title: Prevalence of apolipoprotein E4 genotype and homozygotes (APOE e4/4) among patients diagnosed with Alzheimer's disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Population allele frequencies of apolipoprotein E (APOE) vary by geographic region. The purpose of this study is to summarize and evaluate published estimates for the prevalence of APOE e4 carrier status among the population diagnosed with Alzheimer's disease (AD) by geographic region and country.
  
  
  METHODS
  A systematic review of English-language publications from January 1, 1985, through May 31, 2010, was conducted. Studies reporting APOE e4 status for patients diagnosed with AD were included in the analysis; trials and autopsies were excluded. APOE e4 data were pooled, and prevalence and 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  Pooled estimates for APOE e4 carrier prevalence data were derived from 142 independent samples: 48.7% (95% CI: 46.5-51.0), and from 73 samples for e4/4 (homozygotes): 9.6% (95% CI: 8.4-10.8). The highest estimates were in Northern Europe: 61.3% (95% CI: 55.9-66.7), e4/4 prevalence: 14.1% (95% CI: 12.2-16.0). The lowest estimates were in Asia and Southern Europe. Substantial heterogeneity of these prevalence estimates was observed.
  
  
  CONCLUSIONS
  APOE e4 genotype prevalence varies among AD patients by region and within each country. Further exploration is warranted to better understand the substantial heterogeneity of these prevalence estimates.
authors.affiliation: Center for Epidemiology and Database Analytics, United BioSource Corporation, Lexington, MA 02420, USA. alex.ward@unitedbiosource.com
authors.forename: Alex
authors.initials: A
authors.lastname: Ward
authors.forename: Sheila
authors.initials: S
authors.lastname: Crean
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Mercaldi
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Collins
authors.forename: Dylan
authors.initials: D
authors.lastname: Boyd
authors.forename: Michael N
authors.initials: MN
authors.lastname: Cook
authors.forename: H Michael
authors.initials: HM
authors.lastname: Arrighi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology / Q000235:genetics*; D001057:Apolipoproteins E / Q000235:genetics*; D001208:Asia / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D005787:Gene Frequency; D018740:Genetic Heterogeneity; D005828:Genetics, Population; D005838:Genotype; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D012044:Regression Analysis; D013020:South America / Q000453:epidemiology
chemical_list: D001057:Apolipoproteins E