Apolipoprotein E genotypes in hospitalized elderly patients with vascular dementia.
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 epsilon4 allele and vascular dementia (VaD) in elderly subjects.


OBJECTIVE
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).


METHODS
We evaluated 396 consecutive patients aged > or =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 chi(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 epsilon4 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 epsilon3 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 epsilon2 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 epsilon4 allele is lower in VaD than in AD.
Orsitto
Giuseppe
G
Geriatric Unit, Medical Sciences Department, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Seripa
Davide
D
Panza
Francesco
F
Franceschi
Marilisa
M
Cascavilla
Leandro
L
Placentino
Giuliana
G
Matera
Maria Giovanna
MG
Paris
Francesco
F
Capurso
Cristiano
C
Solfrizzi
Vincenzo
V
Dallapiccola
Bruno
B
Pilotto
Alberto
A
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000235:genetics*; D000704:Analysis of Variance; D053318:Apolipoprotein E3 / Q000145:classification / Q000235:genetics*; D053327:Apolipoprotein E4 / Q000145:classification / Q000235:genetics*; D003072:Cognition Disorders / Q000235:genetics*; D015140:Dementia, Vascular / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D006801:Humans; D007297:Inpatients; D008297:Male; D011110:Polymorphism, Genetic
D053318:Apolipoprotein E3; D053327:Apolipoprotein E4