APOE 84 and the long arm of social inequity: Estimated effects of socio-economic status and sex on the timing of dementia onset

Abstract

It is well established that carriers of the apolipoprotein E (APOE) 84 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 84. In the present paper, we address this issue. As substantial inequities in workforce participation and educational oppor¬tunities have existed between men and women in previous generations, we further examine whether SES-related moderations of the relationship between dementia and APOE 84 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 regres¬sion, and the results suggest that while high SES postpones dementia onset among male APOE 84 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 con¬sidering potential interactions between social and genetic risk factors if we are to understand better the complex aetiology of dementia