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. 2018 Jul;14(7):913-924.
doi: 10.1016/j.jalz.2018.02.009. Epub 2018 Mar 28.

Prevalence of the apolipoprotein E ε4 allele in amyloid β positive subjects across the spectrum of Alzheimer's disease

Niklas Mattsson  1 Colin Groot  2 Willemijn J Jansen  3 Susan M Landau  4 Victor L Villemagne  5 Sebastiaan Engelborghs  6 Mark M Mintun  7 Alberto Lleo  8 José Luis Molinuevo  9 William J Jagust  4 Giovanni B Frisoni  10 Adrian Ivanoiu  11 Gaël Chételat  12 Catarina Resende de Oliveira  13 Karen M Rodrigue  14 Johannes Kornhuber  15 Anders Wallin  16 Aleksandra Klimkowicz-Mrowiec  17 Ramesh Kandimalla  18 Julius Popp  19 Pauline P Aalten  3 Dag Aarsland  20 Daniel Alcolea  8 Ina S Almdahl  21 Inês Baldeiras  13 Mark A van Buchem  22 Enrica Cavedo  23 Kewei Chen  24 Ann D Cohen  25 Stefan Förster  26 Juan Fortea  8 Kristian S Frederiksen  27 Yvonne Freund-Levi  28 Kiran Dip Gill  18 Olymbia Gkatzima  29 Timo Grimmer  30 Harald Hampel  31 Sanna-Kaisa Herukka  32 Peter Johannsen  33 Koen van Laere  34 Mony J de Leon  35 Wolfgang Maier  36 Jan Marcusson  37 Olga Meulenbroek  38 Hanne M Møllergård  21 John C Morris  39 Barbara Mroczko  40 Arto Nordlund  16 Sudesh Prabhakar  41 Oliver Peters  42 Lorena Rami  9 Eloy Rodríguez-Rodríguez  43 Catherine M Roe  39 Eckart Rüther  44 Isabel Santana  13 Johannes Schröder  45 Sang W Seo  46 Hilkka Soininen  32 Luiza Spiru  47 Erik Stomrud  48 Hanne Struyfs  6 Charlotte E Teunissen  49 Frans R J Verhey  3 Stephanie J B Vos  3 Linda J C van Waalwijk van Doorn  50 Gunhild Waldemar  27 Åsa K Wallin  48 Jens Wiltfang  51 Rik Vandenberghe  52 David J Brooks  53 Tormod Fladby  21 Christopher C Rowe  5 Alexander Drzezga  54 Marcel M Verbeek  50 Marie Sarazin  55 David A Wolk  56 Adam S Fleisher  57 William E Klunk  25 Duk L Na  46 Pascual Sánchez-Juan  43 Dong Young Lee  58 Agneta Nordberg  59 Magda Tsolaki  29 Vincent Camus  60 Juha O Rinne  61 Anne M Fagan  39 Henrik Zetterberg  62 Kaj Blennow  63 Gil D Rabinovici  64 Oskar Hansson  48 Bart N M van Berckel  65 Wiesje M van der Flier  66 Philip Scheltens  2 Pieter Jelle Visser  67 Rik Ossenkoppele  68
Affiliations

Prevalence of the apolipoprotein E ε4 allele in amyloid β positive subjects across the spectrum of Alzheimer's disease

Niklas Mattsson et al. Alzheimers Dement. 2018 Jul.

Abstract

Introduction: Apolipoprotein E (APOE) ε4 is the major genetic risk factor for Alzheimer's disease (AD), but its prevalence is unclear because earlier studies did not require biomarker evidence of amyloid β (Aβ) pathology.

Methods: We included 3451 Aβ+ subjects (853 AD-type dementia, 1810 mild cognitive impairment, and 788 cognitively normal). Generalized estimating equation models were used to assess APOE ε4 prevalence in relation to age, sex, education, and geographical location.

Results: The APOE ε4 prevalence was 66% in AD-type dementia, 64% in mild cognitive impairment, and 51% in cognitively normal, and it decreased with advancing age in Aβ+ cognitively normal and Aβ+ mild cognitive impairment (P < .05) but not in Aβ+ AD dementia (P = .66). The prevalence was highest in Northern Europe but did not vary by sex or education.

Discussion: The APOE ε4 prevalence in AD was higher than that in previous studies, which did not require presence of Aβ pathology. Furthermore, our results highlight disease heterogeneity related to age and geographical location.

Keywords: APOE; Age; Alzheimer's disease; Amyloid; CSF; Education; Geographical location; Mild cognitive impairment; PET; Prevalence; Sex; Subjective cognitive decline.

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