Apolipoprotein E phenotypes in demented and cognitively impaired patients with and without cerebrovascular disease

Controversy exists regarding the apolipoprotein E (ApoE) epsilon 4 allele a ssociation with vascular dementia (VaD), ranging from increased epsilon 4 f requency, similar to that found for Alzheimer's disease (AD), to no associa tion between the epsilon 4 allele and VaD. To clarify further the relations hip between ApoE alleles polymorphism and cerebrovascular disease (CVD) in demented and cognitively impaired patients, we examined the ApoE phenotypes in a sample of 280 patients: 155 with AD, 21 with VaD, 32 with mixed demen tia (MD), 45 with mild cognitive impairment (MCI) but without CVD, and 27 i n which vascular disease was the most probable cause of cognitive decline [ vascular mild cognitive impairment (VMCI)]. Our results show that the frequ ency of the ApoE epsilon 4 allele in patients over 70 years old with clinic ally diagnosed VaD and VMCI does not differ significantly from that of cont rols. In contrast, ApoE epsilon 4 allele-bearing individuals had greater ri sk of having late-onset AD (OR = 8.8; 95% CI 3.7-21.0), or non-vascular cog nitive impairment (OR = 7.0; 95% CI 2.5-19.0). fur J Neurol 6:415-421 (C) 1 999 Lippincott Williams & Wilkins.