(Stroke. 1996;27:1310-1315.)
© 1996 American Heart Association, Inc.
Articles |
Apolipoprotein E Polymorphism and Stroke in a Population Sample Aged 75 Years or More
the Karolinska Institute, Department of Clinical Neuroscience and Family Medicine, Huddinge University Hospital, Huddinge (H.B., E.H.C., Z.G., L.L., B.W., M.V.); the Stockholm Gerontology Research Center, Stockholm (H.B., E.H.C., Z.G., M.V., B.W.), Sweden; and the Center for Demographic Studies, Duke University, Durham, NC (E.H.C., L.S.C., K.G.M.).
Correspondence to Hans Basun, MD, PhD, Karolinska Institute, Department of Clinical Neuroscience and Family Medicine, Division of Geriatric Medicine B56, Huddinge University Hospital, S-141 86 Huddinge, Sweden.
Background and Purpose We investigated apolipoprotein E polymorphism stroke risk in a population sample of 1810 persons aged 75 years or more in Stockholm (the Kungsholmen Project). Information on cognition at cohort inception (from 1987 to 1989) and on stroke occurrence (from 1969 to 1994) is available for the cohort. In the cohort, cognitive impairment is associated with the 
4 allele, and longer survival in subjects aged 
85 years with good cognition is associated with the 2 allele and the absence of 4.
Methods We compared stroke incidence in the 1077 of 1124 genotyped subjects who carried 2/3, 3/3, or 3/4 and estimated the proportion of cognitive impairment attributable to stroke.
Results Risk of stroke did not vary with apolipoprotein E polymorphism (P=.82): 24% of 87 incident stroke patients during follow-up compared with 25% of 827 subjects with normal cognition and no stroke diagnosis at baseline carried the 3/4 genotype. An estimated 9% of cognitive impairment was attributable to stroke. Notably, a reduced 3/4 frequency of 20% was found in subjects who survived a prior stroke and were included in the cohort, and risk of hemorrhagic stroke tended to be associated with the presence of the 3/4 genotype and the absence of 2/3.
Conclusions This population-based study indicates that apolipoprotein E polymorphism is not a risk factor for ischemic stroke in subjects aged 75 years (although it might possibly influence survival after stroke occurrence and be a risk factor for infrequent hemorrhagic stroke) and that approximately 10% of cognitive impairment in this age group is attributable to stroke.
Key Words: aged • amyloid • apolipoproteins • cerebral hemorrhage • dementia
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|
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|
|
|
|
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|
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