“ “ Does African ancestry protect against Does African ancestry protect against dementia? A population-based case-control dementia? A population-based case-control study in an admixed Cuban population study in an admixed Cuban population ? ? . . ” ” Juan J. Llibre Rodriguez , Beatriz Macheco Teruel , Cleusa Ferris, Paul McKeigue, Martin J Prince. For and on behalf of 10/66 Univ. de Ciencias Medicas - Habana, Cuba Univ. de Ciencias Medicas - Habana, Cuba Centro Nacional de Genetica, Havana,Cuba Centro Nacional de Genetica, Havana,Cuba Centre for Public Mental Health, KCL, UK Centre for Public Mental Health, KCL, UK
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Univ. de Ciencias Medicas - Habana, Cuba Centro Nacional de Genetica, Havana,Cuba
“ Does African ancestry protect against dementia? A population-based case-control study in an admixed Cuban population ? . ”. Juan J. Llibre Rodriguez , Beatriz Macheco Teruel , Cleusa Ferris, Paul McKeigue, Martin J Prince. For and on behalf of 10/66. Univ. de Ciencias Medicas - Habana, Cuba - PowerPoint PPT Presentation
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““Does African ancestry protect against Does African ancestry protect against dementia? A population-based case-control study dementia? A population-based case-control study in an admixed Cuban populationin an admixed Cuban population? ? ..””
Juan J. Llibre Rodriguez , Beatriz Macheco Teruel , Cleusa Ferris, Paul McKeigue, Martin J Prince. For and on behalf of 10/66
Univ. de Ciencias Medicas - Habana, CubaUniv. de Ciencias Medicas - Habana, CubaCentro Nacional de Genetica, Havana,CubaCentro Nacional de Genetica, Havana,CubaCentre for Public Mental Health, KCL, UKCentre for Public Mental Health, KCL, UK
Population 11,6 millons
Life expectancy Men 79 years Women 80 years
Dementia´s prevalence 6.4-10.2 % (130 000 cases )
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 information about the
contribution of genetic and contribution of genetic and non genetic factors.non genetic factors.
In Cuba, there is sufficient In Cuba, there is sufficient variation of admixture variation of admixture
between individuals to detect between individuals to detect relationships of disease risk to relationships of disease risk to
proportionate admixture.proportionate admixture.
The US/ Nigeria study
• Clear association between apoE e4 and AD in African Americans in Indianapolis, US
» (Hendrie - Ann Neurol 1995)
• No association between apoE e4 and AD in Yoruba in Ibadan, Nigeria
» (Osontokun - Ann Neurol 1995)
Prevalence of dementia by age in Prevalence of dementia by age in CubaCuba
0
5
10
15
20
25
30
65-69 70-74 75-79 80+
Age (years)
Prev. (%)
Cuba - 10/66
Cuba - DSM IV
EURODEM
Llibre Rodríguez J.J, Valhuerdi A., Sanchez I.I., Guerra M.A, Prince M, et al. “The prevalence, correlates and impact of dementia in Cuba”. Neuroepidemiology 2008;31:243–251.
DSM-IV dementia *
10/66 Dementia
Any dementia
ALL 9.00 21.04 21.17
BY SEX
Male 9.39 18.36 18.36
Female 8.80 22.41 22.60
BY AGE
65-69 3.27 5.95 5.95
70-74 8.97 18.18 18.61
75-79 11.67 27.64 27.64
80+ 16.29 48.85 48.85* Incidence rate/ 1000 pyr
Incidence of dementia by sex and age, Cuba Cohort 65 years and over N=2728
Risk factors for incident dementiaRisk factors for incident dementia
Age groupAge group 1.79 (1.37-2.37)1.79 (1.37-2.37)
Male genderMale gender 1.27 (0.62-2.60)1.27 (0.62-2.60)
Main source of admixture Main source of admixture Migration , 1400–1800, Migration , 1400–1800,
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
Esperanza
Aged 104 years!
•Door knocking
•Cognitive test
• Clinical interview
• Socio-demographic and risk factor interview
• Physical/ neurological examination
• Blood test
• Informant interview
10/66 Dementia diagnosisDSM IV DementiaDSM IV/ ICD10 Depression
The 10/66 protocol.
Prince M, Ferri CP, Acosta D, et al. The protocols for the 10/66 Dementia Research Group population-based research programme. BMC Public Health 2007,7:165.
238 dementia cases238 dementia cases
355 controls355 controls
SNP studies (60 SNP studies (60 markers of markers of admixture)admixture)
APOE 4 in 2500 APOE 4 in 2500 population samplespopulation samples
Admixture and dementia
Box plot of African admixture distribution by ethno-racial identity (weighted)