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Journal of Alzheimer s Disease
Article . 2016
License: taverne
Data sources: Pure Amsterdam UMC
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Journal of Alzheimer s Disease
Article . 2016 . Peer-reviewed
Data sources: Crossref
Journal of Alzheimer s Disease
Article . 2016
Data sources: mEDRA
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Evaluation of a Genetic Risk Score to Improve Risk Prediction for Alzheimer’s Disease

Authors: Chouraki, Vincent; Reitz, Christiane; Maury, Fleur; Bis, Joshua C.; Bellenguez, Celine; Yu, Lei; Jakobsdottir, Johanna; +26 Authors

Evaluation of a Genetic Risk Score to Improve Risk Prediction for Alzheimer’s Disease

Abstract

Effective prevention of Alzheimer’s disease (AD) requires the development of risk prediction tools permitting preclinical intervention. We constructed a genetic risk score (GRS) comprising common genetic variants associated with AD, evaluated its association with incident AD and assessed its capacity to improve risk prediction over traditional models based on age, sex, education, and APOE ɛ4. In eight prospective cohorts included in the International Genomics of Alzheimer’s Project (IGAP), we derived weighted sum of risk alleles from the 19 top SNPs reported by the IGAP GWAS in participants aged 65 and older without prevalent dementia. Hazard ratios (HR) of incident AD were estimated in Cox models. Improvement in risk prediction was measured by the difference in C-index (Δ–C), the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI>0). Overall, 19,687 participants at risk were included, of whom 2,782 developed AD. The GRS was associated with a 17% increase in AD risk (pooled HR = 1.17; 95% CI = [1.13–1.21] per standard deviation increase in GRS; p-value = 2.86×10–16). This association was stronger among persons with at least one APOE ɛ4 allele (HRGRS = 1.24; 95% CI = [1.15–1.34]) than in others (HRGRS = 1.13; 95% CI = [1.08–1.18]; pinteraction = 3.45×10–2). Risk prediction after seven years of follow-up showed a small improvement when adding the GRS to age, sex, APOE ɛ4, and education (Δ–Cindex = 0.0043 [0.0019–0.0067]). Similar patterns were observed for IDI and NRI>0. In conclusion, a risk score incorporating common genetic variation outside the APOE ɛ4 locus improved AD risk prediction and may facilitate risk stratification for prevention trials.

Country
Netherlands
Keywords

Alzheimer Disease/diagnosis, Male, EMC NIHES-01-64-01, Apolipoprotein E4, Neuropsychological Tests, Polymorphism, Single Nucleotide, Risk Assessment, Cohort Studies, Alzheimer Disease, Predictive Value of Tests, Risk Factors, 80 and over, Humans, Genetic Predisposition to Disease, Genetic Testing, Apolipoprotein E4/genetics, Polymorphism, Aged, Proportional Hazards Models, Aged, 80 and over, Psychiatric Status Rating Scales, EMC MM-01-39-09-A, Educational Status, Female, Single Nucleotide/genetics, EMC COEUR-09, Genome-Wide Association Study

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    selected citations
    These citations are derived from selected sources.
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    80
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
80
Top 1%
Top 10%
Top 1%
hybrid