title: The APOE polymorphism in Alzheimer's disease patients with neuropsychiatric symptoms and syndromes.
abstract: BACKGROUND
  Neuropsychiatric symptoms (NPS) are a common feature of Alzheimer's disease (AD), resulting in particular AD endophenotypes. The common AD genetic risk factor apolipoprotein E (APOE) has been suggested underlying these AD endophenotypes.
  
  
  METHODS
  APOE genotyping, a comprehensive geriatric assessment (CGA), and Neuropsychiatric Inventory were performed on 322 consecutive older patients. Patients were divided into three groups: AD with NPS (N = 93), AD without NPS (N = 108), and, as a control group, patients with no cognitive impairment (NoCI: N = 121). Patients with NPS were further sub-divided in four groups according to the European Alzheimer's Disease Consortium (EADC) classification of neuropsychiatric syndromes in AD: hyperactive, psychotic, affective, and apathetic.
  
  
  RESULTS
  AD patients with NPS showed a significantly higher grade of cognitive impairment, more severity stage of dementia, more disability in the activities of daily living (ADL), and the instrumental ADL than AD patients without NPS. As expected, an higher frequency of APOE ε3/ε4 genotype was observed in patients with AD, both with and without NPS, than patients with NoCI. No difference in the distribution of APOE genotypes was found between AD patients with vs. without NPS. However, in AD patients APOE ε4-carriers, there was an increased risk of affective [odds ratio (OR): 2.34, 95% confidence interval (CI): 1.19-4.58) and apathetic (OR: 2.24,95%CI: 1.19-4.22) syndromes.
  
  
  CONCLUSIONS
  These findings did not suggest a significant association between APOE polymorphism and presence of NPS in AD patients. In AD patients with NPS, however, APOE ε4-carrier status was associated with an increased risk of affective and apathetic syndromes.
authors: Geriatrics Unit and Gerontology-Geriatric Research Laboratory, Department of Medical Sciences, IRCCS 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, FG, Italy.
authors: Grazia
authors: G
authors: D'Onofrio
authors: Francesco
authors: F
authors: Panza
authors: Davide
authors: D
authors: Seripa
authors: Daniele
authors: D
authors: Sancarlo
authors: Francesco
authors: F
authors: Paris
authors: Leandro
authors: L
authors: Cascavilla
authors: Maria
authors: M
authors: Urbano
authors: Carolina
authors: C
authors: Gravina
authors: Andrea
authors: A
authors: Fontana
authors: Vincenzo
authors: V
authors: Solfrizzi
authors: Fabio
authors: F
authors: Pellegrini
authors: Alberto
authors: A
authors: Pilotto
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D000544:Alzheimer Disease / Q000235:genetics* / Q000503:physiopathology / Q000523:psychology*; D001057:Apolipoproteins E / Q000235:genetics*; D003072:Cognition Disorders; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011110:Polymorphism, Genetic; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
chemical_list: D001057:Apolipoproteins E