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Published in: BMC Neurology 1/2008

Open Access 01-12-2008 | Research article

APOE ε4 lowers age at onset and is a high risk factor for Alzheimer's disease; A case control study from central Norway

Authors: Sigrid B Sando, Stacey Melquist, Ashley Cannon, Michael L Hutton, Olav Sletvold, Ingvild Saltvedt, Linda R White, Stian Lydersen, Jan O Aasly

Published in: BMC Neurology | Issue 1/2008

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Abstract

Background

The objective of this study was to analyze factors influencing the risk and timing of Alzheimer's disease (AD) in central Norway. The APOE ε4 allele is the only consistently identified risk factor for late onset Alzheimer's disease (LOAD). We have described the allele frequencies of the apolipoprotein E gene (APOE) in a large population of patients with AD compared to the frequencies in a cognitively-normal control group, and estimated the effect of the APOE ε4 allele on the risk and the age at onset of AD in this population.

Methods

376 patients diagnosed with AD and 561 cognitively-normal control individuals with no known first degree relatives with dementia were genotyped for the APOE alleles. Allele frequencies and genotypes in patients and control individuals were compared. Odds Ratio for developing AD in different genotypes was calculated.

Results

Odds Ratio (OR) for developing AD was significantly increased in carriers of the APOE ε4 allele compared to individuals with the APOE ε3/ε3 genotype. Individuals carrying APOE ε4/ε4 had OR of 12.9 for developing AD, while carriers of APOE ε2/ε4 and APOE ε3/ε4 had OR of 3.2 and 4.2 respectively. The effect of the APOE ε4 allele was weaker with increasing age. Carrying the APOE ε2 allele showed no significant protective effect against AD and did not influence age at onset of the disease. Onset in LOAD patients was significantly reduced in a dose dependent manner from 78.4 years in patients without the APOE ε4 allele, to 75.3 in carriers of one APOE ε4 allele and 72.9 in carriers of two APOE ε4 alleles. Age at onset in early onset AD (EOAD) was not influenced by APOE ε4 alleles.

