“ “ The 10/66 Dementia Research Group Studies” The 10/66 Dementia Research Group Studies” . . Incidence phase. Incidence phase. Juan J. Llibre Rodriguez. For and on behalf of 10/66 26 26 th th International Conference of Alzheimer International Conference of Alzheimer Disease International. Disease International.
“ The 10/66 Dementia Research Group Studies” . Incidence phase. Juan J. Llibre Rodriguez. For and on behalf of 10/66. 26 th International Conference of Alzheimer’s Disease International. INCIDENCE RATES Burden of a disease. Risk of disease - PowerPoint PPT Presentation
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“ “ The 10/66 Dementia Research Group Studies”The 10/66 Dementia Research Group Studies”. . Incidence phase.Incidence phase. Juan J. Llibre Rodriguez. For and on behalf of 10/66
2626thth International Conference of Alzheimer’s International Conference of Alzheimer’s Disease International. Disease International.
Factors tested as possible predictors of carer strain at follow-up
Sociodemographic factors
Age Education
Gender Follow-up interval
Dementia related factors
Change in cognitive function Dementia severity (CDR)
Dementia subtype Behavioural symptomsQuality of life at follow-up (DEMQOL)General health factorsPrevious stroke Physical illnessDisability (WHODAS 2.0 score) DepressionCare-related factorsAge Number of co-residentsGender Co-resident childNeeds for care Co-resident spouse
Predictors of carer strain (stepwise regression), among people with dementia
Predictor Regression coefficient (95% CI)
P-value
Sociodemographic factors
Follow-up period (per year) +1.9 (-0.2 to +4.0) 0.07
Dementia related factors
Change in cognitive function (per one point decline in COGSCORE)
+0.4 (+0.2 to +0.6) <0.001
Behavioural symptoms +0.4 (+0.1 to +0.6) 0.008Frontotemporal dementia type -9.5 (-16.4 to -2.6) 0.007Quality of life at follow-up -0.2 (-0.3 to -0.1) 0.004General health factorsICD-10 depressive episode -4.9 (-9.4 to -0.4) 0.03Disability (WHODAS 2.0 score) +0.1 (+0.0 to +0.1) 0.03Care-related factorsNeeds for care +6.3 (+2.0 to +10.5) 0.004Carer age +0.1 (+0.0 to +0.2) 0.02
Incidence rate 21.7 per 1000/year (28 760 new cases/year)
Mortality rate in dementia people 195.5 per 1000/year
Does African ancestry Does African ancestry protect against dementia? A protect against dementia? A population-based case-population-based case-control study in an admixed control study in an admixed Cuban populationCuban population??
Admixtures Admixtures mapping provides mapping provides information about the contribution of information about the contribution of
genetic and non genetic factors.genetic and non genetic factors.In Cuba, there is sufficient variation of In Cuba, there is sufficient variation of
admixture between individuals to admixture between individuals to detect relationships of disease risk to detect relationships of disease risk to
proportionate admixture.proportionate admixture.
10/66 admixture studies
• Design– Populations of mixed
African and Caucasian ancestry
– Genotype to measure ancestry directly in individuals
• Hypothesis– Higher levels of African
ancestry associated with lower risk of dementia
Main source of admixture Main source of admixture Migration , 1400–1800, Migration , 1400–1800,
2.9 (1.6-5.3)2.9 (1.6-5.3)* * Adjusted age, sex and educationAdjusted age, sex and education
APOE allele APOE allele frequencyfrequency
White White n=1677n=1677(72%) (72%)
MixedMixed n=394n=394(17%) (17%)
BlackBlack n=261n=261 (11%) (11%)
P-valueP-value test for test for trendtrend
E2 E2 0.0570.057 0.064 0.064 0.0720.072 <0.001<0.001E3E3 0.8650.865 0.8520.852 0.7800.780 E4E4 0.0780.078 0.0840.084 0.1480.148 Association Association between any E4 between any E4 and dementiaand dementia
2.84 2.84 (2.2-3.6)(2.2-3.6)
0.810.81(0.2-2.8)(0.2-2.8)
2.38 2.38 (1.4-3.9)(1.4-3.9)
Overall association Overall association between E4 and between E4 and any dementiaany dementia
2.58 2.58 (2.06- 3.22)(2.06- 3.22)
Adjusted for race 2.50 2.50 (1.91-3.21)(1.91-3.21)
APOE allele frequency by ethno-racial identity
Mean admixture proportion by APOE allele status (case control subsample)