Key result
APOE ε4+ genotype linked to ~582% higher dementia conversion risk in mild cognitive impairment.
Why the study?
The relationship between APOE genotype and cerebrovascular functional and anatomic status in MCI patients and its influence on conversion to dementia was unclear.
Does APOE ε4 carrier status increase the risk of conversion to dementia and cerebrovascular alterations in patients with mild cognitive impairment?
Cohort (n=75)
Does APOE ε4 carrier status increase the risk of conversion to dementia and cerebrovascular alterations in patients with mild cognitive impairment?
Odds Ratio: 6.818 (95% CI 1.894–24.545)
p-value: p=0.003
APOE ε4 genotype increases the risk of progression to dementia in MCI patients both directly and indirectly through functional and anatomic impairment of cerebral vessels.
APOE ε4 links to worse cerebrovascular function and higher MCI-to-dementia conversion in this cohort; leaves open whether vascular interventions alter risk.
The presence of apolipoprotein E (APOE) ε4 allele is the only recognized genetic risk factor for the sporadic form of Alzheimer's disease. The aim of this study was to investigate the relationship between APOE genotype and the functional and anatomic status of cerebral vessels in patients with mild cognitive impairment (MCI). Moreover, we explored whether the possible correlation between APOE genotype and cerebrovascular parameters influences the risk of conversion from MCI to dementia. 75 MCI patients underwent a complete neuropsychological battery at baseline and after 24 months to evaluate the possible conversion to dementia. Ultrasound assessment of neck and intracranial vessels was performed to assess common carotid artery intima-media thickness (IMT), plaque index, and cerebrovascular reactivity (breath-holding index, BHI). APOE genotype was determined to classify patients as carriers (APOE ε4+) and non-carriers (APOE ε4-). Pathologic values of BHI and IMT were significantly more common in ε4 carriers than in non-carriers [OR 6.603 (95% CI: 1.678-25.997), p < 0.05 and OR 5.195 (95% CI 1.319-20.464), p < 0.05; logistic regression adjusted model]. The risk of conversion to dementia was significantly higher in APOE ε4+ patients than in APOE ε4- ones (OR: 6.818; 95% CI:1.894-24.545, p = 0.003). A path-analysis model showed that APOE genotype influences the progression to dementia directly and indirectly by increasing the risk of pathologic values of IMT or BHI. Our data, besides confirming an increased susceptibility of MCI patients with APOE ε4 to develop dementia, show an association between functional and anatomic impairment of the cerebral vessels and APOE ε4+ genotype.
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Viticchi et al. (2014) conducted a cohort in Mild cognitive impairment (MCI) (n=75). APOE ε4+ genotype vs. APOE ε4- genotype was evaluated on Conversion to dementia (OR 6.818, 95% CI 1.894-24.545, p=0.003). APOE ε4+ genotype significantly increased the risk of conversion to dementia in patients with mild cognitive impairment compared to non-carriers (OR 6.818; 95% CI 1.894-24.545; p=0.003).
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