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01-10-2009 | Original Article

Neuropsychiatric symptoms and the APOE genotype in Alzheimer’s disease

Authors: Marina Del Prete, Simona Spaccavento, Angela Craca, Pietro Fiore, Paola Angelelli

Published in: Neurological Sciences | Issue 5/2009

Abstract

The study aimed to characterize neuropsychiatric symptomatology in Alzheimer’s disease (AD) and investigate the role of APOE genotype and other clinical variables in the onset of neuropsychiatric disorders. Moreover, an attempt to study the evolution of behavioral and psychiatric symptoms was made. Fifty-three consecutive outpatients with AD were enrolled. Twenty-four were followed longitudinally for 1 year. MMSE was used to evaluate cognitive functions. The neuropsychiatric inventory (NPI) was administered to assess behavioral and psychiatric symptoms. Genotyping was determined through laboratory testing. At baseline, no specific neuropsychiatric disorder was significantly associated with ApoE genotype, but associated with a peculiar neuropsychiatric profile. Patients with ε ₄ allele showed a wider range of neuropsychiatric disturbances when compared to non-carriers and higher scores for hallucinations and aberrant motor behaviors. The longitudinal results suggest different trends in both groups: over time, ε ₄ carriers showed an increase/delayed onset in some symptoms and a parallel decrease in others, while non-carriers presented an undifferentiated worsening of symptomatology. Clear relations with other clinical and demographic variables were also found. APOE ε ₄ allele is associated to a peculiar neuropsychiatric profile characterizing the onset and evolution of Alzheimer’s disease.

Drevets WC, Rubin EH (1989) Psychotic symptoms and the longitudinal course of senile dementia of the Alzheimer type. Biol Psychiatry 25:39–48PubMedCrossRef

Padovani A, Rozzini L, Vicini Chilovi B et al (2002) I disturbi comportamentali nella malattia di Alzheimer: aspetti clinici ed epidemiologici. Neurol Sci 23:S523–S525

Craig D, Hart DJ, McLlory SP, Passmore P (2004) Apolipoprotein E ε ₄ allele influences aggressive behaviour in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 75:1327–1330PubMedCrossRef

Rivière S, Gillette-Guyonnet S, Nourhashemi F, Vellas B (1999) Nutrition and Alzheimer’s disease. Nutr Rev 57(12):363–367PubMedCrossRef

Broker P, Benhamidat T, Benoit M et al (2003) Nutritional status and Alzheimer’s disease: preliminary results of the REAL.FR study. Rev Med Intern 24(Suppl 3):314s–318sCrossRef

Von Strauss E, Viitanen M, De Ronchi D et al (1999) Aging and occurrence of dementia: findings from a population-based cohort with a large sample of nonagenarians. Arch Neurol 56:587–592CrossRef

Lopez OL, Kamboh MI, Becker JT et al (1997) The apolipoprotein E ε ₄ allele is not associated with psychiatric symptoms or extrapyramidal signs in probable Alzheimer’s disease. Neurology 49:794–797PubMed

Parasuraman R, Greenwood P, Sunderland T (2002) The Apolipoprotein E gene, attention and brain function. Neuropsychology 16(2):254–274PubMedCrossRef

Scarmeas N, Brandt J, Albert M et al (2002) Association between the APOE genotype and psychopathologic symptoms in Alzheimer’s disease. Neurology 58:1182–1188PubMed

10.

Holmes C, Levy R, McLoughlin DM et al (1996) Apolipotrotein E: non-cognitive symptoms and cognitive decline in late onset Alzheimer’s disease. J Neurol Neurosurg Psychiatry 61:580–583PubMedCrossRef

11.

Levy ML, Cummings JL, Fairbanks LA et al (1999) Apolipoprotein E genotype and noncognitive symptoms in Alzheimer’s disease. Biol Psychiatry 45:422–425PubMedCrossRef

12.

McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRA Working Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944PubMed

13.

Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef

14.

Magni E, Binetti G, Padovani A et al (1996) The mini-mental state examination in Alzheimer’s disease and multi-infarct dementia. Int Psychogeriatr 8:127–134PubMedCrossRef

15.

Cummings JL, Mega M, Gray K et al (1994) The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 44:2308–2314PubMed

16.

Mega MS, Cummings JL, Fiorello T, Gornbein J (1996) The spectrum of behavioral changes in Alzheimer’s disease. Neurology 46:130–135PubMed

17.

Binetti G, Mega MS, Magni E et al (1998) Behavioral disorders in Alzheimer’s disease: a transcultural perspective. Arch Neurol 55:539–544PubMedCrossRef

18.

Guigoz Y, Lauque S, Vellas BJ (2002) Identifying the elderly at risk for malnutrition: the mini nutritional assessment. Clin Geriatr Med 18(4):737–757PubMedCrossRef

19.

Angelelli P, Paolucci S, Bivona U et al (2004) Development of neuropsychiatric symptoms in poststroke patients: a cross-sectional study. Acta Psychiatr Scand 109:1–9CrossRef

20.

Monastero R, Mariani E, Camarda C et al (2006) Association between apolipoprotein E ε ₄ allele and apathy in probable Alzheimer’s disease. Acta Psychiatr Scand 113:59–63PubMedCrossRef

21.

Spalletta G, Bernardini S, Bellincampi L et al (2006) Delusion symptoms are associated with APOE ε ₄ allelic variant at the early stage of Alzheimer’s disease with late onset. Eur J Neurol 13:176–182PubMedCrossRef

22.

Chang JB, Wang PN, Chen WT et al (2004) Apoe ε ₄ allele is associated with incidental hallucinations and delusions in patients with AD. Neurolgy 63:1105–1107

23.

Piccininni M, DiCarlo A, Baldereschi M et al (2005) Behavioral and psychological symptoms in Alzheimer’s disease frequency and relationship with duration and severity of the disease. Dement Geriatr Cogn Disord 19:276–281PubMedCrossRef

24.

Murrel SA, Himmelfarb S, Wright K (1983) Prevalence of depression and its correlates in older adults. Am J Epidemiol 117:173–185

25.

Andersen G, Vestergaard K, Ingemann-Nielsen M, Lauritzen L (1995) Risk factors for post-stroke depression. Acta Psychiatr Scand 92:193–198PubMedCrossRef

26.

Kotila M, Numminen H, Waltimo O, Kaste M (1998) Depression after stroke: results of the FINNSTROKE Study. Stroke 29:368–372PubMed

27.

Sparks DL, Scheff SW, Liu H et al (1996) Increased density of senile plaques (SP), but not neurofibrillary tangles (NFT), in non-demented individuals with the apolipoprotein E4 allele: comparison to confirmed Alzheimer’s disease patients. J Neurol Sci 138:97–104PubMedCrossRef

28.

Allen SJ, MacGowan SH, Tyler et al (1997) Reduced cholinergic function in normal and Alzheimer’s disease brain is associated with apolipoprotein E4 genotype. Neurosci Lett 239:33–36

29.

Borroni B, Grassi M, Agosti C et al (2006) Genetic correlates of behavioral endophenotypes in Alzheimer disease: role of COMT, 5-HTTLPR and APOE polymorphisms. Neurobiol Aging 27:1595–1603PubMedCrossRef

Title: Neuropsychiatric symptoms and the APOE genotype in Alzheimer’s disease
Authors: Marina Del Prete
Simona Spaccavento
Angela Craca
Pietro Fiore
Paola Angelelli
Publication date: 01-10-2009
Publisher: Springer Milan
Published in: Neurological Sciences / Issue 5/2009
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-009-0116-9

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Neuropsychiatric symptoms and the APOE genotype in Alzheimer’s disease

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