Kim Jaeho, Park Seongbeom, Yoo Heejin, Jang Hyemin, Kim Yeshin, Kim Ko Woon, Jang Young Kyoung, Lee Jin San, Kim Sung Tae, Kim Seonwoo, Lee Jong Min, Ki Chang-Seok, Na Duk L, Seo Sang Won, Kim Hee Jin
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Neuroscience Center, Samsung Medical Center, Seoul, Korea.
J Alzheimers Dis. 2018;61(4):1377-1385. doi: 10.3233/JAD-170556.
We evaluated how the impact of apolipoprotein E4 (APOE4) differs according to age in Alzheimer's disease (AD) patients. We recruited 846 AD patients and 815 cognitively normal controls and categorized into three groups with respect to their age (<65, 65-74, and ≥75 years). We evaluated the risk of AD in APOE4 carriers and compared cortical thickness and cognitive function according to APOE4 status in each age group. At the point of this study, in young (<65 years) AD, APOE4 noncarriers had the most severe frontal and perisylvian atrophy, while in old (≥75 years) AD, APOE4 carriers had the most severe medial temporal atrophy. In AD under 75 years, APOE4 noncarriers and heterozygotes showed worse performance in language, visuospatial, and frontal function compared to homozygotes, while, in old (≥75 years) AD, APOE4 homozygotes showed worse performance in memory compared to noncarriers. As the detrimental effects of APOE4 seen in older AD patients were not found in younger AD patients, we suggest that some unrevealed factors are associated with cortical atrophy and non-amnestic cognitive dysfunction in young AD with APOE4 noncarriers.
我们评估了载脂蛋白E4（APOE4）在阿尔茨海默病（AD）患者中的影响如何随年龄而不同。我们招募了846名AD患者和815名认知正常的对照者，并根据年龄（<65岁、65 - 74岁和≥75岁）将他们分为三组。我们评估了APOE4携带者患AD的风险，并比较了各年龄组中根据APOE4状态的皮质厚度和认知功能。在本研究中，在年轻（<65岁）的AD患者中，APOE4非携带者额叶和颞周萎缩最为严重，而在老年（≥75岁）的AD患者中，APOE4携带者内侧颞叶萎缩最为严重。在75岁以下的AD患者中，与纯合子相比，APOE4非携带者和杂合子在语言、视觉空间和额叶功能方面表现较差，而在老年（≥75岁）的AD患者中，与非携带者相比，APOE4纯合子在记忆方面表现较差。由于在年轻的AD患者中未发现老年AD患者中出现的APOE4的有害影响，我们认为一些未揭示的因素与APOE4非携带者的年轻AD患者的皮质萎缩和非遗忘性认知功能障碍有关。
