Bellenguez · Nature genetics 2022 · two-stage genome-wide association study · n=788,989 (111,326 cases/proxy cases and 677,663 controls)

New insights into the genetic etiology of Alzheimer's disease and related dementias.

Cited 2570 times in the scientific literature.

Level 4 - case-series / case-control

Large-scale genome-wide case-control association study.

PubMed 35379992 · doi:10.1038/s41588-022-01024-z · record verified 2026-08-29

What was done

Researchers conducted a two-stage genome-wide association study (GWAS) investigating Alzheimer's disease and related dementias (ADD). The study analyzed genomic data across 111,326 clinically diagnosed or proxy AD cases and 677,663 controls, followed by pathway enrichment analyses, gene prioritization in novel loci, and the development of an updated genetic risk score for disease prediction and progression.

What was found

The GWAS identified 75 risk loci, including 42 novel loci. Pathway analyses confirmed amyloid and tau pathway involvement and highlighted microglial processes. Gene prioritization identified 31 candidate genes pointing to additional biological mechanisms, such as tumor necrosis factor alpha signaling via the linear ubiquitin chain assembly complex. The derived genetic risk score predicted future dementia risk and progression from mild cognitive impairment, showing a 1.6- to 1.9-fold increase in AD risk between the lowest and highest deciles beyond the contributions of age and APOE ε4.

Why it matters

This study substantially expands the known genetic architecture of Alzheimer's disease, highlighting specific neuroinflammatory and microglial pathways and providing an improved polygenic score for stratifying risk.

Limits

The abstract does not specify the demographic or ancestral composition of the cohort. A substantial portion of cases relied on proxy-diagnosis definitions rather than neuropathological or clinical confirmation. Functional validation of prioritized genes is not reported in the abstract.

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