Conclusion

APOE ε4 is a very strong risk factor for AD in the population of central Norway, and lowers age at onset of LOAD significantly.
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Literature
1.
go back to reference Mahley RW: Apolipoprotein E: cholesterol transport protein with expanding role in cell biology. Science. 1988, 240 (4852): 622-630. 10.1126/science.3283935.CrossRefPubMed Mahley RW: Apolipoprotein E: cholesterol transport protein with expanding role in cell biology. Science. 1988, 240 (4852): 622-630. 10.1126/science.3283935.CrossRefPubMed
2.
go back to reference Zannis VI, Breslow JL: Human very low density lipoprotein apolipoprotein E isoprotein polymorphism is explained by genetic variation and posttranslational modification. Biochemistry. 1981, 20 (4): 1033-1041. 10.1021/bi00507a059.CrossRefPubMed Zannis VI, Breslow JL: Human very low density lipoprotein apolipoprotein E isoprotein polymorphism is explained by genetic variation and posttranslational modification. Biochemistry. 1981, 20 (4): 1033-1041. 10.1021/bi00507a059.CrossRefPubMed
3.
go back to reference Gerdes LU, Klausen IC, Sihm I, Faergeman O: Apolipoprotein E polymorphism in a Danish population compared to findings in 45 other study populations around the world. Genet Epidemiol. 1992, 9 (3): 155-167. 10.1002/gepi.1370090302.CrossRefPubMed Gerdes LU, Klausen IC, Sihm I, Faergeman O: Apolipoprotein E polymorphism in a Danish population compared to findings in 45 other study populations around the world. Genet Epidemiol. 1992, 9 (3): 155-167. 10.1002/gepi.1370090302.CrossRefPubMed
4.
go back to reference Corbo RM, Scacchi R: Apolipoprotein E (APOE) allele distribution in the world. Is APOE*4 a 'thrifty' allele?. Ann Hum Genet. 1999, 63 (Pt 4): 301-310. 10.1046/j.1469-1809.1999.6340301.x.CrossRefPubMed Corbo RM, Scacchi R: Apolipoprotein E (APOE) allele distribution in the world. Is APOE*4 a 'thrifty' allele?. Ann Hum Genet. 1999, 63 (Pt 4): 301-310. 10.1046/j.1469-1809.1999.6340301.x.CrossRefPubMed
5.
go back to reference Singh PP, Singh M, Mastana SS: APOE distribution in world populations with new data from India and the UK. Ann Hum Biol. 2006, 33 (3): 279-308. 10.1080/03014460600594513.CrossRefPubMed Singh PP, Singh M, Mastana SS: APOE distribution in world populations with new data from India and the UK. Ann Hum Biol. 2006, 33 (3): 279-308. 10.1080/03014460600594513.CrossRefPubMed
6.
go back to reference Gerdes LU, Gerdes C, Hansen PS, Klausen IC, Faergeman O, Dyerberg J: The apolipoprotein E polymorphism in Greenland Inuit in its global perspective. Hum Genet. 1996, 98 (5): 546-550. 10.1007/s004390050257.CrossRefPubMed Gerdes LU, Gerdes C, Hansen PS, Klausen IC, Faergeman O, Dyerberg J: The apolipoprotein E polymorphism in Greenland Inuit in its global perspective. Hum Genet. 1996, 98 (5): 546-550. 10.1007/s004390050257.CrossRefPubMed
7.
go back to reference Strittmatter WJ, Saunders AM, Schmechel D, Pericak-Vance M, Enghild J, Salvesen GS, Roses AD: Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. Proc Natl Acad Sci U S A. 1993, 90 (5): 1977-1981. 10.1073/pnas.90.5.1977.CrossRefPubMedPubMedCentral Strittmatter WJ, Saunders AM, Schmechel D, Pericak-Vance M, Enghild J, Salvesen GS, Roses AD: Apolipoprotein E: high-avidity binding to beta-amyloid and increased frequency of type 4 allele in late-onset familial Alzheimer disease. Proc Natl Acad Sci U S A. 1993, 90 (5): 1977-1981. 10.1073/pnas.90.5.1977.CrossRefPubMedPubMedCentral
8.
go back to reference Saunders AM, Strittmatter WJ, Schmechel D, George-Hyslop PH, Pericak-Vance MA, Joo SH, Rosi BL, Gusella JF, Crapper-MacLachlan DR, Alberts MJ: Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer's disease. Neurology. 1993, 43 (8): 1467-1472.CrossRefPubMed Saunders AM, Strittmatter WJ, Schmechel D, George-Hyslop PH, Pericak-Vance MA, Joo SH, Rosi BL, Gusella JF, Crapper-MacLachlan DR, Alberts MJ: Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer's disease. Neurology. 1993, 43 (8): 1467-1472.CrossRefPubMed
