title: Genetic factors for the development of Alzheimer disease in the Cherokee Indian.
abstract: OBJECTIVE
  To study the relationship between the genetic degree of Cherokee ancestry, the apolipoprotein E *E4 (APOE*E4) allele type, and the development of Alzheimer disease (AD) in individuals from the Cherokee Nation who reside in northeastern Oklahoma.
  
  
  METHODS
  Alzheimer disease center satellite clinic and university departments of neurology, psychiatry, and academic computing.
  
  
  METHODS
  Standardized dementia evaluations based on criteria from the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association were performed on 26 patients aged 65 years or older to establish a diagnosis of AD. Twenty-six control subjects were recruited and similarly assessed. The APOE allele type determinations were obtained on all patients and control subjects. Appropriate statistical analyses were used to compare the genetic degree of Cherokee ancestry, the APOE allele type, and the development of AD.
  
  
  RESULTS
  The data indicated that as the genetic degree of Cherokee Indian ancestry increased, the representation of AD decreased. The 9 patients with AD with a greater than 50% genetic degree of Cherokee ancestry constituted 35% of the group with AD. The 17 remaining patients with AD who were less than 50% Cherokee constituted 65% of the group with AD. In contrast, 17 (65%) of the control subjects were more than 50% Cherokee; only 9 (35%) were less than 50% Cherokee. These percentages of AD were not changed by the *E4 allele. This inverse relationship between the genetic degree of Cherokee ancestry and AD, independent of the APOE*E4 allele status, diminished with increasing age, suggesting an age-related protective effect of being Cherokee. For a decrease of 10% in Cherokee ancestry, the odds of developing AD are estimated to be 9.00 times greater at age 65 years but only 1.34 times greater at age 80 years.
  
  
  CONCLUSIONS
  A greater genetic degree of Cherokee ancestry reduces the risk of developing AD and, thus, seems protective. This protective genetic factor is independent of APOE allele type and diminishes with age.
authors.affiliation: Department of Neurology, University of Texas Southwestern Medical Center at Dallas, USA.
authors.forename: R N
authors.initials: RN
authors.lastname: Rosenberg
authors.forename: R W
authors.initials: RW
authors.lastname: Richter
authors.forename: R C
authors.initials: RC
authors.lastname: Risser
authors.forename: K
authors.initials: K
authors.lastname: Taubman
authors.forename: I
authors.initials: I
authors.lastname: Prado-Farmer
authors.forename: E
authors.initials: E
authors.lastname: Ebalo
authors.forename: J
authors.initials: J
authors.lastname: Posey
authors.forename: D
authors.initials: D
authors.lastname: Kingfisher
authors.forename: D
authors.initials: D
authors.lastname: Dean
authors.forename: M F
authors.initials: MF
authors.lastname: Weiner
authors.forename: D
authors.initials: D
authors.lastname: Svetlik
authors.forename: P
authors.initials: P
authors.lastname: Adams
authors.forename: L S
authors.initials: LS
authors.lastname: Honig
authors.forename: C M
authors.initials: CM
authors.lastname: Cullum
authors.forename: F V
authors.initials: FV
authors.lastname: Schaefer
authors.forename: G D
authors.initials: GD
authors.lastname: Schellenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000483:Alleles; D000544:Alzheimer Disease / Q000235:genetics*; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000235:genetics; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000235:genetics*; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E