Research Article

The effect of alcohol and tobacco consumption, and apolipoprotein E genotype, on the age of onset in Alzheimer's disease

  1. Dylan G. Harwood1,2,
  2. Ari Kalechstein3,
  3. Warren W. Barker2,*,
  4. Silvia Strauman2,
  5. Peter St. George-Hyslop4,
  6. Casandra Iglesias2,
  7. David Loewenstein2,5,
  8. Ranjan Duara2,5,6,7

Article first published online: 14 SEP 2009

DOI: 10.1002/gps.2372

Issue

International Journal of Geriatric Psychiatry

International Journal of Geriatric Psychiatry

Volume 25, Issue 5, pages 511–518, May 2010

Additional Information

How to Cite

Harwood, D. G., Kalechstein, A., Barker, W. W., Strauman, S., St. George-Hyslop, P., Iglesias, C., Loewenstein, D. and Duara, R. (2010), The effect of alcohol and tobacco consumption, and apolipoprotein E genotype, on the age of onset in Alzheimer's disease. International Journal of Geriatric Psychiatry, 25: 511–518. doi: 10.1002/gps.2372

Author Information

  1. 1

    David Geffen School of Medicine at UCLA, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA

  2. 2

    The Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA

  3. 3

    Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA

  4. 4

    Departments of Medicine and Physiology, Center for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada

  5. 5

    Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, FL, USA

  6. 6

    Departments of Medicine and Neurology, University of Miami School of Medicine, Miami, FL, USA

  7. 7

    Department of Neurology, University of South Florida School of Medicine, Tampa, FL, USA

*The Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA.

Publication History

  1. Issue published online: 8 APR 2010
  2. Article first published online: 14 SEP 2009
  3. Manuscript Accepted: 1 JUL 2009
  4. Manuscript Received: 2 JAN 2009

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Keywords:

  • Alzheimer's disease;
  • age of onset;
  • APOE;
  • smoking;
  • drinking

Abstract

Objective

This study examined the association between a history of heavy alcohol use and smoking, presence of the apolipoprotein-E epsilon 4 allele (APOE ε4), and age of disease onset in a community dwelling sample of 685 Alzheimer's disease (AD) patients spanning three ethnic groups.

Design

Cross-sectional study of AD patients evaluated at a University-affiliated outpatient memory disorders clinic.

Subjects

A clinic-based cohort of white non-Hispanic (WNH; n = 397), white Hispanic (WH; n = 264), and African-American (AA; n = 24) patients diagnosed with possible or probable AD according to NINCDS-ADRDA diagnostic criteria.

Measurements

The age of onset of AD was obtained from a knowledgeable family member. All patients were assessed for APOE genotype. History of alcohol and tobacco consumption prior to the onset of dementia was obtained via an interview with the patient and the primary caregiver. A history of heavy drinking was defined as >2 drinks per day and a history of heavy smoking was defined as ≥1 pack per day.

Results

Presence of an APOE ε4 allele, a history of heavy drinking, or a history of heavy smoking were each associated with an earlier onset of AD by 2–3 years. Patients with all three risk factors were likely to be diagnosed with AD nearly 10 years earlier than those with none of the risk factors.

Conclusion

The results suggest that APOE ε4 and heavy drinking and heavy smoking lower the age of onset for AD in an additive fashion. Copyright © 2009 John Wiley & Sons, Ltd.

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