9.
go back to reference Okuizumi K, Onodera O, Tanaka H, Kobayashi H, Tsuji S, Takahashi H, Oyanagi K, Seki K, Tanaka M, Naruse S: ApoE-epsilon 4 and early-onset Alzheimer's. Nat Genet. 1994, 7 (1): 10-11. 10.1038/ng0594-10b.CrossRefPubMed Okuizumi K, Onodera O, Tanaka H, Kobayashi H, Tsuji S, Takahashi H, Oyanagi K, Seki K, Tanaka M, Naruse S: ApoE-epsilon 4 and early-onset Alzheimer's. Nat Genet. 1994, 7 (1): 10-11. 10.1038/ng0594-10b.CrossRefPubMed
10.
go back to reference van Duijn CM, de Knijff P, Cruts M, Wehnert A, Havekes LM, Hofman A, Van Broeckhoven C: Apolipoprotein E4 allele in a population-based study of early-onset Alzheimer's disease. Nat Genet. 1994, 7 (1): 74-78. 10.1038/ng0594-74.CrossRefPubMed van Duijn CM, de Knijff P, Cruts M, Wehnert A, Havekes LM, Hofman A, Van Broeckhoven C: Apolipoprotein E4 allele in a population-based study of early-onset Alzheimer's disease. Nat Genet. 1994, 7 (1): 74-78. 10.1038/ng0594-74.CrossRefPubMed
11.
go back to reference Pearson JV, Huentelman MJ, Halperin RF, Tembe WD, Melquist S, Homer N, Brun M, Szelinger S, Coon KD, Zismann VL, Webster JA, Beach T, Sando SB, Aasly JO, Heun R, Jessen F, Kolsch H, Tsolaki M, Daniilidou M, Reiman EM, Papassotiropoulos A, Hutton ML, Stephan DA, Craig DW: Identification of the genetic basis for complex disorders by use of pooling-based genomewide single-nucleotide-polymorphism association studies. Am J Hum Genet. 2007, 80 (1): 126-139. 10.1086/510686.CrossRefPubMed Pearson JV, Huentelman MJ, Halperin RF, Tembe WD, Melquist S, Homer N, Brun M, Szelinger S, Coon KD, Zismann VL, Webster JA, Beach T, Sando SB, Aasly JO, Heun R, Jessen F, Kolsch H, Tsolaki M, Daniilidou M, Reiman EM, Papassotiropoulos A, Hutton ML, Stephan DA, Craig DW: Identification of the genetic basis for complex disorders by use of pooling-based genomewide single-nucleotide-polymorphism association studies. Am J Hum Genet. 2007, 80 (1): 126-139. 10.1086/510686.CrossRefPubMed
12.
go back to reference Corder EH, Saunders AM, Strittmatter WJ, Schmechel DE, Gaskell PC, Small GW, Roses AD, Haines JL, Pericak-Vance MA: Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. Science. 1993, 261 (5123): 921-923. 10.1126/science.8346443.CrossRefPubMed Corder EH, Saunders AM, Strittmatter WJ, Schmechel DE, Gaskell PC, Small GW, Roses AD, Haines JL, Pericak-Vance MA: Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. Science. 1993, 261 (5123): 921-923. 10.1126/science.8346443.CrossRefPubMed
13.
go back to reference Locke PA, Conneally PM, Tanzi RE, Gusella JF, Haines JL: Apolipoprotein E4 allele and Alzheimer disease: examination of allelic association and effect on age at onset in both early- and late-onset cases. Genet Epidemiol. 1995, 12 (1): 83-92. 10.1002/gepi.1370120108.CrossRefPubMed Locke PA, Conneally PM, Tanzi RE, Gusella JF, Haines JL: Apolipoprotein E4 allele and Alzheimer disease: examination of allelic association and effect on age at onset in both early- and late-onset cases. Genet Epidemiol. 1995, 12 (1): 83-92. 10.1002/gepi.1370120108.CrossRefPubMed
14.
go back to reference Poirier J, Davignon J, Bouthillier D, Kogan S, Bertrand P, Gauthier S: Apolipoprotein E polymorphism and Alzheimer's disease. Lancet. 1993, 342 (8873): 697-699. 10.1016/0140-6736(93)91705-Q.CrossRefPubMed Poirier J, Davignon J, Bouthillier D, Kogan S, Bertrand P, Gauthier S: Apolipoprotein E polymorphism and Alzheimer's disease. Lancet. 1993, 342 (8873): 697-699. 10.1016/0140-6736(93)91705-Q.CrossRefPubMed
15.
go back to reference Benjamin R, Leake A, McArthur FK, Candy JM, Ince PG, Edwardson JA, Torvik A, Morris CM, Bjertness E: Apolipoprotein E genotype and Alzheimer's disease in an elderly Norwegian cohort. Neurodegeneration. 1996, 5 (1): 43-47. 10.1006/neur.1996.0006.CrossRefPubMed Benjamin R, Leake A, McArthur FK, Candy JM, Ince PG, Edwardson JA, Torvik A, Morris CM, Bjertness E: Apolipoprotein E genotype and Alzheimer's disease in an elderly Norwegian cohort. Neurodegeneration. 1996, 5 (1): 43-47. 10.1006/neur.1996.0006.CrossRefPubMed
