Neurology

Association between APOE {varepsilon}2 and A{beta} burden in patients with Alzheimer- and vascular-type cognitive impairment





Objective

To investigate the association between APOE genotype and β-amyloid (Aβ) burden, as measured by PET in patients with subcortical vascular cognitive impairment (SVCI) and those with Alzheimer disease–related cognitive impairment (ADCI).

Methods

This was a cross-sectional study of 310 patients with SVCI and 999 with ADCI. To evaluate the effects of APOE genotype or diagnostic group on Aβ positivity, we performed multivariate logistic regression analyses. Further distinctive underlying features of latent subgroups were examined by employing a latent class cluster analysis approach.

Results

In comparison with 3 homozygotes, in the ADCI group, 2 carriers showed a lower frequency of Aβ positivity (odds ratio [OR] 0.43, 95% confidence interval [CI] 0.23–0.79), while in the SVCI group, 2 carriers showed a higher frequency of Aβ positivity (OR 2.26, 95% CI 1.02–5.01). In particular, we observed an interaction effect of 2 carrier status and diagnostic group on Aβ positivity (OR 5.12, 95% CI 1.93–13.56), in that relative to 3 homozygotes, there were more Aβ-positive 2 carriers in the SVCI group than in the ADCI group. We also identified latent subgroups of Aβ-positive APOE 2 carriers with SVCI and Aβ-positive APOE 4 carriers with ADCI.

Conclusions

Our findings suggest that APOE 2 is distinctly associated with Aβ deposition in patients with SVCI and those with ADCI. Our findings further suggest that there is a distinctive subgroup of Aβ-positive APOE 2 carriers with SVCI among patients with cognitive impairment.

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