risk factor for dementia and Alzheimer's disease, and lifestyle factors like physical inactivity, alcohol drinking, smoking, and dietary fat increased risk especially among carriers. This concerns risk factors, not treatment or cure.
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Study details
- Participants1,449
- Effect size72.5%; OR=11.42
- Evidence strengthLow
How this study scored 58/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of cellular and molecular medicine) |
| Journal's citation record | 2 / 4 | Journal of Cellular and Molecular Medicine: journal h-index 187 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2008 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,449 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 349 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 17.4 citations a year over 20 year(s) since 2008 |
| Impact for its field and year | 4 / 6 | Cited 9.6× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 18 other studies in this library |
| Still being cited | 2 / 4 | Cited 40 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Aulikki M. Nissinen: h-index 86 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 18318693) |
| Free to read | 2 / 2 | Free to read |
| Total | 58 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1111/j.1582-4934.2008.00296.x
- PubMed: 18318693
- Original source →
- Free full text: Journal of Cellular and Molecular Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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.
APA 7th
Kivipelto, M., Rovio, S., Ngandu, T., Kåreholt, I., Eskelinen, M., Winblad, B., et al. (2008). Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. Journal of cellular and molecular medicine. https://doi.org/10.1111/j.1582-4934.2008.00296.x
Vancouver
Kivipelto M, Rovio S, Ngandu T, Kåreholt I, Eskelinen M, Winblad B, et al. Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. Journal of cellular and molecular medicine. 2008. doi:10.1111/j.1582-4934.2008.00296.x. PMID: 18318693.
BibTeX
@article{kivipelto2008-18318693,
author = {Kivipelto, M. and Rovio, S. and Ngandu, T. and Kåreholt, I. and Eskelinen, M. and Winblad, B. and Hachinski, V. and Cedazo-Minguez, A. and others},
title = {{Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study}},
journal = {Journal of cellular and molecular medicine},
year = {2008},
doi = {10.1111/j.1582-4934.2008.00296.x},
pmid = {18318693},
url = {https://doi.org/10.1111/j.1582-4934.2008.00296.x}
}
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