Meta-Analysis of Variations in Association between APOE ɛ4 and Alzheimer’s Disease and Related Dementias Across Hispanic Regions of Origin

Article type: Research Article

Authors: Huggins, Lenique K.L.^{a; b; *} | Min, Se Hee^c | Kaplan, Samantha^d | Wei, Jingkai^e | Welsh-Bohmer, Kathleen^{f; g} | Xu, Hanzhang^{h; i}

Affiliations: [a] Department of Biology, Duke University, Durham, NC, USA | [b] Yale School of Medicine, New Haven, CT, USA | [c] Columbia University School of Nursing, New York, NY, USA | [d] Duke University Medical Center Library and Archives, Durham, NC, USA | [e] Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA | [f] Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA | [g] Department of Neurology, Duke University School of Medicine, Durham, NC, USA | [h] Duke University School of Nursing, Durham, NC, USA | [i] Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA

Correspondence: [*] Correspondence to: Lenique KL Huggins, BS, 367 Cedar Street, Harkness Box 722, New Haven, CT 06510, USA. E-mail: [email protected].

Abstract: Background:Emerging research has shown racial and ethnic variations in the magnitude of association between the apolipoprotein ɛ4 (APOE ɛ4) allele and the risk of developing Alzheimer’s disease and related dementias (ADRD). Studies researching this association among Hispanic groups within and outside of the United States have produced inconsistent results. Objective:To examine the association between the APOE ɛ4 allele and the risk of developing ADRD in global Hispanic populations from different ethnic regions of origin. Methods:PubMed, Embase, Scopus, and PsycInfo were searched for studies relating to Hispanic/Latin American origin, APOE ɛ4, and ADRD. Odds ratios (OR) of ADRD risk for individuals with APOE ɛ4 versus those without APOE ɛ4 were extracted and calculated using random effects analysis. Results:20 eligible studies represented Caribbean Hispanic, Mexican, South American, Spanish, and Cuban groups. Overall, APOE ɛ4 was significantly associated with increased risk of ADRD (Odds Ratio [OR] 3.80, 95% CI: 2.38–6.07). The association was only significant in the South American (OR: 4.61, 95% CI: 2.74–7.75) subgroup. Conclusion:There was an association between APOE ɛ4 and increased ADRD risk for the South American subgroup. The strength of this association varied across Hispanic subgroups. Data is limited with more studies especially needed for adjusted analysis on Spanish, Central American, Cuban Hispanic, and Caribbean Hispanic groups. Results suggest additional environmental or genetic risk factors are associated with ethnic variations.

Keywords: Alzheimer disease, apolipoprotein E4, dementia, Hispanic or Latino

DOI: 10.3233/JAD-221167

Journal: Journal of Alzheimer's Disease, vol. 93, no. 3, pp. 1095-1109, 2023