Cerebral white matter lesions are not associated with apoE genotype but with age and female sex in Alzheimer's disease

Cerebral white matter lesions, such as leukoaraiosis, may be a result of da mage from cerebral ischaemia, and may also be associated with the degenerat ive process in Alzheimer's disease. The apolipoprotein epsilon 4 (apo epsil on 4) genotype is a genetic risk factor for both Alzheimer's disease and is chaemic brain damage through acceleration of atherosclerosis. The aim was t o determine whether apo epsilon 4 may be related to the formation of cerebr al white matter lesions in Alzheimer's disease. The association of apoE gen otype, sex, age, and the presence of several vascular risk factors, with th e presence of white matter lesions in 55 patients clinically diagnosed with Alzheimer's disease was investigated. The cerebral white matter lesions we re identified by T2 weighted MRI and classified on a 4 grade scale from no lesion to diffuse lesion. The odds ratio (OR) of the factors mentioned abov e to the presence of white matter lesions was determined and tested by Fish er's exact test. The association of the lesion grades with these factors wa s analysed by non-parametric tests. The apoE 4 genotype was strongly associ ated with Alzheimer's disease (p=0.0001), but not associated with the prese nce or the degree of cerebral white matter lesions in Alzheimer's disease ( OR=1.09, p>0.99). Aging (>70 years old) was a significant risk factor for w hite matter lesions (OR=7.2, p=0.0006) and age was significantly correlated with the lesion (p=0.0075). The OR of female sex to the lesion grades was 2.89 (p=0.084) and the lesion grade of female sex was significantly higher than that of the male sex (p=0.047). Other vascular risk factors were not s ignificantly associated with the presence of white matter lesions. These fi ndings suggest that there is a sex difference in white matter pathology in Alzheimer's disease.