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Use of twin cohorts for research in Alzheimer's disease*

Department of Psychiatry, and Joseph and Kathleen Bryan Alzheimer's Disease Research Center (Drs. Breitner and Welsh), Duke University Medical Center, Durham, NC; the Department of Psychology (Dr. Gatz), University of Southern California, Los Angeles, CA; the Department of Psychiatry (Dr. Bergem), University of Oslo, Oslo, Norway; the Department of Medical and Molecular Genetics (Dr. Christian), Indiana University School of Medicine, Indianapolis, IN; the Geriatric Research, Education and Clinical Center, VA Medical Center, and Department of Neurology (Dr. Mortimer), University of Minnesota, Minneapolis, MN; College of Health and Human Development (Dr. McClearn), Pennsylvania State University, University Park, PA; the Washington Institute for Mental Illness Research and Training (Dr. Heston), Fort Steilacoom, WA; the Departments of Psychiatry and Behavioral Sciences and of Mental Hygiene (Drs. Anthony and Folstein), The Johns Hopkins University, Baltimore, MD; and the National Institute on Aging (Dr. Radebaugh), Bethesda, MD.

The causes of Alzheimer's disease (AD) remain a mystery despite the recent identification of several putative environmental risk factors and the discovery of several linked genetic loci and point mutations associated with the disease. Particularly uncertain is the generalizability of the genetic findings to the common forms of disease encountered in clinical practice or population research. Twin studies of AD can illuminate causal mechanisms, both genetic and environmental. This consensus document explores the rationale for such twin studies, as well as a number of methodologic problems that render them difficult to implement or interpret. We review existing twin studies of AD and note several ambitious new studies. Finally, we delineate several practical strategies for the near future of twin research in AD.

Address correspondence and reprint requests to Dr. J.C.S. Breitner, Box 3925, Duke University Medical Center, Durham, NC 27710.

*Consensus document from a symposium sponsored by the National Institute on Aging and the Duke University Collaborative Twin Studies of Alzheimer's disease, October 25, 1991.

Received May 19, 1992. Accepted for publication in final form June 18, 1992.

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