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Response to Caselli & Coon

  • Lena Johansson, Institute of Neuroscience and PhysiologyLena.Johansson@neuro.gu.se
Submitted March 17, 2015

We thank Dr. Caselli and Dr. Coon for their comments. Dr. Caselli has noted an error in the in the last row of Table 1, [1] the value in the right column should read "90 (29.0)." Neurology has published a correction of this error.

The APOE data was just analyzed in a sub-sample of 306 women. In those 306 women, 90 had one or two allele e4 -- i.e. 29% - not 11% ---which is written in the table. The incorrect percentage value was faulty computed out of the whole study sample (i.e. n=800). The number of women with allele e4 is therefore what could be expected from other comparable populations. For example, the Kungsholmen Study in Sweden. [2]

Dr. Coon offered the idea of a third variable: socioeconomic status (SES). The main finding of this study [1] was that a higher degree of neuroticism in midlife was associated with increased risk of Alzheimer disease (AD). [1] While the analyses incorporated a dichotomized education (compulsory vs. more than compulsory), no other co-variable of SES was included. It was not meaningful to add more variables while the study had quiet deficient SES data, which made further interpretations uncertain. However, primary analyses included some SES co-variables, i.e. yearly income (husbands' or own), work status (husband's occupation for married women and own occupation for unmarried women), [3] and a multileveled education (lower primary school/higher primary school/secondary school/university). None of these co-variables changed the significant association between neuroticism and AD.

All SES data were collected at baseline 1968, and is a reflection of Swedish women at that time. For example, only one percent of the participants studied at university and one third had full-time work. The effects of these covariates are thus limited to low spread and variation. It is therefore of great interest to make further studies in this area, (in other samples), with better and more modern SES measurements.

1. Johansson L, Guo X, Duberstein PR, et al. Midlife personality and risk of Alzheimer disease and distress. A 38-year followup. Neurology 2014; 83: 1538-1544.

2. Hui-Xin Wang. Education halves the risk of dementia due to apolipoprotein e4 allele: a collaborative study from the Swedish Brain Power initiative. Neurobiol Aging 2012;33:1007.e1-7.

3. Carlsson G. Socialgruppering: Social mobility and class structure. Lund, Sweden: University of Lund, GWK Gleerup; 1958.

For disclosures, please contact the editorial office at journal@neurology.org.

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Neurology | Print ISSN:0028-3878
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