0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Original Investigation |

Age-Specific Incidence Rates for Dementia and Alzheimer Disease in NIA-LOAD/NCRAD and EFIGA Families:  National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA)

Badri N. Vardarajan, PhD1,2; Kelley M. Faber, MS3; Thomas D. Bird, MD4,5; David A. Bennett, MD6; Roger Rosenberg, MD7; Bradley F. Boeve, MD8; Neill R. Graff-Radford, MD9; Alison M. Goate, DPhil10,11; Martin Farlow, MD12; Robert A. Sweet, MD13,14,15; Rafael Lantigua, MD1,16; Martin Z. Medrano, MD17,18; Ruth Ottman, PhD2,3,19,20; Daniel J. Schaid, PhD21; Tatiana M. Foroud, PhD3; Richard Mayeux, MD, MSc1,2,22 ; for the NIA-LOAD/NCRAD Family Study Group
[+] Author Affiliations
1Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Medical Center, New York, New York
2Gertrude H. Sergievsky Center, Columbia University College of Physicians and Surgeons, New York, New York
3Department of Medical and Molecular Genetics, Indiana University, Indianapolis
4Department of Neurology, University of Washington, Seattle
5Department of Medicine, University of Washington, Seattle
6Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
7Department of Neurology and Neurotherapeutics, The University of Texas Southwestern Medical Center, Dallas
8Department of Neurology, Mayo Clinic, Rochester, Minnesota
9Department of Neurology, Mayo Clinic, Jacksonville, Florida
10Department of Psychiatry and Genetics, Knight Alzheimer’s Disease Research Center, Washington University, St Louis, Missouri
11Hope Center for Neurological Disorders, Washington University, St Louis, Missouri
12Department of Neurology, Indiana University Center for Alzheimer’s Disease and Related Disorders, Indianapolis
13Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
14Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
15Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
16Department of Medicine, Columbia University, New York, New York
17Universidad Tecnológica de Santiago, Santiago, Dominican Republic
18currently with Department of Geriatrics, Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
19Department of Epidemiology, Columbia University, New York, New York
20Division of Epidemiology, New York State Psychiatric Institute, New York
21Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
22Department of Neurology, Columbia University, New York, New York
JAMA Neurol. 2014;71(3):315-323. doi:10.1001/jamaneurol.2013.5570.
Text Size: A A A
Published online

Importance  Late-onset Alzheimer disease (LOAD), defined as onset of symptoms after age 65 years, is the most common form of dementia. Few reports investigate incidence rates in large family-based studies in which the participants were selected for family history of LOAD.

Objective  To determine the incidence rates of dementia and LOAD in unaffected members in the National Institute on Aging Genetics Initiative for Late-Onset Alzheimer Disease/National Cell Repository for Alzheimer Disease (NIA-LOAD/NCRAD) and Estudio Familiar de Influencia Genetica en Alzheimer (EFIGA) family studies.

Design, Setting, and Participants  Families with 2 or more affected siblings who had a clinical or pathological diagnosis of LOAD were recruited as a part of the NIA-LOAD/NCRAD Family Study. A cohort of Caribbean Hispanics with familial LOAD was recruited in a different study at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain in New York and from clinics in the Dominican Republic as part of the EFIGA study.

Main Outcomes and Measures  Age-specific incidence rates of LOAD were estimated in the unaffected family members in the NIA-LOAD/NCRAD and EFIGA data sets. We restricted analyses to families with follow-up and complete phenotype information, including 396 NIA-LOAD/NCRAD and 242 EFIGA families. Among the 943 at-risk family members in the NIA-LOAD/NCRAD families, 126 (13.4%) developed dementia, of whom 109 (86.5%) met criteria for LOAD. Among 683 at-risk family members in the EFIGA families, 174 (25.5%) developed dementia during the study period, of whom 145 (83.3%) had LOAD.

Results  The annual incidence rates of dementia and LOAD in the NIA-LOAD/NCRAD families per person-year were 0.03 and 0.03, respectively, in participants aged 65 to 74 years; 0.07 and 0.06, respectively, in those aged 75 to 84 years; and 0.08 and 0.07, respectively, in those 85 years or older. Incidence rates in the EFIGA families were slightly higher, at 0.03 and 0.02, 0.06 and 0.05, 0.10 and 0.08, and 0.10 and 0.07, respectively, in the same age groups. Contrasting these results with the population-based estimates, the incidence was increased by 3-fold for NIA-LOAD/NCRAD families (standardized incidence ratio, 3.44) and 2-fold among the EFIGA compared with the NIA-LOAD/NCRAD families (1.71).

Conclusions and Relevance  The incidence rates for familial dementia and LOAD in the NIA-LOAD/NCRAD and EFIGA families are significantly higher than population-based estimates. The incidence rates in all groups increase with age. The higher incidence of LOAD can be explained by segregation of Alzheimer disease–related genes in these families or shared environmental risks.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination
Make the Diagnosis: Will This Patient Fall?

The Rational Clinical Examination
Original Article: Will This Patient Fall?

brightcove.createExperiences();