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Polygenic Propensity for Longevity, APOE-ε4 Status, Dementia Diagnosis, and Risk for Cause-Specific Mortality: A Large Population-Based Longitudinal Study of Older Adults

Ajnakina, Olesya; Shamsutdinova, Diana; Stahl, Daniel; Steptoe, Andrew; (2023) Polygenic Propensity for Longevity, APOE-ε4 Status, Dementia Diagnosis, and Risk for Cause-Specific Mortality: A Large Population-Based Longitudinal Study of Older Adults. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences , Article glad168. 10.1093/gerona/glad168. (In press). Green open access

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Abstract

To deepen the understanding of genetic mechanisms influencing mortality risk, we investigated the impact of genetic predisposition to longevity and APOE-ε4, on all-cause mortality and specific causes of mortality. We further investigated the mediating effects of dementia on these relationships. Utilising data on 7131 adults aged ≥50 years (mean=64.7 years, SD=9.5) from the English Longitudinal Study of Ageing, genetic predisposition to longevity was calculated using polygenic score approach (PGSlongevity). APOE-ε4 status was defined according to absence or presence of ε4 alleles. The causes of death were ascertained from the National Health Service central register, which were classified into cardiovascular diseases, cancers, respiratory illness, and all other causes of mortality. Of the entire sample, 1234 (17.3%) died during an average of the 10-year follow-up. One standard deviation (1-SD) increase in PGSlongevity was associated with a reduced risk for all-cause mortality (Hazard ratio [HR]=0.93, 95%CI=0.88-0.98, P=0.010) and mortalities due to other causes (HR=0.81, 95%CI=0.71-0.93, P=0.002) in the following 10 years. In gender stratified analyses, APOE-ε4 status was associated with a reduced risk for all-cause mortality and mortalities related to cancers in women. Mediation analyses estimated that the percent excess risk of APOE-ε4 on other causes of mortality risk explained by the dementia diagnosis was 24%, which increased to 34% when the sample was restricted to adults who were aged ≤75 years old. To reduce mortality rate in adults who are aged ≥50 years old, it is essential to prevent dementia onset in the general population.

Type: Article
Title: Polygenic Propensity for Longevity, APOE-ε4 Status, Dementia Diagnosis, and Risk for Cause-Specific Mortality: A Large Population-Based Longitudinal Study of Older Adults
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/gerona/glad168
Publisher version: https://doi.org/10.1093/gerona/glad168
Language: English
Additional information: © The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: APOE-ε4, Longevity, Mediation, Mortality, Polygenic risk
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 Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10175742
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