title: Angiotensin-converting enzyme insertion/deletion polymorphism and the longitudinal progression of Alzheimer's disease.
abstract: OBJECTIVE
  The angiotensin-converting enzyme gene (ACE) insertion (I)/deletion (D) polymorphism is considered a biologically plausible gene for Alzheimer's disease (AD) in cross-sectional studies. The present study aimed to investigate the longitudinal effect of ACE I/D polymorphism on AD progression.
  
  
  METHODS
  This 3-year observational study investigated the longitudinal effect of ACE I/D polymorphism on AD progression. Clinically diagnosed AD patients with a clinical dementia rating (CDR) of 0.5 or 1 were enrolled in the study. The Mini-Mental State Examination (MMSE), Cognitive Assessment Screening Instrument (CASI) and the CDR scale were carried out for all patients on the date of the initial interview and 36 ± 6 months after the initial evaluation.
  
  
  RESULTS
  A total of 177 patients with sporadic AD were enrolled in this study. Among all patients, those with the I/I genotype showed a higher risk of CDR deterioration (I/I versus I/D + D/D: adjusted OR 2.103, 95% CI 1.113-3.972; adjusted P = 0.022). Among 74 AD patients without hypertension, those with the I/I genotype showed significantly greater differences in the MMSE, CASI and the CDR-sum of box scores, and a higher risk of CDR deterioration (I/I versus I/D + D/D: adjusted OR 3.255, 95% CI 1.099-9.639; adjusted P = 0.033) after adjustment for possible confounders during the 3-year follow up.
  
  
  CONCLUSIONS
  Patients with AD who were homozygous for the I allele presented with a more rapid AD deterioration than did those who had other ACE genotypes, particularly those patients without hypertension. Geriatr Gerontol Int 2017; 17: 1544-1550.
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Ping-Song
authors.initials: PS
authors.lastname: Chou
authors.affiliation: Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Meng-Ni
authors.initials: MN
authors.lastname: Wu
authors.affiliation: Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.|Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Mei-Chuan
authors.initials: MC
authors.lastname: Chou
authors.affiliation: Department of Neurology, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: I
authors.initials: I
authors.lastname: Chien
authors.affiliation: Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.|Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of and Master's Program in Neurology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yuan-Han
authors.initials: YH
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000235:genetics* / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic / Q000235:genetics*
chemical_list: D007703:Peptidyl-Dipeptidase A
keywords: Alzheimer's disease; angiotensin-converting enzyme; dementia; genetic risk factors; indel polymorphism