Apolipoprotein E Genotypes in Hospitalized Elderly Patients with Vascular Dementia

• Published in: Dementia and geriatric cognitive disorders 2007-01, Vol.23 (5), p.327-333
• Main Authors: Orsitto, Giuseppe, Seripa, Davide, Panza, Francesco, Franceschi, Marilisa, Cascavilla, Leandro, Placentino, Giuliana, Matera, Maria Giovanna, Paris, Francesco, Capurso, Cristiano, Solfrizzi, Vincenzo, Dallapiccola, Bruno, Pilotto, Alberto
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - genetics; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Apolipoprotein E3 - classification; Apolipoprotein E3 - genetics; Apolipoprotein E4 - classification; Apolipoprotein E4 - genetics; Biological and medical sciences; Cognition Disorders - genetics; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia, Vascular - genetics; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Gene Frequency; Human viral diseases; Humans; Infectious diseases; Inpatients; Intensive care medicine; Male; Medical sciences; Neurology; Original Research Article; Polymorphism, Genetic; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000100972

Background: Polymorphism in the apolipoprotein E (APOE) gene is the major genetic risk factor associated with late-onset Alzheimer’s Disease (AD). However, it is still unclear if a relationship exists between the APOE Ε4 allele and vascular dementia (VaD) in elderly subjects. Objectives: To evaluate the prevalence of APOE alleles in elderly patients with VaD compared to AD patients and to control subjects with no cognitive impairment (NoCI). Patients and Methods: We evaluated 396 consecutive patients aged ≧65 years with definite or suspected cognitive impairment with a clinical (Mini-Mental State Examination, Clinical Dementia Rating, Geriatric Depression Scale), functional (Activities of Daily Living, Instrumental Activities of Daily Living), comorbidity (Cumulative Illness Rating Scale) and instrumental (CT scan, NMR) assessment. Diagnosis of dementia was made according to NINCDS-ADRDA and NINDS-AIREN Work Group and the DSM-IV. APOE genotypes were analyzed by a recently described method resulting in positive/negative chain reaction products for each APOE genotype. Statistical analysis was carried out using the Pearson χ 2 , the Kruskal-Wallis test and the ANOVA post hoc comparisons. Results: A total of 287 elderly patients (males = 138, females = 149, mean age = 77.8 ± 6.9 years, range = 65–98) with diagnoses of VaD (n = 97), AD (n = 82) or NoCI (n = 108) were included in the study. A significantly higher APOE Ε4 allele frequency was observed in AD patients compared to VaD and/or NoCI subjects, while no differences were found between VaD patients and subjects with NoCI (AD = 24.3%, VaD = 10.3, NoCI = 8.7, p < 0.05). Furthermore, a significantly lower APOE Ε3 allele frequency was observed in AD patients compared to VaD and/or NoCI subjects but not between VaD and NoCI patients (AD = 71.3%, VaD = 80.9, NoCI = 83.4, p < 0.05). No significant differences were observed in the APOE Ε2 allele (VaD = 8.8%, AD = 4.4, NoCI = 7.9, p = n.s.) among the 3 groups. Conclusions: In this population, the frequency of the APOE Ε4 allele is lower in VaD than in AD.