title: Mortality is associated with apolipoprotein E epsilon4 in nondemented adults with Down syndrome.
abstract: Apolipoprotein E genotype has been related to survival in the general population, but its strong association with Alzheimer's disease (AD) makes interpretation of findings difficult. Previous studies of adults with Down syndrome (DS) have consistently found that the presence of the apolipoprotein E epsilon2 allele increases longevity and reduces the risk of dementia, while the apolipoprotein E epsilon4 allele increases risk for dementia. In contrast, reduced frequencies of the apolipoprotein E epsilon4 allele among elderly groups have been reported, suggesting that the epsilon4 allele may be associated with early mortality in this population. To disentangle effects of dementia from those of aging, per se, we compared mortality risk as a function of apolipoprotein E genotype in 146 nondemented adults with DS in a prospective study. Individuals with at least one epsilon4 allele were approximately five times more likely to die within a 5- to 7-year follow-up period than those without an epsilon4 allele, adjusting for age, sex, body mass index, level of mental retardation, and cholesterol level. These results suggest that the apolipoprotein E epsilon4 allele has an independent and strong relation to early mortality.
authors.affiliation: New York State Institute For Basic Research in Developmental Disabilities, 1050 Forest Hill Road, Staten Island, NY 10314-6399, USA. wbzigman@aol.com
authors.forename: Warren B
authors.initials: WB
authors.lastname: Zigman
authors.forename: Edmund C
authors.initials: EC
authors.lastname: Jenkins
authors.forename: Benjamin
authors.initials: B
authors.lastname: Tycko
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.forename: Wayne
authors.initials: W
authors.lastname: Silverman
mesh_terms: D000328:Adult; D000483:Alleles; D053327:Apolipoprotein E4; D001057:Apolipoproteins E / Q000378:metabolism*; D003704:Dementia / Q000503:physiopathology*; D004314:Down Syndrome / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D053327:Apolipoprotein E4; D001057:Apolipoproteins E