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From the Research Program in Aging (Dr. Tierney), Clinical Epidemiology Research Program (Dr. Szalai), Psychology (Dr. Snow), and Geriatric Medicine (Dr. Fisher), Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada; Department of Medicine (Neurology) (Drs. Tsuda, Chi, McLachlan, and St. George-Hyslop), Centre for Research in Neurodegenerative Diseases, University of Toronto, Ontario, Canada.
Supported by the Ontario Ministry of Health, the Alzheimer Association of Ontario, Medical Research Council of Canada, Alzheimer Society of Canada, American Health Assistance Foundation, Scottish Rite Foundation, and the Helen B. Hunter Foundation.
Received December 9, 1994. Accepted in final form May 13, 1995.
Address correspondence and reprint requests to Dr Tierney, Research Program in Aging, A438, Sunnybrook Health Science Centre, University of Toronto, 2075 Bayview Avenue, North York, Ontario, Canada, M4N 3M5.
Article abstract-Given the relationship between the presence of ApoE epsilon 4 and Alzheimer's disease (AD), we studied whether knowledge of epsilon 4 status would predict which memory-impaired patients would develop AD over time. One hundred seven patients who presented with memory impairment but not dementia were referred to the study by their family physicians. These patients were followed prospectively over a 2-year period. Twenty-nine patients developed AD, while 78 did not develop dementia. We found that ApoE genotype was a reliable prognostic indicator of who developed AD in this group only when memory test performance was included in the predictive model. These findings indicate the limitations of ApoE genotyping in isolation as a prognostic indicator of AD. Because this study included prospectively selected patients who were followed longitudinally, our findings are likely to have more relevance in the clinical setting than those obtained from currently available retrospective studies.
NEUROLOGY 1996;46: 149-154
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