APOE-epsilon 4 is associated with weight loss in women with AD - A population-based study

Objective: To investigate whether the APOE-epsilon4 allele is associated wi th weight loss in patients with AD or in nondemented elderly subjects. Back ground: Weight loss has been considered a typical feature of AD. APOE-epsil on4 is a risk factor for AD and was recently proposed to be associated with weight loss in elderly women. It is not known whether APOE-epsilon4 is ass ociated with weight loss in patients with AD or in the general population. Methods: Weight and BMI measurements at an average interval of 3.5 years an d APOE phenotype determination were performed in an elderly population (n = 980), including 46 patients with AD and 911 control subjects at the end of the follow-up. Results: On average, patients with AD with the epsilon4 all ele lost 1.9 +/- 4.0 kg (BMI 0.8 +/- 1.8 kg/m(2)) whereas epsilon4 noncarri ers gained 1.2 +/- 3.8 kg (BMI 0.4 +/- 1.5 kg/m(2)) (both p < 0.05), after controlling for diabetes and exercise. However, when men and women were ana lyzed separately, weight loss was observed only in those women with AD with the <epsilon>4 allele. Clinically significant weight loss, defined as loss of greater than or equal to5% of body weight, occurred more frequently in both patients with AD (30% versus 6%; p < 0.05) and control subjects (28% v ersus 18%; p < 0.001) carrying the epsilon4 allele. Conclusions: The APOE-e psilon4 allele may contribute to the unexplained weight loss in AD, especia lly in women.