Sobel E, Louhija J, Sulkava R, Davanipour Z, Kontula K, Miettinen H, Tikkanen M, Kainulainen K, Tilvis R
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
Neurology. 1995 May;45(5):903-7. doi: 10.1212/wnl.45.5.903.
No association between Alzheimer's disease (AD) and apolipoprotein E type epsilon 4 (ApoE epsilon 4) phenotype was found among centenarians in Finland (N = 179). The data are based on ascertainment of all centenarians in Finland in 1991. All examinations were conducted during 1991. The diagnoses of dementia and AD were based on clinical grounds, conforming to DSM-III-R and NINCDS-ADRDA criteria. The percentage of ApoE epsilon 4 alleles among the centenarians was 8.7% (31 of 358 alleles). This is significantly lower than percentages found in younger Finnish populations. Thirty (16.8%) of the 179 centenarians were epsilon 4 allele carriers. One hundred fifty-one (84.4%) of the centenarians were women. Twenty-eight (18.5%) of the women had at least one epsilon 4 allele, as did two (7.1%) of the men. The prevalence of clinically diagnosed AD was 26.8%; 44% of the subjects were cognitively normal, 23% had signs of cognitive decline or at most mild dementia (with no differential diagnosis), and 6% had a dementia clinically diagnosed as being due to some cause other than AD. For AD cases versus cognitively normal subjects, the odds ratio associated with being a carrier of the epsilon 4 allele was 1.34 (p = 0.64; 95% CI = [0.5, 3.3]). Among women, the odds ratio was 0.99 (p = 1.0; 95% CI = [0.4, 2.6]). There were fewer, but not significantly so, epsilon 4 carriers among subjects with cognitive decline or at most mild dementia (12.2%) than there were among the cognitively normal subjects (16.5%). The AD patients had no evidence of difficulty standing on a flat stationary surface unless the surface suddenly moved.(ABSTRACT TRUNCATED AT 250 WORDS)
在芬兰的百岁老人（N = 179）中，未发现阿尔茨海默病（AD）与载脂蛋白E ε4（ApoE ε4）表型之间存在关联。数据基于对1991年芬兰所有百岁老人的确定。所有检查均在1991年进行。痴呆症和AD的诊断基于临床依据，符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）和美国国立神经疾病与中风研究所-阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）标准。百岁老人中ApoE ε4等位基因的比例为8.7%（358个等位基因中的31个）。这显著低于在芬兰年轻人群中发现的比例。179名百岁老人中有30名（16.8%）是ε4等位基因携带者。151名（84.4%）百岁老人为女性。28名（18.5%）女性至少有一个ε4等位基因，男性中有2名（7.1%）也是如此。临床诊断为AD的患病率为26.8%；44%的受试者认知正常，23%有认知能力下降迹象或至多为轻度痴呆（无鉴别诊断），6%的痴呆症临床诊断为由AD以外的某种原因引起。对于AD患者与认知正常的受试者，与作为ε4等位基因携带者相关的优势比为1.34（p = 0.64；95%置信区间 = [0.5, 3.3]）。在女性中，优势比为0.99（p = 1.0；95%置信区间 = [0.4, 2.6]）。在有认知能力下降或至多为轻度痴呆的受试者中，ε4携带者较少（12.2%），但与认知正常的受试者（16.5%）相比，差异不显著。AD患者没有证据表明在平坦静止表面站立有困难，除非表面突然移动。（摘要截取自250字）
