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3. Apolipoprotein E status as a predictor of the development of Alzheimer's disease in memory-impaired individuals

Author

Petersen, Ronald C., Smith, Glenn E., Ivnik, Robert J., Tangalos, Eric G., Schaid, Daniel J., Thibodeau, Stephen N., Kokmen, Emre, Waring, Stephen C., and Kurland, Leonard T.

Subjects
Memory disorders in old age -- Development and progression, Apolipoproteins -- Health aspects, Alzheimer's disease -- Genetic aspects
Abstract

Elderly people with mild cognitive impairment (MCI) who have the apolipoprotein E 4 (apo E 4) allele may be more likely to progress to Alzheimer's disease than those who have other forms of the apo E gene. Researchers administered cognitive tests to 66 elderly patients with MCI at 18-month intervals to observe the progression of cognitive impairment. Investigators took blood samples from the patients to study the relationship between apo E status and disease progression. At the 18-month follow-up, 24% of patients had progressed to dementia. Of those who had subsequent follow-ups, 44% progressed to dementia in an average of 36 months and 55% progressed to dementia in an average of 54 months. Those who carried the apo E 4 allele were more than four times more likely to develop dementia than patients who had other forms of the apo E gene., Objective.--The outcome of patients with mild cognitive impairment is not known, yet these patients present a difficult dilemma for the clinician. This study was designed to characterize the outcome of a group of patients with mild cognitive impairment and to determine whether the presence of the [epsilon]4 allele on the apolipoprotein E gene (APOE) is a predictor of that outcome. Design.--A prospective, longitudinal inception cohort. Setting.--General community clinic. Participants.--A consecutive sample of 66 patients who met criteria for a diagnosis of a mild cognitive impairment and who had at least one clinical reevaluation was identified from the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry. Interventions.--We evaluated patients initially and at 12- to 18-month intervals up to 54 months using standard neurological and neuropsychological measures such as the Mini-Mental State Examination, the Dementia Rating Scale, the Wechsler Adult Intelligence Scale-Revised, the Wechsler Memory Scale-Revised, and the Free and Cued Selective Reminding Test. The APOE status of study patients was determined. Main Outcome Measure.--The development of dementia as determined by the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke/ Alzheimer's Disease and Related Disorders Association criteria. Results.--Sixty-six individuals had been reevaluated once (mean of 18 months), 36 individuals twice (mean of 36 months), and 22 individuals on three occasions (mean of 54 months), with conversion rates to dementia at these intervals of 24%, 44%, and 55%, respectively. A multivariate Cox regression model demonstrated that possession of an APOE E4 allele was the strongest predictor of clinical outcome. Conclusions.--These data suggest the following: (1) patients with mild cognitive impairment can be clinically defined, (2) many members of this group progress to Alzheimer's disease, and (3) APOE [epsilon]4 allele status appears to be a strong predictor of clinical progression. (JAMA. 1995;273:1274-1278)

Published
1995

29. The presence of Alzheimer's disease in a community population

Author

Bowden, Charles, Kokmen, Emre, Beard, C. Mary, Kirkland, Larry R., Jarvik, Lissy F., Evans, Denis A., Funkenstein, H.Harris, Cook, Nancy R., Hennekens, Charles H., Taylor, James O., Albert, Marilyn S., Scherr, Paul A., Chown, Marilyn J., Hebert, Liesi E., and Larson, Eric B.

Subjects
Dementia -- Diagnosis, Alzheimer's disease -- Demographic aspects
Published
1990

32. Comparative Diagnostic Utility of Different MR Modalities in Mild Cognitive Impairment and Alzheimer’s Disease

Author

Kantarci, Kejal, primary, Xu, YueCheng, additional, Shiung, Maria M., additional, O’Brien, Peter C., additional, Cha, Ruth H., additional, Smith, Glenn E., additional, Ivnik, Robert J., additional, Boeve, Bradley F., additional, Edland, Steven D., additional, Kokmen, Emre, additional, Tangalos, Eric G., additional, Petersen, Ronald C., additional, and Jack Jr., Clifford R., additional

Published
2002
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38. No association between TAU haplotype and Alzheimer's disease in population or clinic based series or in familial disease

Author

Baker, Matt, primary, Graff-Radford, Daniel, additional, Wavrant DeVrièze, Fabienne, additional, Graff-Radford, Neill, additional, Petersen, Ronald C, additional, Kokmen, Emre, additional, Boeve, Brad, additional, Myllykangas, Liisa, additional, Polvikoski, Tuomo, additional, Sulkava, Raimo, additional, Verkoniemmi, Auli, additional, Tienari, Pentti, additional, Haltia, Matti, additional, Hardy, John, additional, Hutton, Mike, additional, and Perez-Tur, Jordi, additional

Published
2000
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40. Mild Cognitive Impairment

Author

Petersen, Ronald C., primary, Smith, Glenn E., additional, Waring, Stephen C., additional, Ivnik, Robert J., additional, Tangalos, Eric G., additional, and Kokmen, Emre, additional

Published
1999
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41. Normative Data for the Mattis Dementia Rating Scale

Author

Lucas, John A., primary, Ivnik, Robert J., additional, Smith, Glenn E., additional, Bohac, Daryl L., additional, Tangalos, Eric G., additional, Kokmen, Emre, additional, Graff-Radford, Neill R., additional, and Petersen, Ronald C., additional

Published
1998
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