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The effect of APOE genotype on clinical phenotype in Alzheimer disease

From the Department of Neurology and Alzheimer Center (W.M.v.d.F., S.N.M.S., Y.A.L.P., P.S.) and Department of Clinical Chemistry (S.N.M.S.), Vrije Universiteit Medical Center, Amsterdam, The Netherlands; and Dementia Research Centre (N.C.F.), Institute of Neurology, University College London, London, UK.

Address correspondence and reprint requests to Dr van der Flier, Department of Neurology and Alzheimer Center, Vrije Universiteit Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; e-mail: wm.vdflier{at}vumc.nl

The authors classified 100 patients with Alzheimer disease (AD) as presenting with a memory or nonmemory phenotype. APOE genotype was determined. There was an association between APOE-4 and clinical phenotype (odds ratio = 3.0; 95% CI: 1.2 to 7.8), suggesting that two subtypes of AD can be identified. The typical amnestic phenotype seems to be promoted by the APOE-4 allele, whereas the atypical nonmemory phenotype occurs in the absence of the APOE-4 allele.

Disclosure: The authors report no conflicts of interest.

Received November 21, 2005. Accepted in final form March 30, 2006.

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