Clinical features of dementia associated with apolipoprotein epsilon4: discrimination with a neural network genetic algorithm.
BACKGROUND
It is unclear whether the APOE epsilon4 allele is associated with distinct clinical features in dementia.


METHODS
100 cases meeting ICD criteria for dementia were interviewed using standardized instruments and genotyped for APOE. The presence of the epsilon4 allele was used by a genetic algorithm neural network (GANN) to discriminate symptoms and signs.


RESULTS
The GANN selected six features: gender, systolic blood pressure, absence of ankle tendon reflexes, history of weight loss, history of falls, and interviewer observed lability of mood. Using these features, a neural network discriminated cases according to epsilon4 highly accurately (area under receiver operating characteristic=0.83, sensitivity=0.78, specificity=0.78).


CONCLUSIONS
A GANN is able to discriminate a clinically distinct group of features among dementia patients who express the epsilon4 allele.
Jefferson
M F
MF
Department of Geriatric Medicine, University of Manchester, Clinical Sciences Building, Hope Hospital, Stott Lane, Salford, Manchester M6 8HD, UK.
Burlinson
S
S
Burns
A
A
Mann
D
D
Pickering-Brown
S
S
Owen
F
F
Sriwardhana
C
C
Pendleton
N
N
Horan
M A
MA
D000058:Accidental Falls; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000032:analysis / Q000235:genetics*; D001794:Blood Pressure; D003704:Dementia / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D016571:Neural Networks, Computer; D012021:Reflex, Abnormal; D012307:Risk Factors; D012737:Sex Factors; D015431:Weight Loss
D053327:Apolipoprotein E4; D001057:Apolipoproteins E