16.
go back to reference Johannsen P, Jakobsen JK, Jørgensen AL: [Apolipoprotein E genotypes in patients investigated for dementia]. Ugeskr Laeger. 1997, 159 (38): 5658-5661.PubMed Johannsen P, Jakobsen JK, Jørgensen AL: [Apolipoprotein E genotypes in patients investigated for dementia]. Ugeskr Laeger. 1997, 159 (38): 5658-5661.PubMed
17.
go back to reference Bergem AL, Lannfelt L: Apolipoprotein E type epsilon4 allele, heritability and age at onset in twins with Alzheimer disease and vascular dementia. Clin Genet. 1997, 52 (5): 408-413.CrossRefPubMed Bergem AL, Lannfelt L: Apolipoprotein E type epsilon4 allele, heritability and age at onset in twins with Alzheimer disease and vascular dementia. Clin Genet. 1997, 52 (5): 408-413.CrossRefPubMed
18.
go back to reference Qiu C, Kivipelto M, Agüero-Torres H, Winblad B, Fratiglioni L: Risk and protective effects of the APOE gene towards Alzheimer's disease in the Kungsholmen project: variation by age and sex. J Neurol Neurosurg Psychiatry. 2004, 75 (6): 828-833. 10.1136/jnnp.2003.021493.CrossRefPubMedPubMedCentral Qiu C, Kivipelto M, Agüero-Torres H, Winblad B, Fratiglioni L: Risk and protective effects of the APOE gene towards Alzheimer's disease in the Kungsholmen project: variation by age and sex. J Neurol Neurosurg Psychiatry. 2004, 75 (6): 828-833. 10.1136/jnnp.2003.021493.CrossRefPubMedPubMedCentral
19.
go back to reference Huang W, Qiu C, von Strauss E, Winblad B, Fratiglioni L: APOE genotype, family history of dementia, and Alzheimer disease risk: a 6-year follow-up study. Arch Neurol. 2004, 61 (12): 1930-1934. 10.1001/archneur.61.12.1930.CrossRefPubMed Huang W, Qiu C, von Strauss E, Winblad B, Fratiglioni L: APOE genotype, family history of dementia, and Alzheimer disease risk: a 6-year follow-up study. Arch Neurol. 2004, 61 (12): 1930-1934. 10.1001/archneur.61.12.1930.CrossRefPubMed
20.
go back to reference Folstein MF, Folstein SE, McHugh PR: "Mini-Mental State": A practical method for grading the cognitive state of patients for clinician. J Psychol Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef Folstein MF, Folstein SE, McHugh PR: "Mini-Mental State": A practical method for grading the cognitive state of patients for clinician. J Psychol Res. 1975, 12 (3): 189-198. 10.1016/0022-3956(75)90026-6.CrossRef
21.
go back to reference Brodaty H, Moore CM: The Clock Drawing Test for dementia of the Alzheimer's type: A comparison of three scoring methods in a memory disorders clinic. Int J Geriatr Psychiat. 1997, 12 (6): 619-627. 10.1002/(SICI)1099-1166(199706)12:6<619::AID-GPS554>3.0.CO;2-H.CrossRef Brodaty H, Moore CM: The Clock Drawing Test for dementia of the Alzheimer's type: A comparison of three scoring methods in a memory disorders clinic. Int J Geriatr Psychiat. 1997, 12 (6): 619-627. 10.1002/(SICI)1099-1166(199706)12:6<619::AID-GPS554>3.0.CO;2-H.CrossRef
22.
go back to reference Kjelvik G, Sando SB, Aasly J, Engedal KA, White LR: Use of the Brief Smell Identification Test for olfactory deficit in a Norwegian population with Alzheimer's disease. Int J Geriatr Psychiat. 2007, 22 (10): 1020-1024. 10.1002/gps.1783.CrossRef Kjelvik G, Sando SB, Aasly J, Engedal KA, White LR: Use of the Brief Smell Identification Test for olfactory deficit in a Norwegian population with Alzheimer's disease. Int J Geriatr Psychiat. 2007, 22 (10): 1020-1024. 10.1002/gps.1783.CrossRef
23.
go back to reference McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984, 34 (7): 939-944.CrossRefPubMed McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984, 34 (7): 939-944.CrossRefPubMed
24.
go back to reference Henderson JN, Crook R, Crook J, Hardy J, Onstead L, Carson-Henderson L, Mayer P, Parker B, Petersen R, Williams B: Apolipoprotein E4 and tau allele frequencies among Choctaw Indians. Neurosci Lett. 2002, 324 (1): 77-79. 10.1016/S0304-3940(02)00150-7.CrossRefPubMed Henderson JN, Crook R, Crook J, Hardy J, Onstead L, Carson-Henderson L, Mayer P, Parker B, Petersen R, Williams B: Apolipoprotein E4 and tau allele frequencies among Choctaw Indians. Neurosci Lett. 2002, 324 (1): 77-79. 10.1016/S0304-3940(02)00150-7.CrossRefPubMed
