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The family connection. Doctors have not always had a good answer when a brother, sister, son, or daughter of an Alzheimer's patient asks, "What are my chances of having memory problems as I get older?" Now a method of assessing a family member's lifetime risk of dementia has been developed by MED Professor Lindsay Farrer and SPH Professor Adrienne Cupples, members of the Multi-Institutional Research in Alzheimer's Genetic Epidemiology (MIRAGE) Study Group. It has been applied to a large number of white and African-American families by Robert C. Green, an associate professor of neurology at the School of Medicine, and other MIRAGE colleagues.

The method is based on clinical and genetic data collected over a period of 10 years by 17 medical centers from more than 2,000 families with Alzheimer's disease (AD), including more than 200 African-American families, the largest number of AD families ever studied in this manner. The study is the first to assess a large number of African-American families and to compare the risk of developing AD in white and African-American families.

The study estimates the cumulative risk of dementia by age 85 for first-degree relatives and spouses of AD patients. It takes into account such established risk factors as age, family history, female sex, and the presence of the APOE gene. Estimates for African-American and white family members in every risk category revealed that African-Americans have a higher risk of developing AD. Coauthor Patrick Griffith, a neurologist at Morehouse School of Medicine, says that the underlying causes of this finding are still to be determined. "Because African-Americans have higher rates of hypertension," he says, "the answer may lie in the complex interactions between aging, hypertension, and some types of stroke."

"This information is not simply academic," says Green. "Since treatments to slow or prevent AD are expected to be available within the next few years, accurate risk assessment will be critical to designing treatment trials for these compounds, and ultimately to deciding how to use such treatments in clinical practice."

The dementia risk study was published in the January 16 Journal of the American Medical Association. The MIRAGE Study Group is supported by the National Institute on Aging with additional support from the National Human Genome Research Institute.

Caution, baby on board. Babies born to women who smoke during pregnancy are more likely to be of low birth weight (LBW), making them susceptible to a host of health problems, including an increased risk of infant death. Each year more than 300,000 LBW infants, babies weighing less than five pounds, eight ounces (2,500 grams), are born in the United States.

About 65 percent of all infant deaths occur among low birth weight babies.
A new study by Xiaobin Wang, a MED associate professor of pediatrics, colleagues at the School of Medicine and Boston Medical Center, and associates at the Harvard School of Public Health and Beijing Medical University has found that women with particular genetic variations who smoke are even more at risk of delivering low birth weight babies.

The study found that women who smoked during pregnancy, regardless of genotype, delivered babies who were on average 13.3 ounces lighter than babies born to nonsmokers. Women with specific variants in the CYP1A1 and GSTT1 genes, however, had babies weighing significantly less -- between 1.1 pounds and as much as 2.8 pounds lower than average at birth.

"This study is the first step to understanding how genetic susceptibility interacts with environmental exposures to affect infant birth weight," says Wang. The authors stress that LBW is a very complex entity, and many more environmental and genetic factors need to be examined -- among them diet and alcohol and drug use, as well as the interaction of other maternal genes and the genotype of the developing embryo.

The LBW study appears in the January 9 issue of the Journal of the American Medical Association.

"Research Briefs" is written by Joan Schwartz in the Office of the Provost. To read more about BU research, visit http://www.bu.edu/research.

18 January 2002
Boston University
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