The APOE-4 allele, found in approximately 25% of older adults, is a susceptibility polymorphism for a number of adverse health outcomes, especially Alzheimer's disease (AD). While recognized as a means of increasing the accuracy of diagnosis of AD, the identification of this susceptibility polymorphism provides an opportunity to address important public health questions most relevant to advances in molecular population genetics, pharmacogenetics and public health-- examination of the long-term impact of being positive for E-4 upon quality of life (QOL), and health services use. Using data from a ten-year longitudinal study of adults age 65-105 (EPESE-Duke) we will examine 2,031 community representative persons, equally distributed between African-Americans and Whites, genotyped at the six-year follow-up (32% positive for E-4). QOL is operationally defined to include the following domains: 1) physical health, 2) functional status, 3) cognitive status, 4) psychological well-being, 5) social support, 6) religious/spiritual status, and 7) mortality/active life expectancy. Health service use was determined by self-report and Part A Medicare data. The underlying hypothesis is that only some of the trajectories of QOL and health service use vary between persons with the E-4 allele and those without. Multivariate models will be used to estimate the effects of being E-4 positive on QOL indicators and health services use controlling for demographic characteristics and other potential confounders. Cox proportional hazard, discrete time survival, and hierarchical linear modeling will be used according to the metric and distribution of the dependent variable.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG017559-02
Application #
6372434
Study Section
Special Emphasis Panel (ZRG1-SNEM-4 (01))
Program Officer
Patmios, Georgeanne E
Project Start
2000-05-01
Project End
2003-04-30
Budget Start
2001-05-01
Budget End
2002-04-30
Support Year
2
Fiscal Year
2001
Total Cost
$222,983
Indirect Cost
Name
Duke University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
071723621
City
Durham
State
NC
Country
United States
Zip Code
27705
Kuchibhatla, Maragatha N; Fillenbaum, Gerda G; Kraus, William E et al. (2013) Trajectory classes of body mass index in a representative elderly community sample. J Gerontol A Biol Sci Med Sci 68:699-704
Fillenbaum, Gerda G; Kuchibhatla, Maragatha N; Whitson, Heather E et al. (2010) Accuracy of self-reported height and weight in a community-based sample of older African Americans and whites. J Gerontol A Biol Sci Med Sci 65:1123-9
Fillenbaum, Gerda G; Burchett, Bruce M; Blazer, Dan G (2009) Identifying a national death index match. Am J Epidemiol 170:515-8
Ewbank, Douglas C (2007) Differences in the association between apolipoprotein E genotype and mortality across populations. J Gerontol A Biol Sci Med Sci 62:899-907
Fillenbaum, Gerda G; Burchett, Bruce M; Kuchibhatla, Maragatha N et al. (2007) Effect of cancer screening and desirable health behaviors on functional status, self-rated health, health service use and mortality. J Am Geriatr Soc 55:66-74
Fillenbaum, Gerda G; Hanlon, Joseph T; Landerman, Lawrence R et al. (2004) Impact of inappropriate drug use on health services utilization among representative older community-dwelling residents. Am J Geriatr Pharmacother 2:92-101
Rupper, Randall W; Konrad, Thomas R; Garrett, Joanne M et al. (2004) Self-reported delay in seeking care has poor validity for predicting adverse outcomes. J Am Geriatr Soc 52:2104-9
Ewbank, Douglas C (2004) The APOE gene and differences in life expectancy in Europe. J Gerontol A Biol Sci Med Sci 59:16-20
Blazer, Dan G; Fillenbaum, Gerda G; Gold, Deborah T et al. (2003) APOE epsilon4 as a predictor of subjective quality of life in a biracial older person community sample. J Aging Health 15:645-60
Fillenbaum, Gerda G; Burchett, Bruce M; Lee, Joseph H et al. (2003) Mortality and apolipoprotein E in African-American, and White elders: an attempted replication. Am J Med Genet A 119A:141-6

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