25.
go back to reference Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, Myers RH, Pericak-Vance MA, Risch N, van Duijn CM: Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA. 1997, 278 (16): 1349-1356. 10.1001/jama.278.16.1349.CrossRefPubMed Farrer LA, Cupples LA, Haines JL, Hyman B, Kukull WA, Mayeux R, Myers RH, Pericak-Vance MA, Risch N, van Duijn CM: Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA. 1997, 278 (16): 1349-1356. 10.1001/jama.278.16.1349.CrossRefPubMed
26.
go back to reference Bickeböller H, Campion D, Brice A, Amouyel P, Hannequin D, Didierjean O, Penet C, Martin C, Pérez-Tur J, Michon A, Dubois B, Ledoze F, Thomas-Anterion C, Pasquier F, Puel M, Demonet JF, Moreaud O, Babron MC, Meulien D, Guez D, Chartier-Harlin MC, Frebourg T, Agid Y, Martinez M, Clerget-Darpoux F: Apolipoprotein E and Alzheimer disease: genotype-specific risks by age and sex. Am J Hum Genet. 1997, 60 (2): 439-446.PubMedPubMedCentral Bickeböller H, Campion D, Brice A, Amouyel P, Hannequin D, Didierjean O, Penet C, Martin C, Pérez-Tur J, Michon A, Dubois B, Ledoze F, Thomas-Anterion C, Pasquier F, Puel M, Demonet JF, Moreaud O, Babron MC, Meulien D, Guez D, Chartier-Harlin MC, Frebourg T, Agid Y, Martinez M, Clerget-Darpoux F: Apolipoprotein E and Alzheimer disease: genotype-specific risks by age and sex. Am J Hum Genet. 1997, 60 (2): 439-446.PubMedPubMedCentral
27.
go back to reference Ashford JW, Mortimer JA: Non-familial Alzheimer's disease is mainly due to genetic factors. J Alzheimers Dis. 2002, 4 (3): 169-177.PubMed Ashford JW, Mortimer JA: Non-familial Alzheimer's disease is mainly due to genetic factors. J Alzheimers Dis. 2002, 4 (3): 169-177.PubMed
28.
go back to reference Kumar T, Liestøl K, Maehlen J, Hiorth A, Jettestuen E, Lind H, Brorson SH: Allele frequencies of apolipoprotein E gene polymorphisms in the protein coding region and promoter region (-491A/T) in a healthy Norwegian population. Hum Biol. 2002, 74 (1): 137-142. 10.1353/hub.2002.0006.CrossRefPubMed Kumar T, Liestøl K, Maehlen J, Hiorth A, Jettestuen E, Lind H, Brorson SH: Allele frequencies of apolipoprotein E gene polymorphisms in the protein coding region and promoter region (-491A/T) in a healthy Norwegian population. Hum Biol. 2002, 74 (1): 137-142. 10.1353/hub.2002.0006.CrossRefPubMed
29.
go back to reference Davidson Y, Gibbons L, Pritchard A, Hardicre J, Wren J, Stopford C, Julien C, Thompson J, Payton A, Pickering-Brown SM, Pendleton N, Horan MA, Burns A, Purandare N, Lendon CL, Neary D, Snowden JS, Mann DM: Apolipoprotein E epsilon4 allele frequency and age at onset of Alzheimer's disease. Dement Geriatr Cogn Disord. 2007, 23 (1): 60-66. 10.1159/000097038.CrossRefPubMed Davidson Y, Gibbons L, Pritchard A, Hardicre J, Wren J, Stopford C, Julien C, Thompson J, Payton A, Pickering-Brown SM, Pendleton N, Horan MA, Burns A, Purandare N, Lendon CL, Neary D, Snowden JS, Mann DM: Apolipoprotein E epsilon4 allele frequency and age at onset of Alzheimer's disease. Dement Geriatr Cogn Disord. 2007, 23 (1): 60-66. 10.1159/000097038.CrossRefPubMed
30.
go back to reference Sager MA, Hermann B, La Rue A: Middle-aged children of persons with Alzheimer's disease: APOE genotypes and cognitive function in the Wisconsin Registry for Alzheimer's Prevention. J Geriatr Psychiatry Neurol. 2005, 18 (4): 245-249. 10.1177/0891988705281882.CrossRefPubMed Sager MA, Hermann B, La Rue A: Middle-aged children of persons with Alzheimer's disease: APOE genotypes and cognitive function in the Wisconsin Registry for Alzheimer's Prevention. J Geriatr Psychiatry Neurol. 2005, 18 (4): 245-249. 10.1177/0891988705281882.CrossRefPubMed
31.
