4.6 Article

Interplay between Socioeconomic Markers and Polygenic Predisposition on Timing of Dementia Diagnosis

Journal

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 68, Issue 7, Pages 1529-1536

Publisher

WILEY
DOI: 10.1111/jgs.16406

Keywords

polygenic score; time to dementia diagnosis; genome-wide association studies; Alzheimer's disease; APOE-epsilon 4

Funding

  1. French National Foundation on Alzheimer's disease and related disorders
  2. LABEX (laboratory of excellence program investment for the future) DISTALZ grant
  3. Inserm
  4. Institute Pasteur de Lille
  5. Universite de Lille 2
  6. Lille University Hospital
  7. Medical Research Council [503480]
  8. Alzheimer's Research UK [503176]
  9. Wellcome Trust [082604/2/07/Z]
  10. German Federal Ministry of Education and Research (BMBF): Competence Network Dementia (CND) [01GI0102, 01GI0711, 01GI0420]
  11. National Institutes of Health/National Institute on Aging (NIH/NIA) [R01 AG033193]
  12. NIA [AG081220, RO1AG7644]
  13. AGES [N01-AG-12100]
  14. NHLBI [R01 HL105756]
  15. Icelandic Heart Association
  16. Erasmus Medical Center
  17. Erasmus University
  18. NIH/NIA [U01 AG032984, U24 AG021886, U01 AG016976]
  19. Alzheimer's Association [ADGC-10-196728]
  20. consortium of UK government departments
  21. National Institute for Health Research (NIHR) [PDF-2018-11-ST2-020]
  22. ESRC [ES/S013830/1] Funding Source: UKRI

Ask authors/readers for more resources

OBJECTIVES Identifying the interplay between socioeconomic markers (education and financial resources) and polygenetic predisposition influencing the time of dementia and the diagnosis of clinical Alzheimer & apos;s disease (AD) dementia is of central relevance for preventive strategies. DESIGN Prospective cohort design. SETTING The English Longitudinal Study of Aging is a household survey data set of a representative sample. PARTICIPANTS A total of 7,039 individuals aged 50 years and older participated in the study. Of these, 320 (4.6%) were diagnosed with dementia over the 10-year follow-up. MEASUREMENTS Polygenic score (PGS) for Alzheimer & apos;s disease (AD-PGS) was calculated using summary statistics from the International Genomics of Alzheimer & apos;s Project. An accelerated failure time survival model was used to investigate interactions between AD-PGS and socioeconomic markers on the timing of dementia and clinical AD dementia diagnosis. RESULTS A one standard deviation increase in AD-PGS was associated with an accelerated time to dementia diagnosis by 4.8 months. The presence of the apolipoprotein E gene (APOE-epsilon 4) was associated with an earlier dementia onset by approximately 24.9 months, whereas intermediate and low levels of wealth were associated with an accelerated time to dementia diagnosis by 12.0 months and 18.7 months, respectively. A multiplicative interaction between AD-PGS and years of completed schooling in decelerating the time to clinical AD dementia by 3.0 months suggests educational attainment may serve as a protective mechanism against AD diagnosis among older people with a higher polygenic risk. Interaction between AD-PGS and lower wealth accelerated the time to clinical AD dementia diagnosis by 21.1 to 24.1 months. CONCLUSION Socioeconomic markers influence the time to dementia and clinical AD dementia diagnosis, particularly in those with a higher polygenic predisposition.

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