title: Apolipoprotein E-related all-cause mortality in hospitalized elderly patients.
abstract: The most common apolipoprotein E (APOE) allelic variation is implicated in many age-related diseases and human longevity with controversial findings. We investigated the effect of APOE gene polymorphism on all-cause mortality in elderly patients taking into consideration the functional disability, cognitive impairment, malnutrition, and the occurrence of common age-related diseases. APOE genotypes were determined in 2,124 geriatric hospitalized patients (46.5% men and 53.5% women; mean age, 78.2 +/- 7.1 years; range, 65-100 years). At hospital admission, all patients underwent a comprehensive geriatric assessment to evaluate functional disability, cognitive status, nutritional status, and comorbidity. The main and secondary diagnoses at hospital discharge were also recorded. Mortality status was evaluated in all patients after a maximum follow-up of 5 years (range, from 1.26 to 5.23 years; median, 2.86 years). During the study period, 671 patients died (32.0%). At hospital admission, these patients showed a significant higher prevalence of cardiovascular diseases (56.3% vs 53.4%; p = 0.007), neoplasias (32.3% vs 13.7%; p < 0.001), and lower prevalence of neurodegenerative diseases (17.7% vs 20.7%; p < 0.001) than survived patients. Moreover, they also showed an higher prevalence of disability (52.0% vs 25.6%; p < 0.001), cognitive impairment (31.0% vs 18.8%; p < 0.001), and malnutrition (74.0% vs 46.1%; p < 0.001) than survived patients. In the overall study population, the APOE epsilon2 allele was significantly associated to neurodegenerative diseases (odds ratio = 0.59; 95% confidence interval (CI), 0.37-0.94). No significant association between the APOE polymorphism and disability, malnutrition, co-morbidity status, and with all-cause mortality was observed. In patients with cardiovascular diseases, however, a decreased risk of all-cause mortality was found in the epsilon2 allele carriers (hazard ratio = 0.56; 95% CI, 0.36-0.88). In this population, APOE allele variants might play a role on cardiovascular disease-related mortality.
authors.affiliation: Department of Medical Sciences, Geriatrics Unit & Gerontology-Geriatric Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Matera
authors.forename: Daniele
authors.initials: D
authors.lastname: Sancarlo
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
authors.forename: Carolina
authors.initials: C
authors.lastname: Gravina
authors.forename: Grazia
authors.initials: G
authors.lastname: D'Onofrio
authors.forename: Vincenza
authors.initials: V
authors.lastname: Frisardi
authors.forename: Grazia
authors.initials: G
authors.lastname: Longo
authors.forename: Luigi P
authors.initials: LP
authors.lastname: D'Ambrosio
authors.forename: Filomena
authors.initials: F
authors.lastname: Addante
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Solfrizzi
authors.forename: Davide
authors.initials: D
authors.lastname: Seripa
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001057:Apolipoproteins E / Q000235:genetics*; D002318:Cardiovascular Diseases / Q000235:genetics / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D011110:Polymorphism, Genetic
chemical_list: D001057:Apolipoproteins E