Research Paper Volume 13, Issue 19 pp 23348—23360
Differential moderation effects of ApoE and 5-HTTLPR genotypes on social vulnerability in predicting mortality among community-dwelling middle-aged and older adults: a nationwide population-based study
- 1 Aging and Health Research Center, National Yang Ming Chiao Tung University Yangming Campus, Taipei City, Taiwan
- 2 Institute of Public Health, National Yang Ming Chiao Tung University Yangming Campus, Taipei City, Taiwan
- 3 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei City, Taiwan
- 4 Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
- 5 Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yilan City, Taiwan
- 6 Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, Taiwan
- 7 School of Pharmacy, College of Medicine, National Taiwan University, Taipei City, Taiwan
- 8 Department of Pharmacy, National Taiwan University Hospital, Taipei City, Taiwan
- 9 Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei City, Taiwan
- 10 Department of Family Medicine, Kaohsiung Veterans General Hospital Pingtung Branch, Pingtung County, Taiwan
Received: July 12, 2021 Accepted: October 3, 2021 Published: October 14, 2021https://doi.org/10.18632/aging.203629
How to Cite
Copyright: © 2021 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aging is a dynamic complex process involving social vulnerability over time. The social vulnerability index (SVI) was developed that predicted adverse health outcomes. This study examined effects between SVI status and two genotypes, apolipoprotein E (ApoE) and Serotonin transporter genotyping (5-HTTLPR), on all-cause mortality. Data from the Social Environment and Biomarkers of Aging Study (SEBAS) were obtained, and SVI was constructed using 32 self-reported items of social determinants. Data from 985 participants (age: 65.73 ± 9.47 years, 54.62% males) were obtained for analysis, and the median SVI was 0.35 (IQR 0.29–0.42) with a near normal distribution. Participants with a higher SVI were more likely to be women and have poor cognitive function, more depressive symptoms and poor physical function. Adjusted for age and sex, each incremental deficit in SVI was associated with a 12% increase in mortality risk (HR: 1.12, 95% CI: 1.04–1.20, p = 0.002). An interaction was found between ApoE and SVI but not 5-HTTLPR. The strata-specific hazard ratio confirmed that associations between SVI and mortality was only in non-ε4 carriers (HR: 1.15, 95% CI: 1.07–1.24, p < 0.001), and SVI did not significantly predict mortality among ε4 carriers (HR: 0.84, 95% CI: 0.65–1.10). Differential SVI effects on mortality among middle-age and older adults were identified. In conclusion, a higher SVI was associated with all-cause mortality among middle-aged and older adults, and the association was moderated by ApoE genotypes but not 5-HTTLPR. Further study is needed to evaluate the clinical efficacy of healthy aging intervention programs considering gene-environment interactions and social vulnerability.