TY - JOUR
T1 - The APOE polymorphism in Alzheimer's disease patients with neuropsychiatric symptoms and syndromes
AU - D'Onofrio, Grazia
AU - Panza, Francesco
AU - Seripa, Davide
AU - Sancarlo, Daniele
AU - Paris, Francesco
AU - Cascavilla, Leandro
AU - Urbano, Maria
AU - Gravina, Carolina
AU - Fontana, Andrea
AU - Solfrizzi, Vincenzo
AU - Pellegrini, Fabio
AU - Pilotto, Alberto
PY - 2011/10
Y1 - 2011/10
N2 - 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 ∈3/∈4 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 ∈4-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 ∈4-carrier status was associated with an increased risk of affective and apathetic syndromes.
AB - 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 ∈3/∈4 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 ∈4-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 ∈4-carrier status was associated with an increased risk of affective and apathetic syndromes.
KW - Alzheimer's disease
KW - APOE
KW - apolipoprotein E
KW - dementia
KW - neuropsychiatric symptoms
KW - neuropsychiatric syndromes
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U2 - 10.1002/gps.2644
DO - 10.1002/gps.2644
M3 - Article
C2 - 21905100
AN - SCOPUS:80052761443
VL - 26
SP - 1062
EP - 1070
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
SN - 0885-6230
IS - 10
ER -