Apolipoprotein E, Dementia, and Cortical Deposition of β-Amyloid Protein
Abstract
BACKGROUND: The epsilon 4 allele of apolipoprotein E has been associated with an increased risk of late-onset Alzheimer's disease. In a cohort of elderly subjects we prospectively investigated the relation between the apolipoprotein E genotype, dementia, and the accumulation of beta-amyloid protein in the cerebral cortex. METHODS: Autopsy involving neuropathological analysis and DNA analysis of frozen blood samples were performed in 92 of 271 persons who were at least 85 years of age, who had been living in Vantaa, Finland, on April 1, 1991, and who had died between that time and the end of 1993. All subjects had been tested for dementia. Apolipoprotein E genotyping was done with a solid-phase minisequencing technique. The percentage of the cortex occupied by methenamine silver-stained plaques was used as an estimate of the extent of beta-amyloid protein deposition. RESULTS: The frequency of the epsilon 4 allele was significantly higher in the subjects with Alzheimer's disease than in the subjects without dementia (30 percent vs. 8 percent, P < 0.001). There was a greater accumulation of beta-amyloid protein in the brain and more neurofibrillary tangles in the subjects with the epsilon 4 allele than in those without it (P < 0.001). The deposition of beta-amyloid protein varied according to the genotype in both the subjects with dementia and those without dementia: it was lowest in those with the epsilon 2/epsilon 3 genotype, intermediate in those with the epsilon 3/epsilon 3 genotype, and highest in those with the epsilon 3/epsilon 4 genotype. A single subject had the epsilon 4/epsilon 4 genotype and had dementia. CONCLUSIONS: The epsilon 4 allele of apolipoprotein E is significantly associated with Alzheimer's disease. Even in elderly subjects without dementia, the apolipoprotein E genotype is related to the degree of deposition of beta-amyloid protein in the cerebral cortex.
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There is a strong positive correlation between the APOE ε4 allele and Aβ pathology in human AD brains, with the highest Aβ burden in homozygous APOE ε4 carriers.
“there is a strong positive correlation between the APOE ε4 allele and Aβ pathology in human AD brains with the highest Aβ burden found in homozygous APOE ε4 carriers”
From ApoE4 reduction: An emerging and promising therapeutic strategy for Alzheimer's disease (2022) · cites this paper as Polvikoski et al 1995
The e4 allele is associated with an increased risk of Alzheimer's disease.
“the e4 allele has been associated with an increased risk of Alzheimer's disease, 1-7”
From Preclinical Evidence of Alzheimer's Disease in Persons Homozygous for the ε4 Allele for Apolipoprotein E (1996) · cites this paper as [6]
The e2 allele is associated with slower rates of beta-amyloid protein and neurofibrillary-tangle deposition.
“slower rates of b-amyloid protein and neurofibrillary-tangle deposition, 6,40”
From Preclinical Evidence of Alzheimer's Disease in Persons Homozygous for the ε4 Allele for Apolipoprotein E (1996) · cites this paper as [6]
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Pradeep, S., Jain, A. S., Dharmashekara, C., Prasad, S. K., Kollur, S. P., Syed, A., & Shivamallu, C. (2020) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-200228 · Cited by 30 · see citing works
- Authors
- Polvikoski, T., Sulkava, R., Haltia, M., Kainulainen, K., Vuorio, A., Verkkoniemi, A., Niinistö, L., Halonen, P., & Kontula, K.
- Affiliations
- University of Helsinki (FI)
- University of Eastern Finland (FI)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1995-11-09
- Volume
- 333
- Issue
- 19
- Pages
- 1242-1248
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2341558723
- Cited by
- 493
- References
- 41
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 7 · 2023: 15 · 2022: 22 · 2021: 17 · 2020: 19 · 2019: 16 · 2018: 14 · 2017: 10 · 2016: 12 · 2015: 16 · 2014: 10 · 2013: 17 · 2012: 12
- FWCI
- 21.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
- Keywords
- apolipoprotein E, APOE ε4, Alzheimer's disease, dementia, cerebral cortex, neurofibrillary tangles, genetic risk factors, older adults, methenamine silver staining, neuropathology
- MeSH terms
- Aged, Aged, 80 and over, Alleles, Alzheimer Disease, Apolipoproteins E, Cerebral Cortex, Dementia, DNA, Female, Gene Frequency, Genotype, Humans, Male, Prospective Studies, Cohort Studies, Amyloid beta-Peptides, Neurofibrillary Tangles, Apolipoprotein E4
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