Albert S M, Gurland B, Maestre G, Jacobs D M, Stern Y, Mayeux R
Department of Neurology, Columbia University, New York, New York 10032, USA.
Am J Med Genet. 1995 Dec 18;60(6):583-7. doi: 10.1002/ajmg.1320600621.
The presence of apolipoprotein-epsilon 4 (APOE-epsilon 4) significantly increases the risk of Alzheimer's disease (AD). The association between APOE-epsilon 4 status and functional abilities was explored further in a multicultural sample of community-dwelling, non-demented elders. The sample was limited to cognitively-intact, community-dwelling elders, who were free of stroke or other neurologic disability. In 218 elders who met research criteria, the presence of APO-epsilon 4 was associated with poorer functional status, apart from the effects of neuropsychological performance, gender, age, and education (OR = 2.5, 95% CI: 1.3, 4.9). In 158 subjects without an APOE-epsilon 4 allele, 50% reported no functional limitation; in the 60 subjects with an epsilon 4 allele, only 28% reported no functional limitation (P < .01). The relationship was not explained by the distribution of co-morbidities. The association between poorer function and the presence of an APOE-epsilon 4 allele was evident in each ethnic group. In path analyses, the presence of an APOE-epsilon 4 allele was associated with decreased functional ability in non-demented elders not simply through an association with poorer cognitive status, but also independently. These results suggest that the APOE-epsilon 4 genotype is associated with functional deficit in people with normal neuropsychological profiles.
载脂蛋白ε4（APOE-ε4）的存在显著增加了患阿尔茨海默病（AD）的风险。在一个居住在社区、未患痴呆症的多文化老年人样本中，对APOE-ε4状态与功能能力之间的关联进行了进一步探究。样本仅限于认知功能完好、居住在社区且无中风或其他神经功能障碍的老年人。在218名符合研究标准的老年人中，除了神经心理表现、性别、年龄和教育程度的影响外，APO-ε4的存在与较差的功能状态相关（OR = 2.5，95%CI：1.3，4.9）。在158名没有APOE-ε4等位基因的受试者中，50%报告无功能限制；在60名有ε4等位基因的受试者中，只有28%报告无功能限制（P <.01）。这种关系无法用共病的分布来解释。在每个种族群体中，功能较差与APOE-ε4等位基因的存在之间的关联都很明显。在路径分析中，APOE-ε4等位基因的存在与未患痴呆症的老年人功能能力下降相关，这不仅是通过与较差的认知状态相关，而且是独立相关。这些结果表明，APOE-ε4基因型与神经心理状况正常的人的功能缺陷有关。
