EFFECTS OF APOLIPOPROTEIN-E ON DEMENTIA AND AGING IN THE SHANGHAI SURVEY OF DEMENTIA

We investigated the status of the apolipoprotein E allele in 538 parti cipants in the incidence phase of the ongoing Shanghai Survey of Demen tia, including 103 demented subjects, 72 with mild cognitive impairmen t and 363 cognitively normal. The apo E epsilon 4 allele was present i n 10.2% of control subjects and the allelic frequency did not change b etween ages 60 to 96 years. The apo E epsilon 4 allelic frequency was increased both in those with Alzheimer's disease (AD) (25.4%) and thos e with vascular dementia (VaD) (22.2%), but not in those with other de menting illnesses or the cognitively impaired. All of the subjects hom ozygous for apo E epsilon 4 were demented, three were diagnosed as hav ing AD, and three met NINDS/AIREN criteria for VaD. The increased apo E epsilon 4 allelic frequency in clinically diagnosed VaD patients sug gests that some of the infarcts are secondary to congophilic angiopath y. The adjusted odds ratio of developing AD in this community-derived study for persons with at least one apo E epsilon 4 allele was 4.1 (95 % CI: 2.2, 7.7). Thus, the apo E epsilon 4 risk of developing AD in th is Chinese cohort is similar to that in western community studies.