title: Family member deaths across adulthood predict Alzheimer's disease risk: The Cache County Study.
abstract: OBJECTIVE
  Parental death during childhood, and offspring and spouse death during adulthood have individually been associated with faster cognitive decline and higher Alzheimer's disease (AD) risk in late life. However, the cumulative effect of childhood and adulthood family deaths on AD risk among different age cohorts has not been studied.
  
  
  METHODS
  To examine these associations, this prospective cohort study uses a population-based sample of 4545 initially non-demented participants (56.7% female; age M = 75.0/SD = 6.9 years) observed at four triennial waves, linked with objective Utah Population Database data on cumulative mother, father, sibling, spouse, and offspring death experienced during childhood and adulthood. Cox regression modeled survival time from baseline interview to AD onset, as a function of family deaths during childhood or adulthood, among different age groups, along with gender and presence of ε4 allele at apolipoprotein E (APOE) polymorphic genetic locus.
  
  
  RESULTS
  Age group significantly moderated the relationship between family death and AD; among persons aged 65-69 years at baseline (children of the Great Depression), those exposed to 3-4 deaths and 5+ deaths during adulthood exhibited a doubling of AD risk (adjusted hazard ratio, aHR = 2.25, p = .038, and aHR = 2.72, p = .029), while among persons aged 80 years and older, those exposed to 3-4 deaths during adulthood exhibited lower AD risk (HR = 0.539, p = 0.014). In a combined model of childhood and adulthood deaths, these findings persisted.
  
  
  CONCLUSIONS
  Results suggest a cohort effect in the link between family member deaths during adulthood and AD risk later in life.
authors.affiliation: Department of Family Consumer and Human Development, Utah State University, Logan, UT, USA.|Department of Psychology, Utah State University, Logan, UT, USA.|Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Norton
authors.affiliation: Department of Family Consumer and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fauth
authors.affiliation: Department of Family Consumer and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Clark
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.|Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA.
authors.forename: Dan
authors.identifier: http://orcid.org/0000-0003-0220-7059
authors.initials: D
authors.lastname: Hatch
authors.affiliation: Department of Family Consumer and Human Development, Utah State University, Logan, UT, USA.
authors.forename: Daylee
authors.initials: D
authors.lastname: Greene
authors.affiliation: Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: Roxane
authors.initials: R
authors.lastname: Pfister
authors.affiliation: Department of Psychology, Utah State University, Logan, UT, USA.|Center for Epidemiologic Studies, Utah State University, Logan, UT, USA.
authors.forename: JoAnn T
authors.initials: JT
authors.lastname: Tschanz
authors.affiliation: Department of Family and Consumer Studies and the Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
authors.forename: Ken R
authors.initials: KR
authors.lastname: Smith
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000235:genetics / Q000523:psychology*; D001057:Apolipoproteins E / Q000235:genetics; D003643:Death; D003704:Dementia / Q000523:psychology*; D005190:Family; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E
keywords: Alzheimer's disease; lifespan development; psychosocial stsressors