title: The 5-HTTPR polymorphism confers liability to a combined phenotype of psychotic and aggressive behavior in Alzheimer disease.
abstract: BACKGROUND
  Psychotic symptoms in subjects with Alzheimer disease (AD+psychosis, AD+P) are a marker for a distinct phenotype characterized by more rapid cognitive and functional decline and a liability to aggressive behaviors. We recently found that AD subjects homozygous for long alleles (l) of an insertion/deletion polymorphism in the promoter region of the serotonin transporter (5-HTTPR) had elevated rates of aggressive behavior.
  
  
  OBJECTIVE
  To examine whether the 5-HTTPR ll genotype confers an increased risk of AD+P, and of the combined AD+P/aggressive phenotype.
  
  
  METHODS
  The 5-HTTPR genotype was determined in 332 subjects diagnosed with possible or probable AD. All subjects received structured psychiatric assessments and were categorized with regard to their history of aggressive behaviors and psychotic symptoms.
  
  
  RESULTS
  Consistent with other reports, AD+P was associated with a significant increased risk for aggressive behavior. AD+P and aggression were both significantly associated with 5-HTTPR ll genotype and with an increased l allele frequency. Subjects with the combined behavioral phenotype (AD+P and aggressive behavior) had the highest rate of ll genotype and highest l allele frequency.
  
  
  CONCLUSIONS
  The 5-HTTPR l allele appears to confer risk for the combined AD+P/aggressive phenotype. Confirmation of this association in a similar behaviorally well-characterized independent sample is needed.
authors: Department of Psychiatry, School of Medicine, University of Pittsburgh, Pennsylvania, USA. sweetra@msx.upmc.edu
authors: R A
authors: RA
authors: Sweet
authors: B G
authors: BG
authors: Pollock
authors: D L
authors: DL
authors: Sukonick
authors: B H
authors: BH
authors: Mulsant
authors: J
authors: J
authors: Rosen
authors: W E
authors: WE
authors: Klunk
authors: K B
authors: KB
authors: Kastango
authors: S T
authors: ST
authors: DeKosky
authors: R E
authors: RE
authors: Ferrell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D000483:Alleles; D000544:Alzheimer Disease / Q000175:diagnosis / Q000235:genetics*; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005838:Genotype; D006801:Humans; D008297:Male; D010641:Phenotype; D011110:Polymorphism, Genetic / Q000235:genetics*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000235:genetics*; D018570:Risk Assessment