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J Alzheimers Dis. 2018;61(4):1377-1385. doi: 10.3233/JAD-170556.

The Impact of APOE ɛ4 in Alzheimer's Disease Differs According to Age.

Kim J1,2, Park S1,2, Yoo H3, Jang H1,2, Kim Y1,2, Kim KW1,2,4, Jang YK1,2, Lee JS5, Kim ST6, Kim S7, Lee JM8, Ki CS9, Na DL1,2,10, Seo SW1,2,11, Kim HJ1,2.

Author information

1
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
Neuroscience Center, Samsung Medical Center, Seoul, Korea.
3
Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea.
4
Department of Neurology, Chonbuk National University Hospital, Chonbuk National University Medical school, JeonJu, Korea.
5
Department of Neurology, Kyung Hee University Hospital, Seoul, Korea.
6
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
7
Biostatistics team, Samsung Biomedical Research Institute, Samsung Medical Center, Seoul, Korea.
8
Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
9
Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
10
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
11
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.

Abstract

We evaluated how the impact of apolipoprotein E4 (APOE4) differs according to age in Alzheimer's disease (AD) patients. We recruited 846 AD patients and 815 cognitively normal controls and categorized into three groups with respect to their age (<65, 65-74, and ≥75 years). We evaluated the risk of AD in APOE4 carriers and compared cortical thickness and cognitive function according to APOE4 status in each age group. At the point of this study, in young (<65 years) AD, APOE4 noncarriers had the most severe frontal and perisylvian atrophy, while in old (≥75 years) AD, APOE4 carriers had the most severe medial temporal atrophy. In AD under 75 years, APOE4 noncarriers and heterozygotes showed worse performance in language, visuospatial, and frontal function compared to homozygotes, while, in old (≥75 years) AD, APOE4 homozygotes showed worse performance in memory compared to noncarriers. As the detrimental effects of APOE4 seen in older AD patients were not found in younger AD patients, we suggest that some unrevealed factors are associated with cortical atrophy and non-amnestic cognitive dysfunction in young AD with APOE4 noncarriers.

KEYWORDS:

Alzheimer’s disease; Apolipoprotein E4 (APOE4); cognitive dysfunction; magnetic resonance imaging

PMID:
29376853
DOI:
10.3233/JAD-170556
[Indexed for MEDLINE]

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