Y. Stern et al., THE ABSENCE OF AN APOLIPOPROTEIN EPSILON-4 ALLELE IS ASSOCIATED WITH A MORE AGGRESSIVE FORM OF DISEASE,ALZHEIMERS, Annals of neurology, 41(5), 1997, pp. 615-620
We investigated the relationship between APOE genotype and rate of dis
ease progression and survival in 99 patients with probable Alzheimer's
disease (AD) who were followed biannually for up to 6 years. Patients
were stratified into two groups, those with and without at least one
APOE epsilon 4 allele. The rate of decline in modified Mini-Mental Sta
te Examination scores was slower, the presence of extrapyramidal signs
was decreased, and the development of myoclonus occurred later among
patients with APOE epsilon 4 alleles compared with patients with other
genotypes. Compared with patients without an APOE epsilon 4 allele, t
he risk of mortality was also decreased in patients with at least one
epsilon 4 allele (RR = 0.38; CI = 0.17-0.84, p < 0.02). Because the de
cline in mental ability as well as the development of myoclonus and ex
trapyramidal signs are consistent manifestations of disease progressio
n, our results imply that APOE epsilon 4 is associated with a less agg
ressive form of AD.