go back to reference Olarte L, Schupf N, Lee JH, Tang MX, Santana V, Williamson J, Maramreddy P, Tycko B, Mayeux R: Apolipoprotein E epsilon4 and age at onset of sporadic and familial Alzheimer disease in Caribbean Hispanics. Arch Neurol. 2006, 63 (11): 1586-1590. 10.1001/archneur.63.11.1586.CrossRefPubMed Olarte L, Schupf N, Lee JH, Tang MX, Santana V, Williamson J, Maramreddy P, Tycko B, Mayeux R: Apolipoprotein E epsilon4 and age at onset of sporadic and familial Alzheimer disease in Caribbean Hispanics. Arch Neurol. 2006, 63 (11): 1586-1590. 10.1001/archneur.63.11.1586.CrossRefPubMed
32.
go back to reference Lehtovirta M, Helisalmi S, Mannermaa A, Soininen H, Koivisto K, Ryynänen M, Riekkinen P: Apolipoprotein E polymorphism and Alzheimer's disease in eastern Finland. Neurosci Lett. 1995, 185 (1): 13-15. 10.1016/0304-3940(94)11213-3.CrossRefPubMed Lehtovirta M, Helisalmi S, Mannermaa A, Soininen H, Koivisto K, Ryynänen M, Riekkinen P: Apolipoprotein E polymorphism and Alzheimer's disease in eastern Finland. Neurosci Lett. 1995, 185 (1): 13-15. 10.1016/0304-3940(94)11213-3.CrossRefPubMed
33.
go back to reference Myers RH, Schaefer EJ, Wilson PW, D'Agostino R, Ordovas JM, Espino A, Au R, White RF, Knoefel JE, Cobb JL, McNulty KA, Beiser A, Wolf PA: Apolipoprotein E epsilon4 association with dementia in a population-based study: The Framingham study. Neurology. 1996, 46 (3): 673-677.CrossRefPubMed Myers RH, Schaefer EJ, Wilson PW, D'Agostino R, Ordovas JM, Espino A, Au R, White RF, Knoefel JE, Cobb JL, McNulty KA, Beiser A, Wolf PA: Apolipoprotein E epsilon4 association with dementia in a population-based study: The Framingham study. Neurology. 1996, 46 (3): 673-677.CrossRefPubMed
34.
go back to reference Raber J, Huang Y, Ashford JW: ApoE genotype accounts for the vast majority of AD risk and AD pathology. Neurobiol Aging. 2004, 25 (5): 641-650. 10.1016/j.neurobiolaging.2003.12.023.CrossRefPubMed Raber J, Huang Y, Ashford JW: ApoE genotype accounts for the vast majority of AD risk and AD pathology. Neurobiol Aging. 2004, 25 (5): 641-650. 10.1016/j.neurobiolaging.2003.12.023.CrossRefPubMed
35.
go back to reference Hyman BT, Hedley-Whyte ET, Rebeck GW, Vonsattel JP, West HL, Growdon JH: Apolipoprotein E epsilon4/4 in a neuropathologically normal very elderly individual. Arch Neurol. 1996, 53 (3): 215-CrossRefPubMed Hyman BT, Hedley-Whyte ET, Rebeck GW, Vonsattel JP, West HL, Growdon JH: Apolipoprotein E epsilon4/4 in a neuropathologically normal very elderly individual. Arch Neurol. 1996, 53 (3): 215-CrossRefPubMed
36.
go back to reference Launer LJ, Andersen K, Dewey ME, Letenneur L, Ott A, Amaducci LA, Brayne C, Copeland JR, Dartigues JF, Kragh-Sorensen P, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A: Rates and risk factors for dementia and Alzheimer's disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology. 1999, 52 (1): 78-84.CrossRefPubMed Launer LJ, Andersen K, Dewey ME, Letenneur L, Ott A, Amaducci LA, Brayne C, Copeland JR, Dartigues JF, Kragh-Sorensen P, Lobo A, Martinez-Lage JM, Stijnen T, Hofman A: Rates and risk factors for dementia and Alzheimer's disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology. 1999, 52 (1): 78-84.CrossRefPubMed
37.
go back to reference Ott A, Breteler MM, van Harskamp F, Claus JJ, van der Cammen TJ, Grobbee DE, Hofman A: Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. Bmj. 1995, 310 (6985): 970-973.CrossRefPubMedPubMedCentral Ott A, Breteler MM, van Harskamp F, Claus JJ, van der Cammen TJ, Grobbee DE, Hofman A: Prevalence of Alzheimer's disease and vascular dementia: association with education. The Rotterdam study. Bmj. 1995, 310 (6985): 970-973.CrossRefPubMedPubMedCentral
Metadata
Title
APOE ε4 lowers age at onset and is a high risk factor for Alzheimer's disease; A case control study from central Norway
Authors
Sigrid B Sando
Stacey Melquist
Ashley Cannon
Michael L Hutton
Olav Sletvold
Ingvild Saltvedt
Linda R White
Stian Lydersen
Jan O Aasly
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2008
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-8-9

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