Alz Res Therapy: Alzheimer's and Lewy body dementia, APOE ε4 has different effects on cognitive performance

As we all know, in its typical clinical manifestations, Alzheimer's disease (AD) is manifested as episodic memory impairment in its early stage.
With the development of the disease, other cognitive domains including visual space, language and executive functions also gradually appear obstacles
.
The basic pathological changes noted are the increasing burden of neuronal amyloid beta plaques and neurofibrillary tangles

These findings raise further questions in AD: First, whether APOE ε4 alleles have different effects on other non-aphasia clinical symptoms (execution, visual space) of AD; second, APOE ε4 carriers and Alzheimer’s disease The underlying neuropathology is different, whether it also has a similar susceptibility to aphasia symptoms
.

Lewy body dementia (DLB) is one of the most common forms of dementia.
It is characterized by Lewy-related pathology (LRP), including alpha-synapsin immunopositive neuronal content (Lewy body) and process (Lewy body).
Nerve fibers)

Therefore, Jagan A.
Pillai and others of the Cleveland Clinic conducted the current study in the National Alzheimer's Coordination Center (NACC) data set, which includes a highly determined cohort of multiple locations in the United States, most of which Participants have neuropathological information to explore

They conducted a retrospective cohort study of 2288 neuropathologically confirmed ADP or LRP participants in the National Alzheimer’s Coordination Center database.
They had a record of initial cognitive symptoms and a clinical dementia rating-global (CDR-G ) Score ≤1 (normal cognition, MCI or early dementia)
.
The unadjusted and adjusted logistic regression model that took into account the age, gender, and education level at the time of evaluation examined the difference between the APOE ε4 genotype and the initial symptoms (memory, execution, language and visual space) of the ADP group with LRP and the ADP-LRP group.

A total of 133 participants met the separate ADP standards, 90 met the separate LRP standards, and 895 met the standards for the coexistence of ADP and LRP (ADP-LRP)
.
In all three groups, younger people are more likely to have non-family symptoms

The probability of these two symptoms did not differ between the ADP and ADP-LRP mixed groups
.
In the adjusted model, female gender and higher education increased the chance of initial language symptoms in the ADP group

In LRP, APOE ε4 had no significant effect on the probability of amnesia; however, the interaction that assessed the difference in the probability of amnesia between the ADP and LRP groups did not reach statistical significance
.

The significance of this study is that it has found that compared with non-carriers, the probability of specific initial cognitive symptoms of APOE ε4 carriers is different between ADP and LRP
.
Carriers of ADP APOE ε4 are more likely to have initial symptoms of amnesia, and carriers of LRP APOE ε4 are more likely to have initial symptoms of visual space
.
This supports the hypothesis that APOE ε4 and underlying neuropathology have different effects on initial cognitive symptoms
.

Original source:
Pillai JA, Bena J, Bonner-Jackson A, Leverenz JB.
Impact of APOE ε4 genotype on initial cognitive symptoms differs for Alzheimer's and Lewy body neuropathology.
Alz Res Therapy.
2021;13(1):31.
doi:10.
1186 /s13195-021-00771-1