Get access

Health-Protective and Adverse Effects of the Apolipoprotein E ɛ2 Allele in Older Men

Authors

  • Alexander M. Kulminski PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Svetlana V. Ukraintseva PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Konstantin G. Arbeev PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Kenneth G. Manton PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Junko Oshima MD, PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • George M. Martin MD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Dora Il'yasova PhD,

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author
  • Anatoli I. Yashin PhD

    1. From the *Center for Population Health and Aging, Durham, North CarolinaDepartment of Sociology, Durham, North CarolinaArts and Sciences, Durham, North CarolinaDepartment of Community and Family Medicine, Duke University Medical Center, Duke University, Durham, North Carolina§Department of Pathology, University of Washington, Seattle, Washington.
    Search for more papers by this author

Address correspondence to Alexander Kulminski, Center for Population Health and Aging, Duke University, Trent Hall, Room 002, Trent Drive, Box 90408, Durham, NC 27708. E-mail: Alexander.Kulminski@duke.edu

Abstract

OBJECTIVES: To reexamine a health-protective role of the common apolipoprotein E (APOE) polymorphism focusing on connections between the APOEɛ2—containing genotypes and impairments in instrumental activities of daily living (IADLs) in older (≥65) men and women and to examine how diagnosed coronary heart disease (CHD), Alzheimer's disease, colorectal cancer, macular degeneration, and atherosclerosis may mediate these connections.

DESIGN: Retrospective cross-sectional study.

SETTING: The unique disability-focused data from a genetic subsample of the 1999 National Long Term Care Survey linked with Medicare service use files.

PARTICIPANTS: One thousand seven hundred thirty-three genotyped individuals interviewed regarding IADL disabilities.

MEASUREMENTS: Indicators of IADL impairments, five geriatric disorders, and ɛ2-containing genotypes.

RESULTS: The ɛ2/3 genotype is a major contributor to adverse associations between the ɛ2 allele and IADL disability in men (odds ratio (OR)=3.09, 95% confidence interval (CI)=1.53–6.26), although it provides significant protective effects for CHD (OR=0.55, 95% CI=0.33–0.92), whereas CHD is adversely associated with IADL disability (OR=2.18, 95% CI=1.28–3.72). Adjustment for five diseases does not significantly alter the adverse association between ɛ2-containing genotypes and disability. Protective effects of the ɛ2/3 genotype for CHD (OR=0.52, 95% CI=0.27–0.99) and deleterious effects for IADLs (OR=3.50, 95% CI=1.71–7.14) for men hold in multivariate models with both these factors included. No significant associations between the ɛ2-containing genotypes and IADL are found in women.

CONCLUSION: The ɛ2 allele can play a dual role in men, protecting them against some health disorders, while promoting others. Strong adverse relationships with disability suggest that ɛ2-containing genotypes can be unfavorable factors for the health and well-being of aging men.

Ancillary