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ARTICLE |

Apolipoprotein E E4 Allele and Risk of Dementia FREE

Tuula Pirttila, MD; Terho Lehtimaki, MD; Tapio Nikkari, MD; Harry Frey, MD; Kari Mattila, PhD
JAMA. 1995;273(5):375-375. doi:10.1001/jama.1995.03520290026016
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To the Editor.  —The association between apo E E4 and AD has been shown in patients with probable AD and in autopsyconfirmed AD cases. However, the specificity of apo E E4 as a risk factor for AD is not known. In a recent letter, Dr Frisoni and colleagues1 proposed that the frequency of apo E E4 is increased also in vascular dementia compared with that in controls.We analyzed apo E phenotypes in 30 patients with vascular dementia and 115 age-matched controls using isoelectric focusing and Western blotting as previously described.2 Vascular dementia was diagnosed according to the guidelines established by the NINDS-AIREN International Workshop.3 Seventeen patients with probable vascular dementia had a typical multi-infarct dementia. Possible vascular dementia was diagnosed in 13 patients, eight of whom were considered to have mixed dementia (ie, possible AD and concomitant significant cerebrovascular disease).No difference in apo E E4

REFERENCES

Frisoni GB, Bianchetti A, Govoni S, Trabucchi M, Calabresi L, Franceschini G.  Association of apolipoprotein E E4 with vascular dementia. JAMA . 1994;;271:1317.
Lehtimaki T, Pirttila T, Mehta PD, Wisniewski HM, Frey H, Nikkari T.  Apolipoprotein E (apo E) polymorphism and its influence on apo E concentrations in the cerebrospinal fluid in Finnish patients with Alzheimer's disease. Hum Genet . In press.
Roman GC, Tatemichi TK, Erkinjuntti T, et al.  Vascular dementia: diagnostic criteria for research studies: report of the NINDS-AIREN International Workshop. Neurology . 1993;;43:250-260.
Lopez OL, Larumbe MR, Becker JT, Rezek D, Rosen J, Klunk W, DeKosky ST.  Reliability of NINDS-AIREN clinical criteria for the diagnosis of vascular dementia. Neurology . 1994;;44:1240-1245.
Jellinger K, Danielczyk W, Fischer P, Gabriel E.  Clinicopathological analysis of dementia disorders in the elderly. J Neurol Sci . 1990;;95:239-258.

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Frisoni GB, Bianchetti A, Govoni S, Trabucchi M, Calabresi L, Franceschini G.  Association of apolipoprotein E E4 with vascular dementia. JAMA . 1994;;271:1317.
Lehtimaki T, Pirttila T, Mehta PD, Wisniewski HM, Frey H, Nikkari T.  Apolipoprotein E (apo E) polymorphism and its influence on apo E concentrations in the cerebrospinal fluid in Finnish patients with Alzheimer's disease. Hum Genet . In press.
Roman GC, Tatemichi TK, Erkinjuntti T, et al.  Vascular dementia: diagnostic criteria for research studies: report of the NINDS-AIREN International Workshop. Neurology . 1993;;43:250-260.
Lopez OL, Larumbe MR, Becker JT, Rezek D, Rosen J, Klunk W, DeKosky ST.  Reliability of NINDS-AIREN clinical criteria for the diagnosis of vascular dementia. Neurology . 1994;;44:1240-1245.
Jellinger K, Danielczyk W, Fischer P, Gabriel E.  Clinicopathological analysis of dementia disorders in the elderly. J Neurol Sci . 1990;;95:239-258.
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