Psychiatry Investig.  2022 Mar;19(3):190-196. 10.30773/pi.2021.0347.

Incidence and Cognitive Decline of Alzheimer’s Disease and Other Dementia by Apolipoprotein ε4 Allele Presence: A Community-Based Cohort Study in Korean Elderly

Affiliations
  • 1Department of Psychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
  • 2Department of BioSciences & Department of Statistics, Rice University, Houston, TX, USA
  • 3Division of Teacher Education, College of General Education for Truth, Sincerity and Love, Kyonggi University, Suwon, Republic of Korea
  • 4Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea

Abstract


Objective
This study aimed to investigate the role of apolipoprotein E (APOE) ε4 allele to the incidence of dementia and cognitive decline in a cohort of a Korean community.
Methods
From a community-based dementia-free cohort, 357 participants were genotyped. Participants underwent 2 cognitive assessments separated by a hiatus between 6 to 7 years and were diagnosed as healthy control (n=297), Alzheimer’s disease (AD) (n=44), and other dementia (n=16) at the second assessment. Incidence risk and onset age of disease according to APOE ε4 presence were analyzed in AD and other dementia. Differences in cognitive decline rate depending on APOE ε4 were also examined across all groups.
Results
The relative risks and onset age of dementia were not different by the presence of the APOE ε4 allele. Cognitive decline was more prominent in the presence of APOE ε4 allele (score change=7.4) than non-presence (score change=3.1), and this interaction was significant only in the AD group (F=10.51, p=0.003).
Conclusion
The APOE ε4 alleles can be a critical factor in predicting cognitive change for AD in the Korean community population but not in predicting AD incidence. This finding suggest that clinicians consider the presence of APOE ε4 allele examining patients with rapid declining dementia.

Keyword

Apolipoprotein E; Cognitive decline; Alzheimer’s disease; Community
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