title: Cerebrospinal fluid apolipoprotein E concentration and progression of Alzheimer's disease.
abstract: OBJECTIVE
  Apolipoprotein E plays a role in the pathogenesis of Alzheimer's disease (AD). Cerebrospinal fluid (CSF) and plasma level alterations have been reported in AD patients. In search of a potential biomarker, which would be predictive of cognitive, functional, or motor decline, we analyzed CSF apolipoprotein E (ApoE) levels of AD patients in this regard.
  
  
  METHODS
  Subjects with newly diagnosed AD enrolled into an observational study were followed up longitudinally. Neuropsychological testing and physical examination were performed annually. In a sub-cohort of patients, where baseline CSF ApoE concentration values were available, multiple regression analyses were used to determine possible associations of CSF ApoE concentration and speed of decline on different cognitive, functional, and motor scales (MMSE, iADL, bADL, GDS, UPDRSIII) adjusting for possible confounders.
  
  
  RESULTS
  No association of CSF ApoE levels and speed of decline on the various scales could be established (p = 0.09 to 0.88). Nevertheless, the use of neuroleptic drugs could be linked to higher velocity of global and extrapyramidal deterioration (p = 0.04 and 0.05 for GDS and UPDRSIII, respectively), but not to other outcomes (MMSE, bADL, and iADL).
  
  
  CONCLUSIONS
  Herein, CSF ApoE at time of AD diagnosis could not be shown to be a viable biomarker for future cognitive, functional, or motor decline. Expectedly, the use of neuroleptic drugs was associated with detrimental effects.
authors.affiliation: Clinical Dementia Center, Dept. of Neurology, Georg-August-University Medical Center, Goettingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmidt
authors.affiliation: Clinical Dementia Center, Dept. of Neurology, Georg-August-University Medical Center, Goettingen, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Gerlach
authors.affiliation: Clinical Dementia Center, Dept. of Neurology, Georg-August-University Medical Center, Goettingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Peter
authors.affiliation: Clinical Dementia Center, Dept. of Neurology, Georg-August-University Medical Center, Goettingen, Germany.
authors.forename: Kerim
authors.initials: K
authors.lastname: Gherib
authors.affiliation: Department of Medical Statistics, University Medical Center, Goettingen, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Lange
authors.affiliation: Department of Medical Statistics, University Medical Center, Goettingen, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Friede
authors.affiliation: Clinical Dementia Center, Dept. of Neurology, Georg-August-University Medical Center, Goettingen, Germany DZNE - German Center for Neurodegenerative Diseases, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Zerr
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000188:drug therapy / Q000503:physiopathology*; D001057:Apolipoproteins E / Q000134:cerebrospinal fluid*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003071:Cognition; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D009043:Motor Activity; D009483:Neuropsychological Tests; D012044:Regression Analysis
chemical_list: D001057:Apolipoproteins E; D015415:Biomarkers
keywords: Alzheimer's disease; apolipoprotein E; biomarker; cerebrospinal fluid; cognition