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Morbid Risk in First-Degree Relatives of Persons With Alzheimer's Disease

Leonard L. Heston, MD
Arch Gen Psychiatry. 1988;45(1):97-98. doi:10.1001/archpsyc.1988.01800250113018.
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To the Editor.—  Readers of the Archives should be advised to exercise caution before accepting the conclusions reached by Mohs et al1 regarding the morbid risk of first-degree relatives of persons with Alzheimer's disease. Mohs and coworkers conclude that the risk "approximates 50% by 90 years of age" and go on to suggest that "a common autosomal dominant gene" may be involved.There are two main reasons for doubting these conclusions. First, the risk of Alzheimer's disease in a member of the general population becomes substantial by 90 years of age; most estimates run between 20% and 30%. Therefore, much of the dementia observed by Mohs et al may be coincidental and totally unrelated to genes shared with Alzheimer's disease probands. Indeed, only five cases were observed with onset after 80 years of age among 26.5 relatives at risk at 80 years of age (Mohs and colleagues' Table 1),


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