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APOE ε₄ and the long arm of social inequity: estimated effects of socio-economic status and sex on the timing of dementia onset

Hasselgren, C; Ekbrand, H; Fässberg, MM; Zettergren, A; Zetterberg, H; Blennow, K; Skoog, I; (2019) APOE ε₄ and the long arm of social inequity: estimated effects of socio-economic status and sex on the timing of dementia onset. Ageing & Society , 39 (9) pp. 1951-1975. 10.1017/S0144686X18000351. Green open access

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Abstract

It is well established that carriers of the apolipoprotein E (APOE) ε₄ allele run a greater risk of developing Alzheimer's disease, the most common form of dementia and a strongly age-related condition known to disproportionally affect women. Low educational attainment also stands out as a prominent risk factor, and it has been suggested that occupational class plays a similar role in disease susceptibility. Not yet fully explored, however, is the question of whether socio-economic status (SES) could moderate the effect of APOE ε₄. In the present paper, we address this issue. As substantial inequities in workforce participation and educational opportunities have existed between men and women in previous generations, we further examine whether SES-related moderations of the relationship between dementia and APOE ε₄ are sex-specific. Our analyses are based on a sample of 580 individuals from the H70 Birth Cohort Study and the Prospective Population Study on Women in Gothenburg, Sweden. Data were analysed using Cox proportional hazards regression, and the results suggest that while high SES postpones dementia onset among male APOE ε₄ carriers, this is not the case for women. These findings underscore the long-term impact of social inequity on health as well as the importance of considering potential interactions between social and genetic risk factors if we are to understand better the complex aetiology of dementia.

Type: Article
Title: APOE ε₄ and the long arm of social inequity: estimated effects of socio-economic status and sex on the timing of dementia onset
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0144686X18000351
Publisher version: https://doi.org/10.1017/S0144686X18000351
Language: English
Additional information: © Cambridge University Press 2018. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/).
Keywords: Sweden, dementia, APOE ε₄, socio-economic status, sex differences, health inequity, longitudinal, population studies
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10051335
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