APOE and genetic risk variants influence Alzheimer's disease onset in carriers of an extra copy of APP, with and without Down syndrome
Joan Groeneveld (Amsterdam Neuroscience, Vrije Universiteit Amsterdam)
Danna Perlaza (Network Center for Biomedical Research in Neurodegenerative Diseases(CIBERNED, Hospital de la Santa Creu i Sant Pau)
Clàudia Olivé (Universitat de Barcelona, Universitat Internacional de Catalunya)
Lou Grangeon (Normandie University)
N. Tesi (Vrije Universiteit Amsterdam, TU Delft - Electrical Engineering, Mathematics and Computer Science)
Aude Nicolas (University of Lille)
Chenyang Jiang (Vrije Universiteit Amsterdam, Amsterdam Neuroscience)
Itziar de Rojas (Universitat Internacional de Catalunya, Network Center for Biomedical Research in Neurodegenerative Diseases(CIBERNED)
More Authors (External organisation)
David Wallon (Normandie University)
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Abstract
INTRODUCTION
An extra copy of the amyloid precursor protein (APP) gene causes autosomal dominant Alzheimer's disease (AD) and AD in Down syndrome (DS), but the factors underlying variability in age at onset (AAO) remain unclear. We investigated whether sporadic AD risk variants modify AAO.
METHODS
We analyzed clinical and genetic data from 100 APP duplication (APPdup) carriers and 957 individuals with DS. Cox models assessed associations of apolipoprotein E (APOE) ε2 and ε4 and the AD genetic risk score (AD-GRS; excluding APOE and chromosome 21 variants) with AAO.
RESULTS
Mean AAO was earlier in APPdup than DS (51 ± 7 vs. 53 ± 6 years; P = 0.0005). APOE ε2 delayed onset (hazard ratio [HR] = 0.47, P < 0.0001), whereas APOE ε4 (HR = 1.5, P = 0.0003) and higher AD-GRS (HR = 1.3 per standard deviation, P < 0.0001) accelerated onset. Predicted median AAO differed by 10 years between lowest and highest genetic risk.
DISCUSSION
Sporadic AD genetic risk factors are important modifiers of AAO in APPdup and DS, explaining part of the marked variability in onset.
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