ArticleJournal of the American Geriatrics Society2013
Apolipoprotein E ε4 allele interacts with sex and cognitive status to influence all-cause and cause-specific mortality in U.S. older adults.
Article in Journal of the American Geriatrics Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Does Gender Influence the Relationship Between High Blood Pressure and Dementia? Highlighting Areas for Further Investigation.Journal of Alzheimer's disease : JAD · 2020Pooled it
- Chronic traumatic encephalopathy in contact sports: a systematic review of all reported pathological cases.PloS one · 2015Pooled it
- Outcomes of feeding problems in advanced dementia in a nursing home population.Journal of the American Geriatrics Society · 2013Trial
- Predicting longitudinal basal forebrain volume in the Alzheimer's disease spectrum: the role of sex and ApoE epsilon 4 genotype.Frontiers in neuroscience · 2026Article
- Joint modeling approaches for predicting conversion from mild cognitive impairment to Alzheimer's disease: A systematic review (1999-2025).Belitung nursing journal · 2026Review
- AD and non-AD mediators of the pathway between the APOE genotype and cognition.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Long-term associations between amyloid positron emission tomography, sex, apolipoprotein E and incident dementia and mortality among individuals without dementia: hazard ratios and absolute risk.Brain communications · 2022Article
- Cognitive impairment assessed by Mini-Mental State Examination predicts all-cause and CVD mortality in Chinese older adults: A 10-year follow-up study.Frontiers in public health · 2022Article
- Sex-dependent effect ofDisease models & mechanisms · 2020Review
- Plasma levels of apolipoprotein E, APOE genotype, and all-cause and cause-specific mortality in 105 949 individuals from a white general population cohort.European heart journal · 2019Article
- Understanding the impact of sex and gender in Alzheimer's disease: A call to action.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2018Review
- Studying additive interaction in a healthcare database: Case study of NSAIDs, cardiovascular profiles, and acute myocardial infarction.PloS one · 2018Article
- Racial Differences in the Association Between Apolipoprotein E Risk Alleles and Overall and Total Cardiovascular Mortality Over 18 Years.Journal of the American Geriatrics Society · 2017Article
- Sex-specific patterns and differences in dementia and Alzheimer's disease using informatics approaches.Journal of women & aging · 2016Article
- Attentional performance, impulsivity, and related neurotransmitter systems in apoE2, apoE3, and apoE4 female transgenic mice.Psychopharmacology · 2016Article
- APOE and LDLR Gene Polymorphisms and Dyslipidemia Tracking. Rio de Janeiro Study.Arquivos brasileiros de cardiologia · 2015Article
- Occupational attainment influences survival in autopsy-confirmed frontotemporal degeneration.Neurology · 2015Article
- No association between Apoε4 alleles, HIV infection, age, neuropsychological outcome, or death.Journal of neurovirology · 2015Article
- Mortality in mild cognitive impairment varies by subtype, sex, and lifestyle factors: the Mayo Clinic Study of Aging.Journal of Alzheimer's disease : JAD · 2015Article
- Sex differences in cognitive impairment and Alzheimer's disease.Frontiers in neuroendocrinology · 2014Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesTo confirm associations of apolipoprotein E (ApoE) ε4 carrier status, sex, and time-dependent cognitive status with mortality risk and to investigate these joint effects of these associations in a cohort of community-dwelling U.S. adults.
designProspective cohort study.
settingThe Baltimore Longitudinal Study of Aging (BLSA).
participantsOf 3,047 BLSA participants aged 17 to 98 at first visit (60.1% male), 1,704 with complete ApoE genotype data were included, of whom 1,461 aged 50 and older with one or more visits were eligible. MEASUREMENTS: Time to death from all, cardiovascular, and noncardiovascular causes.
resultsProbability of survival was lower for ApoE ε4 carriers, particularly those who were older. A Cox proportional hazards model for all-cause mortality yielded a hazard ratio (HR) for ApoE ε4 carrier versus noncarriers of 1.31 (95% confidence interval (CI) = 1.02-1.68). This association was also found for cardiovascular mortality. Time-dependent all-cause dementia (HR = 1.73, 95% CI = 1.33-2.26) and mild cognitive impairment (HR = 1.95, 95% CI = 1.42-2.67) increased all-cause mortality risk, associations that were also detected for noncardiovascular mortality. When individuals were free of cognitive impairment, a dose-response relationship with ε4 alleles was found for all-cause mortality (HR = 1.40, 95% CI = 0.94-2.07 for 1 ε4; HR = 2.61, 95% CI = 1.12-6.07 for 2 ε4). After onset of Alzheimer's disease (AD), carrying only one ε4 allele resulted in an approximately 77% greater all-cause mortality risk than in noncarriers. ApoE ε4 carrier status increased all-cause mortality risk in men and interacted with time-dependent AD to increase the risk of this outcome (relative excess risk due to interaction = 2.15, 95% CI = 1.22-3.07).
conclusionApoE ε4 carrier status was found to increase all-cause and cardiovascular mortality risks and interacted with sex and time-dependent AD status to affect all-cause mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.